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HESI Community questions docx-2 477817097000068
Graduate Capstone (MED799)
Aspen University
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Community
RN HESI Study
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- During a two-week postoperative follow-up home visit, a female client who had gastric bypass surgery exhibits abdominal tenderness, shoulder pain, and describes feelings of malaise. Her vital signs are: temperature 101°F, blood pressure 100/50, heart rate 104 beats/minute, and respirations 18 breaths/minute. Which action should the nurse take? a. Determine the client9s current oxygen saturation rate. b. Instruct the client to drive to the hospital for admission c. Recheck the client9s vital signs in 30 minutes **d. Have the client transported via ambulance to the hospital **
- An older man has become increasingly forgetful, frequently eats large quantities of food from refrigerator, and cannot remember when he takes his medications. He has limited mobility to weight-related osteoarthritis in both knees. When assisting the client9s wife with a plan care for the home, which interventions should the nurse suggest? (Select all that apply.) a. Request a referral for motorized wheelchair to assist with mobility. **b. Keep a variety of fresh fruits and vegetables that are easily accessible. ** **c. Put medications into a container that organized the pills by the day and time. ** **d. Encourage participation in televised exercise classes to help strengthen ** **muscles. ** e. Post a sign on refrigerator reminding the client not to eat between meals.
- The school nurse is assessing heights, weights, and body mass indexed (BMI) of the students who are entering high school. Because a majority of the students are found to be overweight, the nurse plans to develop a program that addresses obesity in this age population. Before initiating this program, what additional information is most important for the nurse to obtain? **a. The history of obesity education in the community ** b. The level of parental concern regarding childhood obesity c. The demographic data for the student population d. An activity report from the physical education department
- The epidemiological triad can be used to frame strategies for the prevention of farm machinery injuries. Which action should the nurse take to focus on the agent? a. Teach farm workers not to smoke around farm equipment b. Work with legislators to mandate safe tractor design c. Translate written vehicle instructions into picture format d. Provide rehabilitation services to injured farm hands
- The public health nurse is creating a plan to increase state funding for a local health clinic. Which strategy is likely to be most effective in obtaining funding for the clinic? a. Run the health clinic economically and advertise the services the clinic provides b. Organize concerned citizens to write letters and telephone state representatives
important for the nurse to obtain which information as a part of a community assessment? **a. Availability of fresh water for washing hands after work ** b. Air pollution levels in the surrounding community c. Number of hours of worker9s exposure to direct sunlight d. Percentage of poisonous plants in the work fields 12. A teenage boy with a history of recurring atopic dermatitis (eczema) tells the school nurse that he wants to play high school football. Which action should the nurse take? a. Encourage the teenager to join the swim team instead of the football team b. Notify the parents of problems associated with perspiration for those with eczema **c. Tell the teenager to shower with a non-perfumed soaps immediately after practice ** d. Inform the football coach of the teenager9s skin condition and its manifestations. 13. The wife of an older adult man who has had diabetes mellitus for the past 10 years reports to the home health nurse that her husband fell yesterday while taking his daily walk in the neighborhood. He has a bruised hand and a small abrasion on his left knee. The nurse assess that his neurologic vital signs are stable. To reduce risk for future falls, which assessment is most important for the nurse to obtain? a. Current blood sugar level **b. Degree of paresthesia in feet ** c. Wound healing of knee abrasion d. A1c glycosylated hemoglobin 14. The home health nurse visits a young male client with AIDS who has Kaposi9s sarcoma and peripheral neuropathies. His parents, who are the care-takers, tell the nurse that their son sleeps most of the times. The nurse assess that the client is semi-conscious with stable vital signs, cries out in pain when turned or moved, has a Duragesic pain patch in place, and skin lesions that are closed and dried. Which intervention should the nurse implement? a. Remove the Duragesic patch as directed by prescription b. Give a complete bed bath to further assess the client **c. Discuss end-of-life decisions with the client9s parents ** d. Call for ambulance transportation to the hospital immediately 15. An assessment conducted last year of the health needs of children who attended a middle school indicated that bicycle injuries were a priority problem, so the nurse developed a bicycle safety program. Six weeks after completion of the program, a survey was sent to parents and students. Which finding is the best indicator that the program was effective? **a. The number of students wearing bicycle helmets increased by 10% ** b. 50% of the parents reported that their children are aware of bicycle safety c. The number of students riding bicycles to school increased by 25% d. 80% of the parents identified the need for an annual bicycle safety program 16. The nurse is planning a series of health screening programs for elderly African- Americans. Which health problem should the nurse target for this population?
