RN HESI Community Health with NGN

Question 1: View A child living in an inner city setting reports that there are no playgrounds or sidewalks in their area, so their grandmother does not allow them to go outside after school.
The grandmother cooks traditional meals every evening.
The child describes how they love their grandmother’s cooking, and they get to use homemade tortillas instead of forks to pick up their food to eat.
The child reports that they become short of breath easily when they are playing with their friends, and they have “a lot” of headaches.
On a scale of 0 to 10, with 10 being very happy, how would you rate your happiness with your weight? The child reports “2.”. What do you believe is one thing that you can change to help you lose some of your weight?

A. Increase physical activity B. Improve diet C. Reduce portion sizes D. All of the above

Explanation

Answer and explanation

The correct answer is Choice D.

Choice A rationale

Increasing physical activity is a key component of weight loss. It helps to burn calories, build muscle, and boost metabolism. However, physical activity alone may not be sufficient for weight loss. It’s also important to consider dietary habits.

Choice B rationale

Improving diet is another crucial aspect of weight loss. This can involve eating more fruits, vegetables, and whole grains, reducing the intake of processed foods and sugary drinks, and watching portion sizes. However, diet alone may not be enough for weight loss, and it’s also important to incorporate physical activity.

Choice C rationale

Reducing portion sizes can help to decrease calorie intake, which can contribute to weight loss. However, portion control alone may not lead to weight loss if the individual is not consuming a balanced diet or if they are not physically active.

Choice D rationale

All of the above strategies - increasing physical activity, improving diet, and reducing portion sizes - are important for weight loss. They work together to create a calorie deficit, which is necessary for weight loss. It’s also important to note that these strategies should be implemented as part of a sustainable lifestyle change, rather than a short-term diet.

Question 2: View A teenager with a history of recurring atopic dermatitis (eczema) tells the school nurse of a desire to play high school sports.
Which action should the nurse take?

A. Advise the teenager to shower with non-perfumed soaps immediately after practice. B. Inform the parents of problems associated with perspiration for those with eczema. C. Inform the athletic coach of the teenager’s skin condition and its manifestations. D. Encourage the teenager to join the swim team instead of an outdoor sport.

Explanation

Answer and explanation

The correct answer is Choice A.

Choice A rationale

Showering with non-perfumed soaps immediately after practice is a good practice for a teenager with a history of recurring atopic dermatitis (eczema) who wants to play high school sports. Heat and humidity can cause perspiration, which intensifies itching with atopic dermatitis (eczema), so the client should be encouraged to shower, using non-perfumed soaps, as soon as possible after physical activity to remove perspiration.

Choice B rationale

Informing the parents of problems associated with perspiration for those with eczema is also important. However, this does not directly address the teenager’s desire to play sports. It’s more of a secondary action that supports the primary action of managing the condition.

Choice C rationale

Informing the athletic coach of the teenager’s skin condition and its manifestations could be helpful in ensuring that the coach understands the teenager’s needs and can support them appropriately. However, this is not the most direct action that the nurse can take to help the teenager manage their condition while playing sports.

Choice D rationale

Encouraging the teenager to join the swim team instead of an outdoor sport could potentially reduce exposure to triggers for eczema flares, such as sweat and heat. However, chlorine in swimming pools can also be a trigger for some people with eczema. Therefore, this option might not be the best for everyone and should be considered on an individual basis.

Question 3: View The nurse is triaging victims of a tornado at an emergency shelter. An adult who has been wandering and crying comes to the nurse. Which action should the nurse take?

A. Check the client’s temperature, blood sugar, and urine output. B. Arrange for the client to be transported for laboratory tests and an electrocardiogram (ECG). C. Delegate care of the crying client to an unlicensed assistant. D. Direct the client to the shelter’s nutrition center to obtain water and food.

Explanation

Answer and explanation

The correct answer is Choice D.

Choice A rationale

Checking the client’s temperature, blood sugar, and urine output could be important in certain situations, but in this case, it may not be the most immediate need. The client is wandering and crying, which suggests emotional distress rather than a physical health issue.

Choice B rationale

Arranging for the client to be transported for laboratory tests and an electrocardiogram (ECG) would be an overreaction in this situation. There’s no indication from the client’s behavior that they are experiencing a medical emergency.

Choice C rationale

Delegating care of the crying client to an unlicensed assistant is not the best choice. The client is likely experiencing emotional distress due to the traumatic event, and they would benefit from the care and attention of a trained professional.

