Community Hesi

Question 1

The community health nurses is counseling a group of 14 year olds about safe sexual practices. Which health teaching strategy would be most effective for the nurse to use with this age group.

A.Encourage group members to describe personal experiences in practicing safe sex
B. Provide the group with statistical data about behaviors leading to venereal diseases
C. Tell the group that for aids prevention abstinence is the best safe sex practice
D. Role play situations in which the adolescent is rewarded for practicing safe sex

Answer 1

Role play situations in which the adolescent is rewarded for practicing safe sex

Question 2

A young adult man goes to an emergency treatment area after finishing a marathon run. He is weak dizzy and remains thirsty after drinking a pint of a flavored sports drink. What action should the nurse implement first

A. Instruct the runner that a urine sample is needed
B. Send for the automatic external defibrillator
C. Determine if there are friends or family nearby
D. Give the runner another pint of fluids to drink

Answer 2

Give the runner another pint of fluids to drink

Question 3

An older adult male who fractured his right hip is discharged to home one week following an arthroplasty. Which adjustment to the clients home environment is most important for the home health nurse to implement

A. Lower the temperature on the clients water heater
B. Encourage the client to wear rubber soled shoes
C. Ensure that an elevated toilet seat is installed
D. Leave motion activated light in the living room

Answer 3

Ensure that an elevated toilet seat is installed

Question 4

The nurse is caring for four clients in a women’s health clinic. Which client should the nurse assess for risk for pelvic inflammatory disease

A 30 year old with endometriosis
A 40 year old with leiomyoma
A 50 year old perimenopause
A 20 year old with gonorrhea

Answer 4

A 20 year old with gonorrhea

Question 5

The nurse is teaching a group of adults at a health fair about healthy life style choices. Which information is most important for the nurse to emphasize?

Completely stop the use of cigarette and tobacco products
Eat a diet high in fruits vegetables and whole grains
Avoid the midday sun and use sunscreen
Perform monthly self examination of breasts and testes

Answer 5

Completely stop the use of cigarette and tobacco products

Question 6

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 on does of the measles mumps rubella vaccine. Which intervention should the nurse implement?

Note in the student records that the second dose of the mmr vaccine should be administered prior to entering first grade
Send notices home with the children on the first day of class advising that mmr vaccine series must be completed
Contact kindergarten parents to remind them that the second dose of mmr is due at eh start of the school year
Speak at the next parent teacher association meeting to teach parents the benefits of immunizing their children

Answer 6

Send notices home with the children on the first day of class advising that mmr vaccine series must be completed

Question 7

A middle aged male client presents for his annual health visit at a community clinic. He is 5 ft 10 in tall weighs 250 pounds, and works as an accountant. He smokes at least one pack of cigarettes every day for the last 15 years. Which secondary prevention measure should the nurse recommend the client to follow?

-Compliance with antihypertensive and lipid lowering agents.
-Increase physical activity and diet low in saturated fat
-Smoking cessation
-Blood pressure and lipid screening

Answer 7

Blood pressure and lipid screening

Question 8

A male high school student is referred to the school nurse because he lost consciousness during gymnastics class. His neurological vital signs are with normal limits, and his blood pressure is 100/62. He is 6 ft 3 in tall weighs 135 pound and his body mass index is 16.9. which assessment data should the nurse obtain first?

Serial bp reading every 30 minutes
Twenty-four hour diet recall
Use of performance enhancing drugs
Recent exposure to allergens

Answer 8

Twenty-four hour diet recall

Question 9

The nurse is planning to implement a health education program on breast screening for Hispanic women at a community center. Which component of the teaching plan best provides culturally competent care?

Provide handouts and brochures in the English and Spanish languages
Ask a Hispanic breast cancer survivor to present the educational class
Include treatment modalities with survival statistics for Hispanic women
Design flyers that target Hispanic women encouraging their attendance

Answer 9

Provide handouts and brochures in the English and Spanish

Question 10

The nurse is planning a health education program for 10-year old. Which setting is most likely to increase the preadolescent’s participation in the program?

The school classroom
Community center
Home of one of the children
A local place of worship

Answer 10

The school classroom

Question 11

The public health nurse receives grant funding to implement primary prevention strategies for migrant farm workers and their families. Which action should the nurse plan to include?

