HESI community Evolve

Which type of crisis has occurred when a sudden terrorist act causes the deaths of thousands of adults and children and negatively affects their families, friends, communities, and the nation? - Situation-maturational - Situational - Maturational - Adventitious

Adventitious Rationale: An adventitious crisis is a crisis or disaster that is unplanned and accidental; its subcategories include natural disasters, national disasters, and crimes of violence. A situational-maturational crisis is not a typical category. If 2 events occurred around the same time - for example, retirement (maturational crisis) and the unexpected death of a spouse (situational crisis) - the client would have to deal with both issues. A situational crisis results from an external source and the loss if often unexpected. A maturational crisis occurs as an individual moves into a new stage of development and prior coping styles are no longer effective; maturational crises are usually predictable.

Which activity by the community nurse is an illness prevention strategy? - Encouraging the client to exercise daily - Arranging in an immunization program for chickenpox - Teaching the community about stress management - Teaching the client about maintaining a nutritious diet

Arranging in an immunization program for chickenpox Rationale: An illness prevention program protects people from actual or potential threats to health.

Which nursing activities are examples of primary prevention? Select all that apply. - Preventing disabilities - Correcting dietary deficiencies - Establishing gals for rehabilitation - Assisting with immunization programs - Facilitating a programs about the dangers of smoking

Assisting with immunization programs Facilitating a programs about the dangers of smoking Rationale: Preventing disabilities is a tertiary prevention. Correcting dietary deficiencies is a secondary intervention. Establishing goals for rehabilitation is a tertiary intervention.

The nurse is teaching a parenting class. Which suggestion would the nurse make about managing the behavior of a young school-age child? - Avoid answering questions - Give the child a list of expectations - Be consistent about established rules - Allow the child to plan the day's activities

Be consistent about established rules Rationale: Because of a child's short attention span and distractibility, consistent limit time stetting by parents is essential toward providing an environment that promotes concentration, prevents confusion, and minimizes conflicts. Questions should be answered, but the answers should not be judgmental. A list of expectations may be overwhelming at this age. Parents need to assist children with routine tasks; children this age may not be concerned with time frames.

How does the nurse play the role of a "change agent" in a community-based nursing practice? - By helping clients identify and clarify health problems - By establishing relationships with community service orgaizations - By establishing an appropriate plan of care, based on assessment of clients - By identifying and implementing new and more effective approaches to problems

By identifying and implementing new and more effective approaches to problems Rationale: As a change agent, the nurse can empower individuals and their families to creatively solve problems or become instrumental in creating change within a health care agency. Nurses act as managers when they ask clients to identify and clarify health problems. Nurses act as educators when they establish relationships with community service organizations. Nurses act as counselors when they establish an appropriate care plan based on the client's assessment.

Which point about community health nursing made by the student nurse needs correction? - The focus is on preserving, protecting, promoting, or maintaing health - The emphasis is to improve the quality of health and life within the community - Community health nursing does not provide direct or indirect care services to subpopulations in a community - Community health nursing can be described as nursing practice in the community, with the primary focus being the health care of individuals, and groups in that community

Community health nursing does not provide direct or indirect care services to subpopulations in a community

Which avoidance instruction would the public health clinic nurse use to teach prevention of toxoplasmosis? - Contact with cat feces - Exposure to heavy metals - Ingestion of freshwater fish - Excesive radiation exposure

Contact with cat feces

The nurse is teaching first aid to a group of community members. A participant asks which first aid should be administered, after calling 911, to a person who suffers extensive burns. Which response by the nurse is appropriate? - Apply ice to burned areas because this decreases pain - Cover the burned areas with a bed sheet because this provides protection - Do nothing because attempting to treat the burned areas may cause further damage - Use first aid cream to burned areas because this prevents infection and decreases pain

Cover the burned areas with a bed sheet because this provides protection Rationale: The appropriate response is to cover he newly burned skin areas with a clean, dry bed sheet while awaiting emergency assistance and after calling 911. This will provide protection by limiting contamination by microorganisms and preventing exposure to air, which increases pain. Ice can cause additional tissue damage. Doing nothing does not meet the individual's immediate needs. Cream is difficult to remove and may result in additional charge.

Which preventive and primary care service provided by a community health center is most expensive? - Running errands - Health education - Disease management - Routine physical examinations

Disease management Rationale: Running errands is relatively inexpensive, because the cost is merely the cost of transportation.

Which competencies are important in rural settings? Select all that apply. - Spiritual values - Emergency care - Family dynamics - Physical assessment - Clinical decision-making

Emergency care* Physical assessment* Clinical decision-making Rationale: A shortage of health care resources in rural areas is a serious problem, and most rural hospitals experience a shortage of primary health care providers. Nurses in rural hospitals must be competent to provide emergency care for clients until they are stabilized and transferred to a bigger hospital. The nurse in rural health care setting must be competent in physical assessment, which includes comprehensive data collection pertinent to the clients health. The nurse would be competent in applying evidence-based practice for making appropriate clinical decisions.