a. Peripheral vascular disease b. Sickle cell anemia c. Decreased visual acuity **d. High blood pressure ** 17. The nurse is serving on a medical center committee to update goals and protocols based on current national standards. Which goal most directly addresses the Healthy People 2020 initiative? a. Decrease incidence of professional boundary violations **b. Reduce emergency room wait times for indigent clients ** c. Encourage the use of the 5 rights of delegation d. Standardize communication for shift-to-shift report 18. A homeless client with alcohol dependency will be dismissed from the emergency department in 24 hours. The nurse notes that a tuberculin skin test was prescribed by the healthcare provider. What intervention is most important for the nurse to implement prior to discharge? **a. Identify how the client will follow-up to have the results read. ** b. Give the client written information about the tuberculosis test c. Determine if the client understands the purpose of the tuberculin test d. Explain to the client results should be read between 48 and 72 hours 19. A Hispanic mother insists on using special candles to treat her child9s ear infection. The nurse should demonstrate cultural accommodation by making which request? a. Use the prescribed antibiotics and if there is no improvement, use the candles **b. Give the prescribed antibiotics in addition to using the candles. ** c. Do not use the candles because of the risk of fire and subsequent burns to the child. d. Provide the prescribed antibiotics instead of using the candles 20. The nurse is making a home visit to female client with end stage heart disease. She has a living will and states that she refuse to ever go back to a hospital. During the visit, the nurse notes that the client is pale and short of breath while speaking. The nurse discovers 3+ pitting edema in both ankles and bilateral pulmonary crackles. Which intervention should the nurse implement first? a. Explain the need for hospitalization **b. Obtain a peripheral oxygen saturation level ** c. Elevate her feet above the level of her heart d. Apply 2L of oxygen per nasal cannula 21. The nurse must delegate some aspects of a homebound client9s care to a home health aide. Which intervention should the nurse delegate to the home health aide? a. Evaluate a pressure sore **b. Apply a prosthetic device ** c. Perform a sterile dressing change d. Assess the client9s need for an elevated toilet seat 22. After assessing the health care needs of an elementary school, the nurse determines that an increased prevalence of pediculosis capitis is a priority problem. The nurse develops a 2-month program with the goal to eradicate the condition in the school. The
(Arrange the client with the highest priority first, on top, and lowest priority last, on bottom.) a. A 7-year-old who has type 1 diabetes mellitus and is experiencing extreme hunger and shakiness b. A 12-year-old with history of asthma who is wheezing and complaining of shortness of breath. c. A 5-year-old who is crying uncontrollably because of an incontinent bowel episode. d. A 10-year-old with bleeding lacerations on both knees after falling in gym class. **B, A, D, C 3 12, 7, 10, 5 ** 28. The parish nurse notes that an elderly male client has had a 5 pound weight loss since his check-up one month ago. The client has good hygiene, still drives a car, and lives alone. To which agency should the nurse refer this client? a. The Adult Day Care Center **b. The Senior Citizen Center ** c. The Women, Infant, and Children office d. The Social Security Administration office 29. While presenting a workshop titled, <Improving Access to Health Services= to community leaders, the community health nurse is asked by a city council member to explain the reason for addressing this issue. Which statement provides the best response? **a. The committee for <Healthy People 2020= has identified <access= as a national goal ** b. The Institute of Medicine includes <access= as one of its priority recommendations. c. The Community Health Improvement Process is used for issues in high risk populations. d. The Center for Disease Control has identified this problem as a variable in morbidity 30. The school nurse is assessing a group of middle school students for signs of scoliosis and discovers a female student with a noticeable unequal symmetry of the upper and lower back. Which intervention is most important for the nurse to implement? **a. Make a referral to have the scoliosis further evaluated ** b. Ask the student about her ability to participate in sports c. Measure the degree of the thoracic and lumbar curvature d. Review student9s health record for a recent growth spurt 31. A newly hired school nurse conducts a <windshield= survey of the geographic area served by the school. Which method is best for the nurse to use to objectively validate the findings obtained? a. Obtain mortality data for the geographic area b. Talk with teachers about their concerns for the students c. Discuss with the PTA board their perception of school events **d. Review the previous school nurse9s anecdotal documents. **