Teach a class in providing first aid for heat exhaustion
Organize free community wide tuberculosis screenings
Distribute brochures on measures to avoid pesticide exposure
Ask a physical therapist to speak about managing low back pain

Answer 11

Distribute brochures on measures to avoid pesticide exposure

Question 12

The parish nurse notes that an elderly male client has had a 5 lbs 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?

The adult day care center
The social security administration office
The women infant and children office
The senior citizen center

Answer 12

The senior citizen center

Question 13

The nurse is screening for hypertension at a local health fair. One of the community residents has a blood pressure reading of 138/80. Which interventions should the nurse implement for this client? Select all that apply

Obtain another blood pressure to verify the first reading
Ask the client about any current antihypertensive medications
Recommend further evaluation for possible pre-hypertension
Encourage the client to keep doing whatever you are doing
Assess clients life style and other risk factors for hypertension

Answer 13

-Obtain another blood pressure to verify the first reading
-Ask the client about any current antihypertensive medications
-Recommend further evaluation for possible pre-hypertension

Question 14

Which intervention should the nurse implement to help prevent client from getting a vector born infectious disease?

Demonstrate the correct way to remove ticks imbedded in the skin
Discuss the importance of wearing insect repellent when camping
Instruct the client to drink only bottled water when traveling abroad
Encourage the client to get immunizations prior to international travel

Answer 14

Discuss the importance of wearing insect repellent when camping

Question 15

The nurse is working with parent teacher organization to increase safety for children walking to and from a nearby elementary school. Which action should the nurse include to help achieve this goal?

Advise the residents to keep their porch lights on during hours that children are walking to and from school
Help the residents plan a campaign to remind people driving through the school zone to wear seatbelts at all times
Lead a discussion about the benefits of designated safe houses located throughout the school neighborhood
Encourage residents with older homes along the school route to get their homes inspected for excessive lead levels

Answer 15

Lead a discussion about the benefits of designated safe houses located throughout the school neighborhood

Question 16

The nurse is working with the family of a child with cerebral palsy. In order to help the nurse understand the connections among family members, resources and agencies in the community with assessment data gathering tool is best for the nurse to use?

Genogram
Ecomap
Medical record
Family tree

Answer 16

Ecomap

Question 17

Due to a limited supply the local health department needs to prioritize the distribution of influenza vaccinations. 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?

An 80 year old resident in an Alzheimer’s unit
A 65 year old aide working in a nursing home
A 60 year old client with diabetes and agoraphobia
An 8 year old girl with poorly controlled asthma

Answer 17

A 60 year old client with diabetes and agoraphobia

Question 18

The community health nurse determines that the average family income of a certain community is 67k per a year with a range of 27k to 102k based on this demographic information what additional information is important for the nurse to assess?

Interventions focused on college educated individuals
Characteristics of families in the upper middle class
The frequency of incomes about and below the average
The reliability of such a high average family income

Answer 18

The frequency of incomes about and below the average

Question 19

After assessing the health needs of an elementary school, the nurse determines that an increased incidence of bicycle injuries is a priority problem. The nurse develops a 2 month program with the goal to eliminate bicycle injuries in the school. The program includes educational pamphlets sent home to parents and two educations sessions by the school nurse. Which action should the nurse implement to evaluate the effectiveness of the program?

Compare the incidence of bicycle injuries at the beginning and end of the program
Determine the type of bicycle injuries each child sustained before conducting the sessions
Conduct an initial survey of the children to determine their knowledge of bicycle safety
Survey parents after one month to assess their understanding of the educational pamphlet

Answer 19

Compare the incidence of bicycle injuries at the beginning and end of the program

Question 20

The community health nurse who works in a gulf coast town that caters to tourists is presenting a class to residents and business owner of the town on disaster management. Which content is most important for the nurse be included in this class?

Hurricane preparedness for families and businesses
Available evacuation routes from the town
Methods used to treat water to ensure it is safe to drink
Actions to be taken during a tornado

Answer 20

Methods used to treat water to ensure it is safe to drink

Question 21

The home health nurse is evaluating client who is receiving enteral feedings by nasogastric NG tube. Which assessment finding indicates to the nurse that a change to the clients nutrition may be warranted for this client?

Ulceration of .5 cm at left nares ng tube insertion site
Intestinal migration of ng tube verified by aspirate ph of 7.1
Residual volume of 25 ml after each scheduled feeding
Nausea occurs after each instillation of ng feeding

Answer 21

Nausea occurs after each instillation of ng feeding

Question 22

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?

