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Hesi Community Health Exam
Hesi Community Health Exam
The client's previous history of a LBW infant and the non-modifiable risk
factor of ethnicity are the most important risk factors for this pregnancy
because the incidence of (LBW) infants is twice as high for African-
American (B) births than Caucasian births. The modifiable risk factors of
(A, C, and D) are related to infant morbidity, but (B) is most important
because it is non-modifiable.
24. A young woman tells the public health nurse that a Have you shared any needles or had sex with your friend?
friend was recently diagnosed with Hepatitis B and she
is concerned about getting the disease. During the Hepatitis B virus is transmitted by sharing needles or unprotected sex,
assessment interview, which question is most important so (C) is the most important question for the nurse to ask this young
for the nurse to ask this woman? woman. Hepatitis A is transmitted by (A). The incubation period for
Did you drink after or use any utensils that your friend Hepatitis B is 75 days, so (B and D) are not priority questions at this
used? time.
Have you noticed any yellowish tinge to the whites of
your eyes?
Have you shared any needles or had sex with your
friend?
How long ago was your friend diagnosed with Hepatitis
B?
25. During a home health visit, a male client reports Schedule an appointment with the healthcare provider for prompt evaluation.
to the nurse that he felt a solid testicular mass
during self-exam, but that it wasn't painful. What A painless testicular mass is an abnormal finding, and the nurse should instruct
instruction should the nurse provide the client? the client to obtain prompt medical evaluation (C). (A, B, and D) place the client
Continue to monitor the mass until the next at risk, since they do not emphasize prompt medical evaluation.
scheduled annual medical exam.
Notify the healthcare provider if the mass
becomes soft, painful, or starts to drain.
Schedule an appointment with the healthcare
provider for prompt evaluation.
Testicular nodules are of concern only if they
feel matted or are not easily movable.
26. A 12-year-old female is seen by the school Gather additional data by taking a health history and measuring vital signs.
nurse after recently experiencing increasing
difficulty sitting still and paying attention in Based on the available data, the child may have hyperthyroidism (Graves
class, and increasingly illegible handwriting. The disease). The nurse should gather additional data (C) that may help confirm this
nurse observes that the child has protruding suspicion. (A or D) are premature actions at this time. Once additional data are
eyeballs and a staring expression. What action collected, a call to the parents is warranted (B).
should the nurse take next?
Refer the child for psychologic evaluation due
to attention deficit disorder.
Call the child's parents to schedule the child for
an immediate medical exam.
Gather additional data by taking a health history
and measuring vital signs.
Collaborate with the teacher to place the child
on a behavior modification program.
27. Lillian Wald was a significant person in the Development of public health nursing practice.
history of American nursing. Which First nursing service for occupational health.
contributions can be attributed to her? (Select Instituted a sliding scale fee for service.
all that apply.) Established committee that was the forerunner of the NLN.
Development of public health nursing practice.
First nursing service for occupational health.
Campaigned for laws to require registration for (A, B, D, and E) are correct. Lillian Wald is known mostly for her work in public
nurses. health (A) but she also developed the first nursing service for occupational
Established committee that was the forerunner health (B). She also established a committee -- The Associated Alumnae of
of the NLN. Training Schools for Nurses -- which later developed into the ANA and the NLN
Instituted a sliding scale fee for service. (D). In her work for occupational health, she instituted a sliding scale fee for
service (E). She advocated for Women's Rights, but had no significant input into
making nursing registration mandatory (C).
28. A male client is brought to the Wearing a helmet or not is certainly an individual decision.
emergency department as the result of a
motorcycle accident. He was not
wearing a helmet at the time of the Within the framework of the TTM, the client's comment indicates that he is in the pre-
accident, and states that he has no contemplation stage where he is not even considering change. By responding with (A),
intention of ever wearing one. Within the the nurse allows the client to express feelings and diffuses the strength of the response.
framework of the Transtheoretical Model (B, C, and D) are likely to make the contemplator more hostile and resistant to change.
(TTM), which response should the nurse
provide?
Wearing a helmet or not is certainly an
individual decision.
You should seriously consider wearing a
helmet.
Riding a motorcycle with a helmet
increases your safety.
I really think you don't have the facts
about helmet use
29. *Delete* The person, the environment or situation, and health.
Nursing theories serve to describe, explain, predict, or prescribe nursing care measures.
Any science has a domain, which is the view or perspective of the discipline. The
elements of nursing's paradigm direct the activity of the nursing profession, including
knowledge development, philosophy, theory, educational experience, research, practice,
and literature identified with the profession. Nursing identified its domain in a paradigm
that includes four linkages: the person, health, environment/situation, and nursing (A). (B,
C, and D) are not linkages of the domain.