- The local health department needs to prioritize the distribution of influenza vaccinations due to a limited supply. In determining which individuals should receive the limited available vaccine, which person should the public health nurse ask to return to the clinic later when more vaccine is available? **a. A 60-year-old with diabetes and agoraphobia ** b. An 80-year-old resident in an Alzheimer9s unit c. A 65-year-old aide working in a nursing home. d. An 8-year-old girl with poorly-controlled asthma
- A nurse designs a series of four weekly classes for client with Type 2 diabetes. Which information should the nurse use as an outcome evaluation for the classes? a. Parking convenience for attendees continued to be a major concern b. Demonstrating by the use of a blood glucose meter was an effective teaching strategy **c. Fasting blood glucose average readings were 20% lower at the end of the ** **classes ** d. Discussion of food exchanges and calories was a well attended class
- On a repeat home visit to see an 84-year-old widow, the nurse discovers that the client is unkempt, smells of stale urine, and does not recognize her neighbors or the nurse. What action should the nurse take first? **a. Complete a physical and mental exam of the client ** b. Call Adult Protective Services to obtain emergency nursing home placement. c. Seek the family9s assistance in caring for the client d. Call the client9s pharmacy to determine what medications she is taking
- The community health nurse believes that immunization rates in a lower-socioeconomic section of the city are probably below the target set by the state health department. What action should the nurse take first to intervene with this health problem? a. Join a political action group that focuses attention on the issue in the local news media b. Partner with a local children9s hospital in setting up free <shot= clinics in the neighborhood **c. Review current epidemiological population data that might document a low ** **immunization rate ** d. Call a meeting of citizens to inform them of the important of having their children immunized
- An older adult male with a history of type 2 diabetes mellitus (DM2) is seen in the community health clinic for an annual physical examination. Which nursing action should be included in assessing for long-term complications of diabetes? (Select all that apply.) a. Obtain venous sample for liver enzymes b. Obtain urine specimen to assess for albumin **c. Test lower extremities for changes in sensation ** d. Auscultate for adventitious breath sounds **e. Palpate pedal pulses and foot temperatures **
c. Cataracts **d. Diabetes mellitus ** 43. One hundred families in a community refuse to have their children immunized because of religious beliefs. When one documented case of whooping cough occurs within this aggregate, which intervention should the nurse implement? a. Quarantine the one hundred family aggregate b. Immunize all members of the one hundred families **c. Quarantine all family members of the child with whooping cough ** d. Immunize all children under age 5 in the one hundred family aggregate 44. A 93-year-old client with a number of co-morbidities is assessed by the home health nurse. What problem is most important for the nurse to investigate further? a. Social isolation **b. Medication interactions ** c. Urinary incontinences d. Caregiver stress 45. Which interventions should the nurse implement to help prevent a client from getting a vector-born infectious disease? a. Encourage the client to get immunizations prior to international travel. **b. Discuss the importance of wearing insect repellent when camping ** c. Instruct the client to drink only bottled water when traveling abroad d. Demonstrate the correct way to remove ticks imbedded in the skin 46. A home health nurse is reviewing the laboratory results for several clients with a history of heart failure (HF). Which client finding should the nurse report to the healthcare provider immediately? a. Total cholesterol 190 mg/dl. **b. B-type natriuretic peptide 550 pg/ml. ** c. Glycosylated Hemoglobin of 7% d. Potassium 3 mEq/L 47. The community health nurse who works in a town that has a large chemical plant is concerned about the occurrence of a natural disaster related to chemical exposure. Which action is most important for the nurse to take? a. Evaluate company safety procedures for prevention of chemical exposures **b. Elicit the company9s participation in a disaster preparedness program. ** c. Determine the antidotes for the chemicals produced by the company d. Inform employees of their potential risk for a chemical exposure incident. 48. A community group proposes building a new well-child clinic because this year9s demographics reflect that a large percentage of the population is less than 19 years of age. Which question indicates that the nurse understands the potential gaps in these data? a. What is the distribution of males to females within this population? **b. What percentage of the population was under 19 years of age in each of the 5 previous years? ** c. How will the large percentage of under 19-year-olds affect the community9s dependency ration?