Which suggestion by the nurse is an example of primary prevention? - Engage in daily physical exercise - Get yearly physical examinations - Attend hypertension screening programs - Read about how to prevent diabetes complications

Engage in daily physical exercise Rationale: Primary prevention activities are directed toward promoting a healthy lifestyle and increasing the level of well-being, like engaging in daily physical exercise. Performing yearly physical examinations and providing hypertension screening programs are secondary preventions. Teaching a person with diabetes how to prevent complications is a tertiary prevention.

Two siblings who live in a camp for migrant workers have contracted measles. The nurse, trying to determine which individuals has contact with the children, identifies those with immunity and assesses the probability of containing the measles to the camp. Which technique has the nurse used in managing this situation? - Nursing process - Incidence process - Probability process - Epidemiological process

Epidemiological process Rationale: Epidemiological process is a term given to the set pattern of procedures followed in the community when the health of the public is threatened b a communicable disease. The nursing process may be used as part of the investigation, but the scope of the problem extends beyond nursing.

Which role is the nurse expected to have in a community-based nursing practice if there is a sudden spread of malaria? - Educator - Collaborator - Epidemiologist - Client advocate

Epidemiologist Rationale: As an educator, the nurse provides knowledge to clients and families so that they can learn how to care for themselves. As a collaborator, the nurse collaborates with hospice staff, social workers, and pastoral care to initiate a plan to support end-of-life care for the client and support the family. As a client advocate, the nurse provides necessary inforation for clients to make informed decisions in choosing and using services.

The nurse is analyzing and explaining the demographics of a population under research. Which phase of the nursing process is the nurse exercising when analyzing and explaining the demographics of a population under research? - Diagnosis phase - Evaluation phase - Assessment phase - Implementation phase

Evaluation phase Rationale: During the diagnosis phase, the nurse develops hypotheses related to the medication study. During the assessment phase, the nurse formulates the theoretical framework, reviews the literature, and identifies the study variables. During the implemnetation phase, the nurse obtains the necessary approvals, recrutis subject, and implemet the study protocol.

Which services do community health care provide in preventive and primary care services? Select all that apply. - Daycare - Health screenings - Physical assessments - Disease management - Acute and chronic care management

Health screenings* Physical assessments* Disease management Rationale: Day care and acute and chronic care management services are provided by nurse-managed clinics.

The nurse is instructing a community group regarding risk factors for coronary artery disease. Which risk factor cannot be modified? - Heredity - Hypertension - Cigarette smoking - Diabetes mellitus

Heredity

The nurse is caring for a client who has been sleeping for 12 to 14 hours on weekend nights. The nurse instructs the client to sleep for no longer than 9 hours because excessive sleeping can lead to health issues. Which reaction might the nurse expect if the client is in the maintenance stage? - I've been following a proper sleep pattern for more than a year - I like to sleep; that's why I doze. I just don't care about all this health advice. - I've tried to follow a proper sleep routine, but I end up sleeping for more than 12 hours - Please suggest a regimen that can help me stay awake or will help me normalize my sleep pattern

I've been following a proper sleep pattern for more than a year Rationale: If the client says that they doze becasue they like to sleep, this reflects the precontemplation stage. If the client says that they are trying to follow a proper sleep routine but still end up sleeping for more than 12 hours, this describes the action stage. If the client asks the nurse to suggest a regimen that can help them stay awake or normalize sleep patterns, this reflects the preparation stage

The nurse is teaching campfire safety to a group of community members and includes information about what to do if a person catches on fire. The nurse teaches the most effective method for putting out the flames. Which information from the group members indicates successful learning? - Wrap hand with towel and slap at the flames - Instruct the victim to roll on the ground. - Pour cold liquid over the flames - Remove the victim's burning clothes

Instruct the victim to roll on the ground. Rationale: STOP, DROP, AND ROLL

The nurse administers a pneumococcal vaccine to a 70-year-old-client. The client asks, " Will I have to get this every year like I do with the flu shot?" How would the nurse respond? - You need to receive the pneumococcal vaccine every other year - The pneumococcal vaccine should be received in early autumn every year - You should get the flu and pneumococcal vaccines at your annual physical examination - It is unnecessary to have any follow-up injections of the pneumococcal after this dose

It is unnecessary to have any follow-up injections of the pneumococcal after this dose Rationale: The CDC recommend that adults be immunized with pneumococcal vaccine at age 65 years or older with a single dose of the vaccine. If the pneumococcal vaccine was received before 65 years of age, or if there is the highest risk of fatal pneumococcal infection, revaccination should occur 5 years after the initial vaccination.