30. A terrorist attack has occurred and Provide supportive nursing care until antitoxin is available.
several people have inhaled Ricin. Which
intervention should the emergency Production of the Ricin antitoxin involves immunizing sheep with inactive ricin, which
department nurse implement when results in the production of antibodies that are harvested to produce a freeze-dried
caring for these clients? product for reconstitution and injection for victims exposed to Ricin poisoning. Although
Administer the antibiotic streptomycin, the antitoxin is ready to be manufactured, full licensing is likely in 5 years (2014).There is
IV STAT. no known cure or treatment for Ricin exposure so supportive care (D) should be
Provide all clients with the Ricin antidote. provided until the antitoxin is available. (A) may be administered for secondary
Implement strict respiratory isolation infections but is not a treatment for Ricin exposure. (B) does not exist at this time. Ricin
immediately. does not have person-to-person transmission, so (C) is not necessary.
Provide supportive nursing care until
antitoxin is available.
31. *Delete* Conduct a windshield survey of the geographic areas served by the school
The windshield survey (the nurse drives through neighborhoods viewing homes, stores,
churches, air quality, etc.) (D) gives the nurse the best initial overview of the children
and a sense of their community. (A, B, and C) provide information about some of the
children and parents, but are not as comprehensive as the windshield survey.
32. *Delete* Census data.
Risk management data.
Budgeting process information.
Client-satisfaction surveys.
Changes in the community's demographic data.
Census data (A), risk management data (B), budgeting process information (C), data obtained from
client-satisfaction surveys (E), and changes in the community's demographic data (F) provide pertinent
data for planning for the current and future healthcare needs of the community. Available workforce (D),
although a concern, is not a factor in quality-assurance directives.
33. The nurse is designing a Pneumonic plague.
bioterrorism plan for a Smallpox.
community. Which agents
are transmitted person to Correct selections are (B and E). The pneumonic plague (B) can be transmitted person to person via
person via respiratory or respiratory droplets. Smallpox (E) can produce aerosolized droplets of ruptured pock marks in the
inhalation exposure? buccal cavity, thus aerosolizing the virus and causing respiratory transmission. (A) is a biological toxin
(Select all that apply.) that is not transmitted person to person. (C) can be spread by respiratory transmission from an exposure
Ricin. source, but is not transmitted person to person (communicable). (D) is a biological toxin commonly
Pneumonic plague. associated with food-borne or ingestion exposures, but is not communicable. (F) is found in livestock,
Anthrax. but is not communicable.
Botulism.
Smallpox.
Brucellosis.
34. Which example should the A community has adopted a no smoking policy.
nurse identify as a
significant outcome for Environmental quality and tobacco are two of the 12 leading indicators of Healthy People 2020 that are
the Leading Health addressed by a community that adopts a no smoking policy (A), which reduces secondary smoke
Indicators of Healthy exposure of children as well as impacting Air Quality Index (AQI). Although (B and C) are indirectly
People 2020? related to other indicators of Healthy People 2020 , such as access to health services and social
A community has adopted determinants (high school graduation), the most significantly related outcome is a community wide no
a no smoking policy. smoking policy. (D) is unrelated to Healthy People 2020 .
A rural community has a
public transportation
system.
The high school drop out
rate has decreased by
15%.
A county has decreased
their divorce rate by 10%.
35. *Delete* Most of the clients are unemployed or disabled.
Access to mass transit may be an issue.
Basic physiologic needs of this population are often unmet.
Correct choices are (A, B, and D). The unemployed or disabled will likely comprise a majority of this
clinic's clients (A); the lack of access to mass transit may affect the population's ability to keep health
care appointments (B); and low-income clients are at risk for basic physiologic needs being left unmet
(D). Most clients are not likely to have health insurance (C) because they lack the funds to pay the
insurance premiums. Homebound status is not a defining qualification for public assistance, such as
Medicaid (E). To state that a low-income population is more likely to be non-compliant with healthcare
recommendations is an example of stereotyping (F).
36. Attendance at a community health clinic is rising Submit a written proposal to the Board of Directors about hardware and
and clients have long waits for service. The software improvement needs.
charge nurse believes that a computer system
would be helpful in decreasing the time needed Submitting written information to the Board will give Board members the
to conduct intake and exit processing. What is opportunity to review the proposal (C) and is the best method of introducing the
the best way for the nurse to introduce the idea idea. (A) is dismissing responsibility to the medical director. (B) is disrespectful to
of obtaining a computer system for the clinic? the Board, by not first presenting the idea to the Board. (D) is manipulative.
Ask the medical director to talk to the Board of
Directors about obtaining funds to implement a
computer system.
Send a signed letter to the editor of the local
newspaper describing the benefits to the
community.
Submit a written proposal to the Board of
Directors about hardware and software
improvement needs.
Meet informally with some Board members to
enlist their support for the idea of implementing
a computer system.
