HESI RN
HESI Community Health
1. The school nurse who is reviewing immunization records of students who will start kindergarten within the next month notes that most of the students have only received one dose of the measles, mumps, rubella (MMR) vaccine. Which intervention should the nurse implement?
- A. Note in the student records that the second dose of the MMR vaccine should be administered prior to entering first grade
- B. Send notices home with the children on the first day of class advising that MMR vaccine series must be completed
- C. Contact kindergarten parents to remind them that the second dose of MMR is due at the start of the school year
- D. Speak at the next parent-teacher association meeting to teach parents the benefits of immunizing their children
Correct answer: C
Rationale: The correct intervention for the school nurse is to contact kindergarten parents to remind them that the second dose of the MMR vaccine is due at the start of the school year. This approach directly addresses the issue of incomplete vaccination coverage and ensures that children receive the complete vaccination on time. Choice A is incorrect as it only notes the need for the second dose without actively engaging parents. Choice B is not as effective as directly contacting parents and may lead to delays in completing the vaccination series. Choice D, while promoting immunization, does not directly address the current situation of incomplete MMR vaccination among the kindergarten students.
2. The healthcare professional is preparing to administer a blood transfusion to a client with anemia. Which action is most important to prevent a transfusion reaction?
- A. Check the client's vital signs before starting the transfusion.
- B. Use a blood filter when administering the transfusion.
- C. Verify the blood type and Rh factor with another healthcare professional.
- D. Administer antihistamines before starting the transfusion.
Correct answer: C
Rationale: Verifying the blood type and Rh factor with another healthcare professional is the most crucial action to prevent a transfusion reaction. Ensuring compatibility between the donor blood and the recipient is essential in preventing adverse reactions such as hemolytic transfusion reactions. Checking vital signs is important for monitoring the client during the transfusion process but does not directly prevent a transfusion reaction. Using a blood filter can help remove clots and debris but does not address the risk of a reaction due to blood type incompatibility. Administering antihistamines before the transfusion is not a standard practice to prevent transfusion reactions related to blood type incompatibility.
3. The school nurse is coaching a group of high school students on ways to deal with the stress of final exams. Today the class is focusing on healthy food choices for lunch in the school cafeteria. Which option should the nurse recommend?
- A. cheeseburger on a whole wheat bun, French fries, and a large cola beverage
- B. tuna casserole with peas and corn, a fresh apple, crackers, and orange juice
- C. fruit salad with fresh berries and oranges, chicken vegetable soup, and tea
- D. chef salad with turkey, ham, and ranch dressing, apple juice, and milk
Correct answer: C
Rationale: The recommended option for managing stress during final exams is a balanced and nutritious meal. Fruit salad with fresh berries and oranges, chicken vegetable soup, and tea offer a variety of nutrients and antioxidants that can help combat stress. Option A is not ideal as it includes high-fat and high-calorie foods. Option B is a good choice, but Option C provides a wider range of nutrients and hydration. Option D is a healthy choice with a variety of proteins and vitamins, but Option C offers lighter options that may be easier to digest during stressful times.
4. A client with a history of heart failure is admitted with severe dyspnea. Which laboratory result requires immediate intervention?
- A. Blood glucose of 150 mg/dL.
- B. Serum potassium of 3.5 mEq/L.
- C. Serum creatinine of 1.0 mg/dL.
- D. Blood urea nitrogen (BUN) of 20 mg/dL.
Correct answer: C
Rationale: The correct answer is C. A serum creatinine level of 1.0 mg/dL is within the normal range. However, in a client with heart failure and severe dyspnea, fluid retention is a significant concern. An elevated serum creatinine level may indicate impaired kidney function, which can worsen fluid overload. Therefore, immediate intervention is required to prevent further complications. Choices A, B, and D are within normal ranges and not indicative of immediate intervention in this scenario.
5. A school nurse is providing education on the importance of physical activity to elementary school students. Which activity is most appropriate for this age group?
- A. a lecture on the benefits of exercise
- B. an interactive game that involves physical movement
- C. a worksheet about different types of physical activities
- D. a video presentation on famous athletes
Correct answer: B
Rationale: An interactive game that involves physical movement is the most appropriate activity for elementary school students when educating them on the importance of physical activity. This choice is preferred because it engages children directly in physical activity, making the learning experience fun, interactive, and memorable. Children at this age group learn best through hands-on experiences and active participation, which can be effectively facilitated through interactive games. Choices A, C, and D are less suitable for this age group as they do not actively involve children in physical movement or interactive learning experiences. A lecture may not be engaging enough for young children, a worksheet may not provide the required level of activity, and a video presentation may not offer the same level of direct engagement and participation as an interactive game.
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