HESI RN Practice Test--Community Health-Community Health Practice Exam (100% Correct Answers)

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1. 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? Refer the child for psychologic evaluation due to attention deficit disorder. Call the child's parents for an immediate medical exam Gather additional data by taking a health history and measuring vital signs Collaborate w/ the teacher to place the child on a behavior modification program. Gather additional data by taking a health history and measuring vital signs Based on the available data, the child may have hyperthyroidism (Grave's Disease). The nurse should gather additional date (C) that may help confirm this suspicion. (A or D) are premature actions at this time. Once additional data are collected, a call to the parents is warranted (B). 2. 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 Develop strict diet plans for school-aged children Provide diet classes for obese children during school hours. Require all children to participate in organized team sports Set goals that are focused on developing healthier lifestyles Setting goals focused on healthy lifestyles that include good nutrition, healthy food choices, and regular physical (A) is helpful in managed childhood obesity. B is not appropriate for school-aged children. The focus should be on increasing activity and making healthier food choices. C may make the children more self-conscious about their weight. Physical activities should be geared to things that will promote lifetime activities, not (D), which might not appeal to all children. 3. A terrorist attack has occurred and several people have inhaled Ricin. Which intervention should the emergency department nurse implement when caring for these clients? Administer the antibiotic streptomycin, IV STAT. Provide all clients w/ the Ricin antidote Implement strict respiratory isolation immediately Provide supportive nursing care until antitoxin is available Provide supportive nursing care until antitoxin is available Production of the Ricin antitoxin involves immunizing sheep with inactive ricin, which results in the production of antibodies that are harvested to produce a freeze-dried product for reconstitution and injection for victims exposed to Ricin poisoning. Although the antitoxin is ready to be manufactured, full licensing is likely in 5 yars (2014). There is no known cure or treatment for Ricin exposure so supportive care (D) should be provided until the antitoxin is available. (A) may be administered for secondary infections but is not a treatment for Ricin exposure. (B) does not exist at this time. Ricin does not have person-to-person transmission, so (C) is not necessary. 4. 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? Did you drink after or use any utensils that your friend used? 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? "Have you shared any needles or had sex with your friend?" Hepatitis B is transmitted by sharing needles or unprotected sex, so (C) is the most important question for the nurse to ask this young woman. Hepatitis A is transmitted by (A). The incubation period for Hepatitis B is 75 days, so (B & D) are not priority questions at this time. 5. 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 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% A community has adopted a no smoking policy Environmental Quality & Tobacco are two of the 12 leading indicators of Healthy People 2020 that are addressed by a community that adopts a no smoking policy (A) which reduces secondary smoke exposure of children of children as well as impacting Air Quality Index (AQI). Although (B & C) are indirectly relate to other indicators of Healthy People 2020, such as Access to Health Services and Social Determinants (high school graduation), the most significantly related outcome is a community wide no smoking policy. (D) is unrelated to Healthy People 2020. 6. Which intervention should the public health nurse implement when attempting to address one of the leading health indicators of Healthy People 2020? Lead a weekly water aerobics class for the elderly at a community center Teach a class on cultural awareness to nursing students at the university Design and implement a no smoking campaign at the local high school Write a grant to help provide glucometes to indivduals who cannot afford one Design and implement a no smoking campaign at the local high school The activity in C addresses a reduced cigarette smoking by adolescents, which is the focus of Tobacco use as a leading health indicator for Healthy People 2020. Regular exercise (A) is a leading indicator but it recommends daily exercise for 30 minutes a day, not weekly. (B and D) are not leading indicators for Healthy People 2020. 7. Lillian Wald was a significant person in the history of American Nursing. Which contributions can be attributed to her? (Select all) -Development of Public health nursing practice -First nursing service for occupational health -Campaigned for laws to require registration for nurses -Established committee that was the forerunner of the NLN -Instituted a sliding scale fee for service -Development of Public health nursing practice -First nursing service for occupational health -Established committee that was the forerunner of the NLN -Instituted a sliding scale fee for service 8. A male client is brought to the emergency department as the result of a motorcycle accident. He was not wearing a helmet at the time of the accident, and states that he has no intention of ever wearing one. Within the framework of the Transtheoretical Model (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 that you don't have the facts about helmet use" "Wearing a helmet or not is certainly an individual decision." Within the framework of the TTM, the client's comment indicates that he is in the pre-contemplation stage where he is not considering change. By responding with A, the nurse allows the client to express feelings and diffuses the strength of the response. B, C, and D are likely to make the contemplator more hostile and resistant to change. 9. After accepting the position of school nurse in a public elementary school, what strategy is best for the nurse to use to obtain an overview of the student body? Review all of the health records of the students presently registered for classes Talk with the current officers of the parent-teacher association Send home a survey form to parents of third grade students Conduct a windshield survey of the geographic areas served by the school Conduct a windshield survey of the geographic areas served by the school The windshield survey gives the nurse the best initial overview of the children and a sense of their community. A, B, C, provide information about some of their children and parents, but are not as comprehensive as the windshield survey. 