d. How can the income level of the families within the community be determined? 49. During a community health screening fair for older adults, the nurse observes that a woman has pale, bluish feet. With sores on both lower extremities that are healing poorly. Which intervention should the nurse implement? a. Create a list of foods that promote wound healing. b. Send client to the emergency room for treatment. c. Refer to healthcare provider for complete evaluation d. Instruct client to apply antibiotic ointment to sores 50. The nurse caring for a 62-year-old African-American male client arranges a time for the client9s wife, 80-year-old mother, three children, and sister to meet with the healthcare provider to discuss the client9s medical condition. Which cultural variation is the nurse including when providing care for this client? a. Social spacing b. Cultural repatterning **c. Social organization ** d. Environmental control 51. The RN care-manager at the public department is making a home visit to a client with four children under the age of 6. The client is a single mother and the family is living below poverty level. Which intervention should the nurse include as a primary level prevention measure? **a. Enroll the client in the Women, Infant, and Children program ** b. Counsel the client on available birth control methods c. Provide the client with a listing for local healthcare providers. d. Provide the client with the local bus schedule.
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A 12-year-old female is seen by the school nurse after recently experiencing increasing difficulty sitting and paying attention in class, and increasingly illegible handwriting. The nurse observes that the child has protruding eyeballs and a staring expression. What action should the nurse take next? Gather additional data by taking a health history and measuring vital signs
When asked to help develop interventions to combat obesity among children, the community health nurse should stress the importance of implementing which activity? Set goals that are focused on developing healthier lifestyles
A terrorist attack has occurred and several people have inhaled Ricin. Which intervention should the emergency department nurse implement when caring for these clients? Provide supportive nursing care until antitoxin is available
A young woman tells the public health nurse that a friend was recently diagnosed with Hepatitis B and she is concerned about getting the disease. During the assessment interview, which question is most important for the nurse to ask this woman? Have you shared any needles or had sex with your friend?"
Which example should the nurse identify as a significant outcome for the Leading Health indicators of Healthy People 2020? A community has adopted a no smoking policy
During an initial clinic visit, the nurse is taking the history for a client who wants to confirm her pregnancy. The client's last child has a history of low-birth-weight (LBW). Which additional finding is most important for the nurse to consider? - African-American ethnicity
The home health nurse is planning a visit with a client who has been discharged home after hospitalization. Which action should the nurse implement? Schedule home visits that take place during the daylight hours
Which topic should the nurse include in planning a primary prevention class for adolescents? Suicide risks and prevention
The nurse is working in a community clinic that serves a population comprised mainly of migrant families. In planning the use of resources for secondary prevention, which activity should be the priority? - Skin testing for tuberculosis
The nurse is assessing a Vietnamese child during a home health visit and identifies round swellings on the child's back. The child's mother says she rubbed the edge of a coin on her child's oiled skin. The nurse should recognize that this behavior is prompted by which cultural belief? - The purpose is to rid the body of disease
Which topic should the nurse include in planning a secondary prevention project for the local retirement community? Vision and hearing screening
The nurse is planning a community-based project to reduce obesity in a school-aged population. Which outcome statement best supports the goal for this population? Within 2 years, students with a body mass index greater than 95% will be reduced by 50%
While discussing the science of nursing, the nurse identifies the domain of nursing theory. Which linkages should the nurse provide to describe nursing's paradigm? The person, the environment or situation, and health
The nurse is developing a plan to provide quality health care for a certain community. Data obtained from which resources should be helpful to the nurse in developing a community healthcare plan for this community? (Select all) -Census data -Risk management data -Budgeting process information -Client-satisfaction surveys -Changes in the community's demographic data
The nurse is teaching a community group about risks of cardiovascular disease. Several clients ask the nurse to determine their risk. Which client should the nurse identify as having the greatest risk for cardiovascular disease? A male with a low-density lipoprotein (LDL) level of 200mg/dl