37. A nurse working in a community health setting A 17-year-old who is sexually active with numerous partners.
is performing primary health screenings. Which
individual is at highest risk for contracting an (A) is at greatest risk for developing sexually transmitted diseases, including HIV,
HIV infection? because the greater the number of sexual partners one has, the greater the risk
A 17-year-old who is sexually active with for contracting STDs. (B) represents the group with the lowest number of infected
numerous partners. persons because there is little transfer of body fluid during sexual acts. (C)
A 45-year-old lesbian who has been sexually would not be sharing needles, so contracting STDs is not necessarily a risk. A
active with two partners in the past year. male homosexual in a monogamous relationship has a decreased risk of
A 30-year-old cocaine user who inhales the contracting HIV--as long as BOTH partners are monogamous and neither is
drug and works in a topless bar. infected (D).
A 34-year-old male homosexual who is in a
monogamous relationship.
38. *Delete* Impaired physical mobility related to muscle rigidity and weakness.
Primary prevention (A) involves activities that focus on reducing the potential for illness
before it occurs, such as immunizations. Tertiary prevention (B) minimizes the
consequences of a disorder or illness through aggressive management or rehabilitation.
Secondary prevention (C) includes early diagnosis and implementing interventions aimed
at a cure or reducing the progress of a disease. Primary nursing (D) describes a method
of nursing management and nursing care assignments, not a healthcare strategy.
42. The nurse is teaching a community A male with a low-density lipoprotein (LDL) level of 200 mg/dl.
group about risks of cardiovascular
disease. Several clients ask the nurse The risk factors for cardiovascular disease include nonmodifiable variables, such as
to determine their risk. Which client gender, family history, and race, and modifiable variables, such as underlying diseases
should the nurse identify as having the (hypertension, diabetes mellitus, hyperlipidemia, and obesity, smoking, sedentary lifestyle,
greatest risk for cardiovascular and stress). Laboratory results that support these risk factors include elevated LDL and
disease? serum cholesterol levels, so (C), being male, has a higher risk than (D). (A and B) have
A male with a serum cholesterol level borderline results.
of 199 mg/dl.
A female with a serum cholesterol
level of 201 mg/dl.
A male with a low-density lipoprotein
(LDL) level of 200 mg/dl.
A female with a low-density-
lipoprotein (LDL) level of 160 mg/dl.
43. *Delete* Suicide risks and prevention.
Primary prevention focuses on health promotion and prevention of injury and illness.
Since suicide is a leading cause of death in adolescents, including (C) is essential. Health
screenings and interventions are designed to increase the probability of early diagnosis
and treatment, so (A, B, and D) are important secondary prevention topics for
adolescents.
44. The nurse is planning a community- Within 2 years, students with a body mass index greater than 95% will be reduced by 50%.
based project to reduce obesity in
a school-aged population. Which Goals are intended to be expressed in specific outcomes that provide direction toward
outcome statement best supports interventions and determine change in measurable terms. Outcome statements include past or
the goal for this population? present events with specific quantitative expectations with a time frame, so (C) supports these
Increase in exercise will decrease specific terms. (A, B, and D) are not as specific as (C).
obesity in children with a
sedentary life style.
Students with a body mass index
above the 95 percentile will
decrease.
Within 2 years, students with a
body mass index greater than 95%
will be reduced by 50%.
In the target population, 30% of
students will be below the 95
percentile in weight
45. The home health nurse is planning Schedule home visits that take place during the daylight hours.
a visit with a client who has been
discharged home after a To ensure safety of the client and the nurse, home visits should be scheduled during daylight
hospitalization. Which action should hours (B). The nurse practice act requires the nurse to wear an identification name tag during
the nurse implement? client care which also provides clear role expectations (A) for the client. Making visits with
Avoid creating barriers by wearing another home care provider (B) provides an opportunity for the nurse to evaluation and
a name tag in the home. coordinate care (C). (D) is not necessary.
Schedule home visits that take
place during the daylight hours.
Ensure HIPAA laws are observed
by avoiding visits with other home
care providers.
Use a duplicate copy of the client's
record to provide concurrent
services.
46. *D* Skin testing for tuberculosis.
Secondary prevention focuses on health promotion, which includes screening, early detection
and diagnosis of disease. Among migrant families, tuberculosis rates are unusually high and
should be a priority focus for secondary prevention (A). Although (B, C, and D) are important
screenings, the incidence and the risk for spread of tuberculosis is a priority in this population.
47. *Delete* The purpose is to rid the body of disease.
Coining, a Vietnamese practice, may produce welt-like swellings from rubbing a coin
lengthwise on oiled skin to rid the body of disease (B). Certain cultural practices that address
illness may be considered abusive by another culture and misunderstood by uninformed
professionals. (A, C, and D) are not correct interpretations.
48. Which topic should the nurse Vision and hearing screening
include in planning a secondary
prevention project for the local Health screenings (D) are the mainstay of secondary prevention, which focuses on health
retirement community? promotion, which includes screening, early detection and diagnosis of disease. (A and B) are
Safety measures in the home. primary prevention topics which include health-promoting activities designed to reduce the
Adult immunization program. likelihood of a specific illness occurring. Tertiary prevention includes interventions aimed at
Rehabilitation after surgery. disability limitation and rehabilitation (D) from disease, injury, or disability.
Vision and hearing screening