10. A nurse organizes a community action group to help resolve health problems in a low income neighborhood with a large population of recent immigrants from Africa. What problem should the nurse address first? High rate of unemployment Low immunization rate of children Provision of substandard health care Access to bilingual care providers Low immunization rate of children In the early phase of a community group to experience success in resolving a problem so that they feel encouraged and empowered to continue working together. B is the problem easiest to tackle. While A and C are important, they are complex problems to address, and it is crucial for the group to expereince success on a smaller scale issue so that they will be encouraged to attempt resolving more complex problems in the future. D is important, particularly with Hispanic immigrant populations, but not as important as initial group success to this non-hispanic majority 11. The nurse is preparing to discharge an elderly, recently widowed female client following a mild stroke. At this time she is able to walk with the aid of a walker. As part of the discharge planning, what referral is most important for the nurse to make? Pastoral Care Meals-on-Wheels Grief support group Physical therapy Meals-on-Wheels 12. The nurse is designing a bioterrorism plan for a community. Which agents are transmitted person to person via respiratory or inhalation exposure? (Select all) - Ricin - Pneumonic plague - Anthrax - Botulism - Smallpox - Brucellosis -Pneumonic plague -Smallpox 13. An occupational health nurse is reviewing a 20-year-old trend in the United States that has resulted in an increase in certain medical conditions due to the rapid expansion of an urban industrial workforce. Which medical conditions are specifically identified with this trend? - Asthma - Alcoholism -Lung cancer - Lead poisoning - West Nile virus infection - Hepatitis B virus infection -Asthma -Lung cancer 14. Which presentation of an infectious disease is acquired through an indirect transmission? - Syphilis contracted from a sexual partner - Measles resulting from a daycare center outbreak - Malaria following exposure in a mosquito-infested area - Nosocomial influenza spreading rapidly in a long-term center Malaria following exposure in a mosquito-infested area 15. What action is best for the community health nurse to take if the nurse suspects that an infant is being physically abused? - Follow agency protocols to report suspected abuse - Report suspicions to the local child abuse reporting hotline - Educate the child's caregivers about growth and development issues - Call the police department to have the child removed from home Follow agency protocols to report suspected abuse 16. The nursing education coordinator is creating employee orientation materials for staff nurses who plan to work at a clinic that serves a lower socioeconomic neighborhood. What information should the educator include regarding the clinic's client population? (Select all) -Most of the clients are unemployed or disabled - Access to mass transit may be an issue - Clients will need reminders to bring insurance cards - Basic physiologic needs of this population are often unmet - Clients who are homebound will qualify for Medicaid - Nonadherence to healthcare recommendations is likely -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 17. The nurse administers a booster dose of DTaP (diphtheria, tetanus, and pertussis) vaccine to an infant. Which level of prevention is the nurse implementing? Primary prevention Tertiary Prevention Secondary Prevention Primary Nursing Primary prevention 18. 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? Cigarette smoking African-American ethnicity Poor nutritional status Limited maternal education African-American ethnicity The client's previous history of a LBW infant and the non-modifiable 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. 19. The home health nurse is planning a visit with a client who has been discharged home after hospitalization. Which action should the nurse implement? Avoid creating barriers by wearing a name tag in the home 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 Schedule home visits that take place during the daylight hours 20. Which topic should the nurse include in planning a primary prevention class for adolescents? Risk factors for heart disease Dietary management of obesity Suicide risks and prevention Coping w/ stressful situations Suicide risks and prevention 21. 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 Glucose monitoring for diabetes Blood work for cardiovascular disease Height and weight for altered nutrition Skin testing for tuberculosis 22. 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 child's behavior was not acceptable The purpose is to rid the body of the disease The method is commonly used for discipline Temper tantrums are commonly managed using this method The purpose is to rid the body of disease 23. Which topic should the nurse include in planning a secondary prevention project for the local retirement community? Safety measures in the home Adult immunization program Rehabilitation after surgery Vision and hearing screening Vision and hearing screening 24. 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? Increase in exercise will decrease obesity in children with a sedentary life style Students w/ a body mass index above 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 Within 2 years, students with a body mass index greater than 95% will be reduced by 50% 25. 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 Stress reduction, self-care, and a systems model Curative care, restorative care, and terminal care Self-actualization, fundamental needs, and belonging. The person, the environment or situation, and health 26. 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 that apply) - Census data - Risk management data - Budgeting process information - Available workforce in the community - Client-satisfaction surveys - Changes in the community's demographic data -Census data -Risk management data -Budgeting process information -Client-satisfaction surveys -Changes in the community's demographic data 27. 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 serum cholesterol level of 199 mg/dl A female with a serum cholesterol level of 201 mg/dl A male w/ a low-density lipoprotein (LDL) level of 200 mg/dl A female w/ a low-density lipoprotein (LDL level of 160 mg/dl A male with a low-density lipoprotein (LDL) level of 200mg/dl 28. 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? Request a chaplain to counsel with the couple Assign a home health care aide to provide care daily Talk to the husband about placing his wife in a nursing home Contact the client to discuss the situation Assign a home health care aide to provide care daily 29. 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 A 45-year-old lesbian who has been sexually active with two partners in the past year A 30-year-old cocaine user who inhales the drug and works in a topless bar A 34-year-old male homosexual who is in a monogamous relationship A 17-year-old who is sexually active with numerous partners 30. 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? - 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 of 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 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 - Ineffective coping r/t depression and dysfunction due to disease progression - Ineffective breathing pattern related to respiratory muscle weakness - Fear related to constant possibility of experiencing seizures 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? - Continue to monitor the mass until the next scheduled annual medical exam - Notify the healthcare provider if the mass becomes soft, painful, or starts to drain - Schedule an appointment w/ the healthcare provider for prompt evaluation - Testicular nodules are of concern if they feel matted or not easily movable Schedule an appointment with the healthcare provider for prompt evaluation 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? 16% increase in overall body fat Reduced melanin production Thinning of skin with loss of elasticity Calcium loss in the bones 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)? "Take the oral preparation 30 minutes before diving" "Apply the skin patch behind the ear 12 hours before your trip." "Use the medication at the first feeling of nausea on the boat "Apply a new skin patch every 6 hours to the chest or abdomen" "Apply the skin patch behind the ear 12 hours before your trip." [Show More]

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