The multidisciplinary home healthcare team is discussing a female client diagnosed with Parkinson's disease. The home healthcare nurse reports the cient is getting worse and her husband is no longer able to care for her in the home. Which action should the home health nurse implement first? Assign a home health care aide to provide care daily
A nurse working in a community health setting is performing primary health screenings. Which individual is at highest risk for contracting an HIV infection? A 17-year-old who is sexually active with numerous partners
Attendance at a community health clinic is rising and clients have long waits for service. The charge nurse believes that a computer system would be helpful in decreasing the time needed to conduct intake and exit processing. What is the best way for the nurse to introduce the idea of
obtaining a computer system for the clinic? Submit a written proposal to the Board of Directors about hardware and software improvement needs 31. The home health nurse is admitting a client with Parkinson's disease to the home healthcare service. In planning care for this client which nursing diagnosis has priority? Impaired physical mobility related to muscle rigidity and weakness 32. During a home health visit, a male client reports to the nurse that he felt a solid testicular mass during self-exam, but that is wasn't painful. What instruction should the nurse provide the client? Schedule an appointment with the healthcare provider for prompt evaluation 33. A home health nurse knows that a 70-year-old male client who is convalescing at home following a hip replacement, is at risk for developing decubitus ulcers. Which physical characteristic of aging contributes to such a risk? Thinning of the skin with loss of elasticity 34. A college student asks the nurse in the Campus Student Health Center about obtaining medication for motion sickness before a scuba diving trip. What instruction should the nurse give the student regarding the use of prescription-strength scopolamine (Transderm-V)? Apply the skin patch behind the ear 12 hours before your trip." 35. A client presents at a community-based clinic with complaints of shortness of breath, headache, dizziness, and nausea. During the assessment, the nurse learns that the client is a migrant worker who often uses a gasoline-powered pressure washer to clean equipment and farm buildings. Which type of poisoning is the most likely etiology of this client's symptoms? carbon monoxide 36. The nurse is conducting a process evaluation of a prevention education program for older adults who are risk for substance abuse. Which data source provides the information the nurse needs to conduct this process evaluation? documentation of client education in the nursing record 37. A 17-year old unmarried, pregnant client with drug addiction is a high school dropout, homeless, and has a history of past abuse arrives at the clinic for her first prenatal visit. Which findings should the nurse document as health risk factors for the client? (Select all that apply) a. age c. drug addiction d. history of abuse e. pregnancy f. homelessness 38. The nurse is designing a community health project based on a report provided by the World Health Organization that describes healthcare problems in the United States. Which healthcare issue should the nurse give the highest priority when planning the project? number of people without access to healthcare 39. The nurse working in a community health clinic that serves recent Somali immigrants notes that most mothers refuse to give permission for routine immunizations of their preschoolers. Which individual is likely to have the most influential on these women's perceptions about their children's healthcare needs? tribal chief 40. The community health nurse is planning a series of educational courses about the healthcare system and meeting healthcare needs for the community center. Which adjunct issue should the nurse address for a group of older adults. retirement issues 41. A female adult walks into a local community health clinic and tells the nurse that she is homeless and cannot seem to find help. Which statement indicates to the nurse that a client is
nursing and is able to communicate effectively, both orally and in writing, and possesses good administrative, consultative, and listening skills nurse consultant 55. The nurse-manager is planning to transform safety ideas into prevention and protection strategies in the work place. What committee should review and plan policies and education about safety in the work place? quality assurance committee 56. Several employees who have a 10 year or longer hx of smoking ask the occupation nurse for assistance w/ smoking cessation. The RN develops a 2 mo program that includes weekly group sessions on lifestyle changes and use of OTC products. Which measurement provides the best indication of theprogram's effectiveness? Ask the employee to inform the group if they stop smoking and if they start back up again. 57. 100 families in a community refuse to have their children immunized b/c of religion. When 1 documented case of whooping cough occurs w/i the aggregate, which intervention should the RN implement? Quarantine all family members of the child w/ whooping cough. 58. A RN has started a group for senior citizens in a church setting. The group decides that their first project will be a program for home-bound members. Which program outcome is the best measure of the project's effectiveness? Number of home bound seniors who are visited.