Teach farm workers not to smoke around farm equipment
Translate written vehicle instructions into picture format
Provide rehabilitation services to injured farm hands
Work with legislators to mandate safe tractor design

Answer 22

Work with legislators to mandate safe tractor design

Question 23

A community hit by a hurricane has suffered mass destruction and flooding. Sewage facilities are non functioning and the area is contaminated with human excreta. The nurse is developing a plan of care for clients diagnosed with cholera after an outbreak. Which intervention has the highest priority?

Administer prophylactic antibiotics as prescribed
Provide fluid and electrolyte replacement
Isolate all infectious diarrhea victims
Administer cholera vaccine

Answer 23

Provide fluid and electrolyte replacement

Question 24

A prescription for discharge is written for an elderly female client who has asked to be discharged to her home. The client lives alone and is able to walk 10-15 feet with assistance. Which action should the nurse implement first?

Arrange for a bedside commode to be delivered to the home
Meet with case manager to plan a home safety evaluation
Provide the client with information about medical alert devices
Review the home medication schedule with the client and family

Answer 24

Meet with case manager to plan a home safety evaluation

Question 25

Which expected outcome statement is most relevant to the plan of care for an elderly female client who has a nursing problem of “altered nutrition less than body requirements related to social isolation” and lives alone in her own home?

Client will participate in daily meals at a senior nutrition center
Client will describe a menu of well balanced meals
Client understands the need for placement in a long-term care facility
Client will receive well-balanced diet from meals on wheels

Answer 25

Client will participate in daily meals at a senior nutrition center

Question 26

A 4-year old near drowning victim who is severely disabled due to anoxia that occurred during the incident is being transferred to a long term care facility. When helping the parents select a treatment center for their child, which factor should the nurse encourage the parents to consider?

Proximity of the facility to their home
How many children are residents of the facility
What type of home schooling is available at the facility
Availability of medical care for emergencies

Answer 26

Proximity of the facility to their home

Question 27

An older male client refuses a recommended annual influenza vaccination because it made him sick last year. He tells nurse the nurse that he will take his prescription for amantadine if he develops symptoms of the flu. Which response should the nurse provide?

Since the client received the vaccine last year this plan should be supported
It is best for the client to take the influenza vaccine and avoid using amantadine
It is unlikely the vaccine will make the client sick in two consecutive years
If symptoms of the flu develop the client should obtain the influenza vaccination

Answer 27

It is best for the client to take the influenza vaccine and avoid using amantadine

Question 28

A male client comes to the public health clinic requesting information about which immunizations he should receive prior to visiting a developing nation. Which immunization should the nurse recommend as a priority for this client?

Tetanus toxoid vaccine
Influenza vaccine
Hepatitis b vaccine
Hepatitis a vaccine

Answer 28

Hepatitis a vaccine

Question 29

A government office worker is seen in the emergency room after opening an envelope containing a powder like substance which is being tested for anthrax. Which discharge instruction should the nurse provide the client concerning inhalation anthrax?

Return to the emergency room if flu like symptoms develop within 42 days
Notify co-workers to get the anthrax vaccine at the public health department
Isolation from friends and family members is recommended for 3 weeks
Cleanse all surfaces touched with pre-moistened anti-bacterial wipes

Answer 29

Return to the emergency room if flu like symptoms develop within 42 days

Question 30

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 conditions in the school. The program includes educational pamphlets sent home to parents and regular assessment of children by the school nurse. What action should the nurse implement to evaluate the effectiveness of the program?

Evaluate the teachers ability to identify pediculosis capitis 2 months after initiation of the program
Conduct an initial examination of each child in the school to obtain baseline data
Survey parents 3 weeks after pamphlets are sent home to assess their understanding of the condition
Measure the prevalence of pediculosis capitis among the children after four months

Answer 30

Measure the prevalence of pediculosis capitis among the children after four months

Question 31

An older female client tells the home health nurse that she has no money, and since she does not deserve to eat, she has not asked anyone to bring her food. What information is most important for nurse to obtain?

Client thoughts about wanting to hurt herself
Medication history for antipsychotic agents
Availability of family members to provide meals
Community resources to provide financial aid

Answer 31

Client thoughts about wanting to hurt herself

Question 32

The public health nurse is called to investigate a report of several cases of chickenpox at a day care center. The day care worker states that five children have been sent home over the past two weeks with fever and itchy blisters. Which intervention should the nurse implement first?

