HESI RN
Community Health HESI Questions
Question 1 of 5
A school nurse is organizing a vaccination clinic for middle school students. Which vaccine is most important for the nurse to include?
Correct Answer: B
Rationale: In the context of organizing a vaccination clinic for middle school students, the most important vaccine for the school nurse to include is option B) tetanus, diphtheria, and pertussis (Tdap). This vaccine is crucial for adolescents as it protects against three serious bacterial infections. Tetanus, diphtheria, and pertussis are all highly contagious diseases that can have severe consequences if contracted. Tetanus causes muscle stiffness and spasms, diphtheria affects the respiratory system leading to breathing difficulties, and pertussis (whooping cough) can be especially dangerous for young adolescents. Including the Tdap vaccine in the clinic is important to ensure that students are protected against these diseases, especially considering the close quarters and interactions within a school setting that can facilitate the spread of infections. The other options are also important vaccines, but in the context of a middle school setting, Tdap takes precedence due to the specific risks associated with tetanus, diphtheria, and pertussis at this age. Hepatitis B (option A) is important for overall health but may not be as urgent in this setting. Varicella (option C) and MMR (option D) are essential vaccines as well, but Tdap should be the priority in this scenario due to the risks posed by tetanus, diphtheria, and pertussis in a school environment.
Question 2 of 5
Following an emergency Cesarean delivery, the nurse encourages the new mother to breastfeed her newborn. The client asks why she should breastfeed now. Which information should the nurse provide?
Correct Answer: C
Rationale: In this scenario, the correct answer is C) To stimulate contraction of the uterus. After childbirth, the uterus needs to contract to prevent excessive bleeding. Breastfeeding triggers the release of oxytocin, a hormone that causes uterine contractions, helping the uterus return to its pre-pregnancy size and reducing the risk of postpartum hemorrhage. Option A) To bond with the baby, is a common reason for breastfeeding, but in this specific situation, the immediate benefit is related to uterine contractions. Option B) To help the baby latch on better, is not directly related to the mother's physiological response post-Cesarean delivery. Option D) To promote milk production, while important in the long term, is not the immediate priority right after a Cesarean section. Educationally, this question highlights the physiological benefits of breastfeeding beyond just infant nutrition. It emphasizes the role of breastfeeding in promoting maternal health by aiding in uterine involution and preventing postpartum complications. This knowledge is crucial for nurses working in community health settings to provide evidence-based care and support to postpartum mothers.
Question 3 of 5
A 6-year-old child is alert but quiet when brought to the emergency center with periorbital ecchymosis and ecchymosis behind the ears. The nurse suspects potential child abuse and continues to assess the child for additional manifestations of a basilar skull fracture. What assessment finding would be consistent with the basilar skull fracture?
Correct Answer: D
Rationale: In this scenario, the correct answer is D) Rhinorrhea or otorrhea with a halo sign. This finding is consistent with a basilar skull fracture, which is a serious injury that can occur due to significant head trauma. Rhinorrhea (nasal discharge) or otorrhea (ear discharge) with a halo sign (a ring of blood surrounding the fluid) indicates a cerebrospinal fluid leak, which is a concerning sign of a basilar skull fracture. Option A) Blurred vision is not typically associated with a basilar skull fracture but can occur with other head injuries or conditions affecting the eyes. Option B) Shoulder pain is not specifically linked to a basilar skull fracture. It is more commonly seen in musculoskeletal injuries or conditions involving the shoulder. Option C) Abdominal pain is not a typical manifestation of a basilar skull fracture. Abdominal pain may indicate issues within the abdomen, such as gastrointestinal problems or referred pain from other areas. Understanding the signs and symptoms of basilar skull fractures is crucial for healthcare providers, especially in cases of suspected child abuse where prompt identification and intervention are essential. This educational context underscores the importance of thorough assessment skills and knowledge of potential red flags for serious injuries in pediatric patients.
Question 4 of 5
The nurse notices that the influenza immunization rate is much lower for certain demographic groups than for others. Which intervention is likely to be most useful in increasing the rates of immunization in the underserved community groups?
Correct Answer: A
Rationale: The correct answer is A) designated clinics conveniently located in target neighborhoods. This intervention is likely to be most useful in increasing immunization rates in underserved community groups because it addresses key barriers to accessing healthcare services, such as transportation and proximity. By providing designated clinics in target neighborhoods, individuals in underserved communities can easily access the influenza vaccine without having to travel long distances or incur additional costs. This strategy improves convenience and increases the likelihood that individuals will receive the immunization. Option B) reports decreasing influenza rates during times of greatest prevalence does not directly address the issue of access to immunization services in underserved communities. While providing information about decreasing rates may raise awareness, it may not necessarily lead to increased vaccination rates, especially in populations facing barriers to access. Option C) legislative proposals that mandate influenza vaccinations for all may be met with resistance and may not effectively address the underlying reasons for low immunization rates in underserved communities. Mandates can be controversial and may not necessarily address the root causes of disparities in healthcare access. Option D) radio announcements about the availability of the influenza vaccine may increase awareness but may not overcome the practical barriers that individuals in underserved communities face in accessing healthcare services. Simply knowing about the availability of the vaccine may not be sufficient to increase immunization rates in these populations. In an educational context, understanding the importance of addressing barriers to healthcare access and tailoring interventions to meet the specific needs of underserved communities is crucial in community health nursing. By implementing strategies that improve access and convenience, nurses can effectively increase immunization rates and promote better health outcomes in these vulnerable populations.
Question 5 of 5
Community health nurses are particularly concerned with the source of communicable diseases such as hepatitis A. Which group of individuals have a higher risk of contracting that type of hepatitis?
Correct Answer: B
Rationale: In the context of community health nursing, understanding the risk factors associated with communicable diseases such as hepatitis A is crucial for effective prevention and intervention strategies. In this scenario, option B) low-income families living in cramped quarters have a higher risk of contracting hepatitis A. Low-income families living in cramped quarters are more susceptible to poor sanitation and hygiene practices due to overcrowding, limited access to clean water, and inadequate bathroom facilities. These conditions create an environment conducive to the spread of hepatitis A, which is primarily transmitted through the fecal-oral route. Option A) IV drug users who share needles are at higher risk for bloodborne diseases like hepatitis B and C, but not specifically hepatitis A, which is mainly transmitted through contaminated food or water. Option C) those who have recently received a blood transfusion are at risk for bloodborne pathogens but not necessarily hepatitis A, which is not commonly transmitted through blood products. Option D) sexually active persons with multiple partners are more at risk for sexually transmitted infections like HIV or hepatitis B and C, but again, not hepatitis A which is not primarily transmitted through sexual contact. Educationally, this question highlights the importance of understanding the social determinants of health and how they influence the risk of communicable diseases in different populations. It emphasizes the need for community health nurses to identify vulnerable groups and tailor interventions to address specific risk factors for effective disease prevention and control.