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Community Health Leadership Hesi
Where should you initiate preventive measures for kids with dental caries- WIC Program
After numerous patient teachings, a man with Parkinsons disease still cant instill his eye drops – Ask a family member to help.
A school nurse wants to initiate a presentation to parents regarding 25% of the schools children being obese – Determine the parent’s involvement and how much they’re concerned about their children’s health problem.
A school nurse wants to do a program about children’s health risks, what should she consider – Height and weight ©
What pt. should be seen first – A man with Gunshot wound with a pulse ox of 90%
Nurse see’s pt with NGT drinking glass of water after the UAP leaves room – take the glass and speak with the UAP
A nurse observes a wife of a pt in bed with the pt. – close the door and give them privacy
Charge nurse is drunk and smells of alcohol – report it to the nurse supervisor
The clinic receptionist is considered a gatekeeper – “you can speak with the RN about purchasing a car seat” ©
Flu vaccines are low, which client should you tell to come back later when there is enough vaccine – diabetic client with agoraphobia
A nurse took a sleeping pill 4 hours ago – send her home
A nurse forgot her glasses at home and she lives a hour away – send her home to get her glasses.
In preparing for a bioterrorism attack, which should the nurse consider – Tuleremia
A nurse is referring a patient with Ancanthosis nicigricans to a family doctor – body mass index
Patients postoperative with different drains, who should nurse assess first – 40ml dark cloudy urine x4 hours.(c)
Who should nurse see first – African American baby that’s spitting up and has lost 6oz in the past week
Patient wants to get off birth control & have a baby, she has a family history of diabetes & she was treated for Chlamydia 6 months ago, what causes the most concern – Chlamydia
What pt should be considered for involuntary commitment to the psych ward – (1) Pt who hasn’t eaten in 3 days & thinks that he is Jesus. (2) A women who mumbles in corner about killing herself. (3) A man who says that the communist are telling him to kill the Catholics.
A nurse & social worker talking loudly about a pt referral but there are no patients around the nurse’s station – tell them to go to a private work station to talk. ©
A nurse tells a UAP to collect a sputum sample, the nurse should first – determine if UAP is capable of doing the task & if she’s done it before.
An experienced UAP working at an antepartal clinic, what can she do – take initial VS & urine dipstick.
Nurse caring for a 65 year old African American male, she sets up a meeting with his wife, 3 kids, and mother, to talk to the MD. What cultural variance is the nurse demonstrating – Social organization
A charge nurse gets report about a lot of concerns, which one is most important – water spill on the floor.
A pt tells the nurse that she doesn’t want a male nurse – reassign the nurse
Which pt is most at risk to get pneumonia – homeless person who is an alcoholic and smoker. ©
Nurse wants to start an outreach program, what should she explain when she’s trying to receive funding for the program – that the program will help people in nearby factories, schools, churches.
The RN is assisting the MD with a thoracent, & the ED dept calls to say that a pt with agina needs to be admitted ASAP_._ An LVN & UAP are available to help, what should RN do – tell PN to assist with thoracentisis, RN take report on agina pt, UAP get room ready for new for pt.
A hospital is thinking about getting new equipment, what is cost efficient for the hospital to consider – can other units in the hospital use the equipment.
A nurse is giving test to detect influenza, the test is 99% accurate_._ The test has a high rate of – sensitivity
A nurse does a community health fair about cardio, how can the nurse determine if the teachings were effective upon an assessment 6 months later – 10% reduction in cardiac death. ©
Who are at the greatest risk to get Hepatitis A – a family living in a crammed area
How can the charge nurse decrease role ambiguity among the staff nurses – explain the role
A nurse wants to do research on infant death rate, where would she go – Bureau of vital statistics.
Which resources will benefit a rural community – trauma health center
A charge nurse will intervene if she notices – a clerk taking (telephone) orders from the MD.
Female pt goes to local community health clinic, she’s homeless and cant seem to find
HESI Community questions docx-2 477817097000068
Course: Graduate Capstone (MED799)
University: Aspen University
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