Validate that the children sent home did develop chickenpox
Report the presence of a viral endemic at the day care center
Confirm the number of children with symptoms
Determine how many people have been exposed

Answer 32

Validate that the children sent home did develop chickenpox

Question 33

A community health nurse is applying for a federal grant to support a smoking cessation educational program. In which order should the nurse prioritize these nursing activities?

Arrange in order top to bottom
Determine the target aggregate that will be served by the program
Consider pros and cons of different methods of data gathering
Select and train the data collection personnel
Review and analyze the data

Answer 33

Determine the target aggregate that will be served by the program
Consider pros and cons of different methods of data gathering
Select and train the data collection personnel
Review and analyze the data

Question 34

The nurse is documenting the medical history of a young adult male client who was recently diagnosed with type 1 diabetes mellitus. He smokes 2 packs of cigarettes daily and his father died of a heart attack at the age of 45. Which annual screening is most important for the nurse include?

Peripheral neuropathy
Retinopathy
Renal insufficiency
Hyperlipidemia

Answer 34

Hyperlipidemia

Question 35

A graduate nursing student requests information, including laboratory findings and chest x-ray results, about all clients with symptoms of h1n1 who have been seen during the last month in a community health clinic. Which action should the charge nurse take?

Ask if permission has been obtained from the research committee
Ask the student to sign a standard waiver form
Obtain written authorization from clients to release the information
Provide the information for research purposes only

Answer 35

Obtain written authorization from clients to release the information

Question 36

A nurse is planning a nutrition class for a group of senior citizens at a community center and wants to emphasize the amount and types of fat is some foods versus others. What is the best teaching method for the nurse to use?

Ask each senior to bring a food for others to taste, then estimate the fat contained in these foods
Display posters with foods and tell the seniors about the fat content
Determine foods most often eaten by this group and discuss the nutritional panel of each product
Show a movie about cooking with foods that are low in fat but delicious

Answer 36

Determine foods most often eaten by this group and discuss the nutritional panel of each product

Question 37

School teachers notify the schools nurse that a group of children of the migrant farm workers often miss school or sleep during classes. The nurse learns that the children range in age from 12 to 14 years old and work in an orchard with their parents until 2200 every night. Which action should the nurse implement?

Notify child protective services and local law enforcement of truancy concerns
Schedule classes to teach the children and parents about adolescent health concerns
Arrange a meeting with the manager of the orchard to discuss child labor concerns
Organize focus groups with the childrens parents regarding educations concerns

Answer 37

Organize focus groups with the childrens parents regarding educations concerns

Question 38

when visiting a community health clinic a clients blood pressure is measured at 146/94. What information should the nurse provide the client?

Participate in an exercise program for six weeks
Obtain a blood pressure daily for two weeks
Increase dietary intake of omega 3
Begin a low sodium diet immediately

Answer 38

Obtain a blood pressure daily for two weeks

Question 39

The nurse is developing a program about the risk factors of acquiring human immunodeficiency virus for the group of young adults at a community health center. Which lifestyle behavior should the nurse include in the presentation that poses a risk for hiv?

Participation in blood donations for a local blood bank center
A history of receiving autologous blood transfusion
Travel to places where drinking water is contaminate
Self report of illegal intravenous drug abuse

Answer 39

Self report of illegal intravenous drug abuse

Question 40

Tuberculosis screening at a federal prison reveals that two male inmates have positive skin test. What action is most important for the nurse to take?

Start the two men on anti-tubercular medications
Screen the prison guards for tb
Refer the two men for chest xrays
Re-screen the entire prison population in 6 weeks

Answer 40

Refer the two men for chest xrays

Question 41

The school nurse is conducting an audit of incident reports for adolescent students. Which finding is the best indication that the healthy people 2020 objectives are being addressed?

The absenteeism rate has increased greatly over the past two years
During the last year fewer firearms were retrieved on school property
The number of requests for pregnancy testing is higher than last year
Decline in the number of the students enrolled in school during the year

Answer 41

During the last year fewer firearms were retrieved on school property

Question 42

A male construction worker presents at the industrial clinic with a fever and a cough. He states I think I have that sudden acute respiratory syndrome that’s been in the news. What is important for the nurse to do first?