Choice D rationale

Directing the client to the shelter’s nutrition center to obtain water and food is the best action in this situation. The client may be dehydrated or hungry, which could be contributing to their distress. Providing for these basic needs can help to calm the client and provide a sense of safety and stability.

Question 4: View The community health nurse determines that the average family income of a certain community is $67,000 per year with a range of $27,000 to $102,000.
Based on this demographic information, which additional information is important for the nurse to assess?

A. Characteristics of families in the upper-middle class. B. Interventions focused on college-educated individuals. C. The reliability of such a high average family income. D. The frequency of incomes above and below the average.

Explanation

Answer and explanation

The correct answer is D.

Choice A rationale

While understanding the characteristics of families in the upper-middle class can provide some insights, it does not give a comprehensive view of the community’s health needs. The income range suggests there are also families with lower incomes, and their health needs might be different.

Choice B rationale

Focusing interventions solely on college-educated individuals could overlook those who do not have a college education but still contribute to the average family income. Health needs can vary widely among individuals regardless of their educational background.

Choice C rationale

While it’s important to verify the reliability of the high average family income, it does not directly inform the nurse about the community’s health needs. Income is just one aspect of a community’s demographic profile.

Choice D rationale

Understanding the frequency of incomes above and below the average can help the nurse identify income inequality within the community. This information is crucial as income inequality can impact access to healthcare services and health outcomes.

Question 5: View A mother who is six weeks postpartum reports to the home health nurse that her milk supply seems to be diminishing.

The nurse notices that the mother’s 16-month-old child is constantly vying for her attention.
What is the best advice the nurse can provide to help the mother with breastfeeding while also caring for a toddler?

A. Have the 16-month-old child play in another room during breastfeeding. B. Read a book to the 16-month-old child while the mother is breastfeeding the infant. C. Encourage the toddler to watch TV while the mother is breastfeeding the baby. D. Give the toddler crayons and paper while the mother is breastfeeding the infant.

Explanation

Answer and explanation The correct answer is B. Choice A rationale

Having the 16-month-old child play in another room during breastfeeding might not be feasible or safe, depending on the child’s maturity and the safety of the environment.

Choice B rationale

Reading a book to the 16-month-old child while the mother is breastfeeding the infant can be a practical solution. It allows the mother to attend to both children simultaneously, keeping the older child engaged while tending to the infant.

Choice C rationale

While watching TV might keep the toddler occupied, it’s not the best option. Excessive screen time is not recommended for children at this age.

Choice D rationale

Giving the toddler crayons and paper is a good idea, but it might not keep the child engaged for the entire duration of the breastfeeding.

Question 6: View The home health nurse assesses an older adult client and observes possible signs of abuse.
Which resource should the nurse use to guide their decision regarding reporting these suspicions?

A. American Nurses Association (ANA) Code of Ethics. B. Nursing procedure manual. C. State law. D. Nurse practice act.

Explanation

Answer and explanation The correct answer is C. Choice A rationale

While the ANA Code of Ethics provides general guidance on ethical nursing practice, it does not provide specific procedures for reporting elder abuse.

Choice B rationale

A nursing procedure manual might not contain the specific legal procedures for reporting elder abuse. These procedures can vary by jurisdiction.

Choice C rationale

State law often provides specific guidelines on how and when to report suspected elder abuse. Therefore, it would be the most appropriate resource for the nurse to use in this situation.

Choice D rationale

The Nurse Practice Act governs nursing practice in each state, but it might not provide detailed procedures for reporting elder abuse.

Question 7: View The nurse is developing disaster plans for a community.
Which situation is an example of a high-intensity and small-scope disaster?

A. A hurricane that destroys 50,000 homes and kills 5,000 victims. B. A forest fire that destroys 25,000 acres with significant damage to livestock. C. A tornado that destroys 25 houses and uproots an interstate for 0.5 miles. D. An explosion at a water treatment plant that affects the community water supply.

Explanation

Answer and explanation The correct answer is C. Choice A rationale

A hurricane that destroys 50,000 homes and kills 5,000 victims is a high-intensity disaster, but it is not small-scope. The impact is widespread, affecting a large number of homes and people.

Choice B rationale

A forest fire that destroys 25,000 acres and causes significant damage to livestock is also a high-intensity disaster. However, the scope is not small as it affects a large area and has a significant impact on the local economy.

Choice C rationale

A tornado that destroys 25 houses and uproots an interstate for 0.5 miles is an example of a high-intensity, small-scope disaster. The disaster is high-intensity due to the destructive nature of a tornado, but the scope is relatively small, affecting only a limited number of houses and a small section of an interstate.

Choice D rationale

An explosion at a water treatment plant that affects the community water supply is a high- intensity disaster due to the potential for widespread impact on the community’s water supply. However, the scope is not necessarily small as it could affect a large population.

Question 8: View The home health nurse visits a young adult client who has AIDS with Kaposi’s sarcoma and peripheral neuropathies. The client’s parents, who are the caretakers, tell the nurse that their child sleeps most of the time.
The nurse assesses that the client is semi-conscious with stable vital signs, cries out in pain when turned or moved, has a fentanyl patch in place, and skin lesions that are closed and dried.
Which intervention should the nurse implement?

A. Give a complete bed bath to further assess the client. B. Remove the fentanyl patch as directed by prescription. C. Call for ambulance transportation to the hospital immediately. D. Discuss end-of-life decisions with the client’s parents.

Explanation

Answer and explanation The correct answer is D. Choice A rationale

Giving a complete bed bath to further assess the client may not be the most appropriate intervention in this case. The client is semi-conscious and cries out in pain when turned or moved. A complete bed bath could potentially cause unnecessary discomfort and distress.

Choice B rationale

Removing the fentanyl patch as directed by prescription may not be the best course of action. Fentanyl is a powerful opioid used to manage severe pain. The client’s parents report that their child cries out in pain when turned or moved, suggesting that the client is experiencing significant pain. Removing the fentanyl patch could potentially exacerbate the client’s pain.

Choice C rationale

Calling for ambulance transportation to the hospital immediately may not be necessary at this time. The client’s vital signs are stable, and there is no indication of an immediate medical emergency based on the information provided.

Choice D rationale

Discussing end-of-life decisions with the client’s parents is the most appropriate intervention. The client is semi-conscious, sleeps most of the time, and is in significant pain. These symptoms suggest that the client’s condition is deteriorating. It is important to have conversations about end-of-life care preferences and decisions to ensure that the client’s wishes are respected and that the parents are prepared.

Question 9: View A nurse designs a series of four weekly classes for clients with type 2 diabetes mellitus. Which information should the nurse use as an outcome evaluation for the classes?

A. Discussion of food exchanges and calories was a well-attended class. B. Parking convenience for attendees continued to be a major concern. C. Demonstrating the use of a blood glucose meter was an effective teaching strategy. D. Fasting blood glucose average readings were 20% lower at the end of the classes.

Explanation

Answer and explanation The correct answer is D. Choice A rationale

While the discussion of food exchanges and calories being well-attended indicates interest and engagement in the class, it does not necessarily reflect an improvement in the clients’ management of their diabetes.

Choice B rationale

Parking convenience for attendees, while important for accessibility and attendance, does not provide information about the effectiveness of the classes in improving diabetes management.

Choice C rationale

Demonstrating the use of a blood glucose meter can be an effective teaching strategy, but it does not provide measurable outcomes related to the clients’ diabetes control.

Choice D rationale

Fasting blood glucose average readings being 20% lower at the end of the classes is a direct and measurable outcome that indicates improved diabetes control. This suggests that the classes were effective in teaching clients how to better manage their type 2 diabetes.

Question 10: View The community health nurse collaborated with the American Heart Association to launch a comprehensive educational program about strokes and acute coronary syndrome.
Which result indicates that the program was successful?

A. All educational pamphlets prepared for distribution were disseminated among the served counties. B. 75% of the workshop attendees rated the educational program as outstanding. C. Cardiac-related fatalities decreased by 109% six months after the program’s presentation. D. 65% of the program’s participants committed to adopting a healthier lifestyle.

Explanation

Answer and explanation The correct answer is C. Choice A rationale

While the dissemination of all educational pamphlets among the served counties indicates successful distribution of information, it does not necessarily reflect a change in health outcomes or behaviors.

Choice B rationale

Although a high rating from workshop attendees indicates that the program was well-received, it does not provide measurable health outcomes.

Choice C rationale

A decrease in cardiac-related fatalities by 109% six months after the program’s presentation is a direct and measurable outcome that indicates the program was successful in its goal to prevent strokes and acute coronary syndrome.

Choice D rationale

While a commitment to adopting a healthier lifestyle from 65% of the program’s participants is a positive outcome, it is based on self-report and does not provide direct evidence of a decrease in strokes or acute coronary syndrome.