Take the clients temperature and a pulse rate
Place a surgical mask on the client and nurse
Ask the client about recent travel or exposure
Obtain a description of his sputum and cough

Answer 42

Ask the client about recent travel or exposure

Question 43

During a home health visit the nurse notices that an older male client with type 2 diabetes mellitus is wearing loose cloth slippers. The client reports that he cannot comfortably wear other shoes because his toenails get in the way. The nurse inspects the clients feet and finds long thick nails that curl down under some of the toes. Which action should the nurse take?

Demonstrate proper foot care to the client and his family
Have a home health aide assist client with hygiene weekly
Schedule an appointment for the client with podiatrist
Trim the clients toenails gradually over several visits

Answer 43

Schedule an appointment for the client with podiatrist

Question 44

In reviewing the objectives for Healthy people 2020 the nurse determines that the community has a significant problem in preventing dental caries among children to bring about change that addresses this identified community health problem. Where is the best place to initiate a prevention program?

Community youth center
Hospital emergency departments
The local shopping mall
Women infant and children office

Answer 44

Women infant and children office

Question 45

The public health nurse is working in an agriculture based community near the united states mexico border. Which aggregate should the nurse identify as the highest need for local public health services?

Migrant workers who plant and harvest field crops
School aged children who are not bilingual
Elderly population in the community who are on fixed incomes
Adolescents who are exposed to intense sun and hot environments

Answer 45

Migrant workers who plant and harvest field crops

Question 46

A teenage boy with a history of recurring atopic dermatitis tells the school nurse that he wants to play high school football. Which action should the nurse take?

Encourage the teenager to join the swim team instead of the football team
Notify the parents of the problems associated with perspiration for those with eczema
Tell the teenager to shower with a non perfumed soaps immediately after practice
Inform the football coach of the teenagers skin condition and its manifestations

Answer 46

Tell the teenager to shower with a non perfumed soaps immediately after practice

Question 47

A male migrant farm worker who lives in a mobile home with several other workers visits the migrant health care center. He reports increasing episodes of dizziness headaches abdominal cramps and difficulty breathing what nursing action has the highest priority?

Gather information about clients recent exposure to pesticides
Obtain a blood sample to assess for lead paint exposure
Determine the number and age of persons living in the mobile home
Ask about the length of his workday and frequency of rest breaks

Answer 47

Gather information about clients recent exposure to pesticides

Question 48

An established community has a history of being skilled in identifying and managing problems. What role should the community health nurse assume in program development for this community?

Community leader or facilitator
Data organizer
Group gatekeeper
Technical expert or advisor

Answer 48

Technical expert or advisor

Question 49

An older adult client visits the community health clinic and reports the onset of pain, redness and swelling of the right eye. Which question is most important for the clinic nurse to ask the client?

Do you have any discharge from the eye
Have you started any new prescriptions
Are all of your immunizations current
How often do you wash your hands

Answer 49

Do you have any discharge from the eye

Question 50

Several employees who have a 10 year or longer smoking history ask the occupational health nurse for assistance with smoking cessation. The nurse develops a 2 month program that includes weekly group sessions on lifestyle changes and use of wove the counter nicotine substitute products. Which measurement provides the best indication of the programs effectiveness?

Survey employees to determine how many are smoking 2 months after the end of the program
At the end of the program test the employees knowledge of OTC nicotine substitute products
Ask the employees to inform the group if they stop smoking and if they start smoking again
Design a questionnaire that identifies lifestyle changes that contribute to smoking cessation

Answer 50

Survey employees to determine how many are smoking 2 months after the end of the program

Question 51

An adult male client with recurrent ascites from cirrhosis tells the home health nurse that he has no appetite or energy. The nurse should provide what diet suggestions for this client. Select all that apply.

Eat concentrated sweets for a quick energy boost
Avoid adding salt to foods when cooking or at the table
Try to eat at least six small meals daily
Limit helpings of fresh fruits and vegetables
Choose small helping of lean protein such as legumes

Answer 51

Avoid adding salt to foods when cooking or at the table
Try to eat at least six small meals daily
Choose small helping of lean protein such as legumes

Question 52

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?

Complete a physical and mental exam of the client
Call the clients pharmacy to determine what medications she is taking
Seek the family’s assistance in caring for the client
Call adult protective services to obtain emergency nursing home placement

Answer 52

Complete a physical and mental exam of the client