Which characteristic is most common to those living in poverty? - Open expression of anger - Long-term feeling of powerlessness - Willingness to postpone gratification - Compliance with health recommendations

Long-term feeling of powerlessness

A senior high school student, whose immunization status is current, asks the school nurse which immunizations will be included in the precollege physical. Which vaccine should the nurse tell the student to expect to receive? - Hepatitis C (HepC) - Influenza type B (HIB) - Measles, mumps, rubella (MMR) - Diphtheria, tetanus, pertussis (DTaP)

Measles, mumps, rubella (MMR) Rationale: Individuals born after 1956 should receive an additional dose of MMR vaccine if they are students in postsecondary educational institutions. Currently there is no vaccine for hepatitis C. The HIB immunization is unnecessary. If the student received an additional DTaP at age 12, it is not necessary. A booster dose of tetanus toxoid should be received every 10 years.

What purpose does a community health center serve in preventive and primary care services? - Outpatient clinics that provide primary care to a specific population - Aim to increase worker productivity, decrease absenteeism, and reduce the use of costly medical care - Emphasize program management, interdisciplinary collaboration, and community health principles - Include a complete program designed for health promotion and accident or illness prevention in the workplace

Outpatient clinics that provide primary care to a specific population Rationale: Community health centers are outpatient clinics that provide primary care to a specific population, such as clients with young children or clients with diabetes.

The nurse is teaching a birthing/parenting class about breast-feeding. Which hormone stimulates the production of milk during lactation? - Inhibin - Estrogen - Prolactin - Progesterone

Prolactin Rationale: Inhibin prevents the secretions of follicle-stimulating hormone and gonadotropin releasing hormone. Estrogen and progesterone are the sex hormones produces by the ovaries

Which characteristic makes a crisis access hospital (CAH) different from an intensive care unit (ICU)? - Offers 24-hour emergency care - Offers health care to acutely ill people - Provides temporary care for 96 hours or less - Provides the most expensive health care delivery

Provides temporary care for 96 hours or less Rationale: A CAH is a rural hospital that provides temporary care for 96 hours or less to stabilize clients before they are transferred to a larger hospital. An ICU or critical care unit is a hospital unti it which clients receive close monitoring and intensive medical care. Both CAH and ICU offer 24-hour emergency care. The CAH and ICU care for acutely ill clients by monitoring them on multiple devices. An ICU is the most expensive health care delivery site, because the nurse cares for only or two clients at a time.

Which services do block and parish nursing provide for preventive and primary care services? (Select all that apply.) - Respite care - Running errands - Homemaker aides - Routine physical examination - Communicable disease control

Respite care, Running errands, Homemaker aides Rationale: Routine physical examinations are provided by a primary health care provider's office. Communicable disease control services are provided by occupational health.

The son of a migrant farm workers has no history of immunizations an is brought to the county health clinic. After measles is diagnosed, the public health nurse goes to the migrant camp to search for people with a greater-than-average chance of contracting the disease. Which terminology is the name of this variable? - Risk factor - Frequency rate - Probability rate - Causative factor

Risk factor Rationale: Risk factor is the term given to those factors that identify the target population, so community resources may be used in the best interest of all. Frequency rate is how frequently measles occurs in migrant workers camp. Probability rate is possibility of incidence. Causative factor is the term used for the casue of a given disease if it is known.

Which activities would the nurse include when teaching adults about activities that increase the risk of developing bladder cancer? Jogging 3 miles a day Drinking three cans of soda a day Smoking two packs of cigarettes a day Working with dyes used in rubber every day Using a jackhammer and chainsaw every day

Smoking two packs of cigarettes a day Working with dyes used in rubber every day Rationale: The occurence of bladder cancer is related to smoking. Dyes in rubber and hair dyes are environmental carcinogens; working with them daily increases an individual's risk of bladder cancer.

Which resource or facility has enabled rural hospitals to have increased access to specialist consultations? - Medicare - Medicaid - Telemedicine - Critical access hospital

Telemedicine Rationale: uses advanced tech to connect rural hospitals to specialists for consultation. Medicare is for people 65 years of age or older. Meidcaid provides health insurance to low income families. Critical assess hospitals are rural hopitals with no more than 25 inpatient beds.

A community healthcare nurse is conducting a survey about homeless children in the community. Which finding helps the nurse distinguish absolute homelessness from relative homelessness? -The children are under-immunized and at risk for childhood illness - The children are more likely to drop out of school - The children have access to health care only through the emergency department - The children do not have a physical shelter and may sleep outdoors or in vehicles.

The children do not have a physical shelter and may sleep outdoors or in vehicles. Rationale: Absolute homelessness to describe people who have no physical shelter. These children sleep outdoors, in vehicles, abondoned buildings, or other places not intended for human habitation. Relative homelessness describes those who have a physical shelter but one that does not meet the standards of helath and safety.

Which goal is the main focus of community health nursing? - To meet the acute care needs of a population - To improve the quality of health in a population - To influence political processes affecting public policies - To assess the health care needs of an individual or family

To improve the quality of health in a population

Which topic is most important for the nurse to teach in a community health promotion class for middle-aged adults? - Tobacco cessation - Infection prevention - Alcohol abstinence - Pain management

Tobacco cessation Rationale: Smoking is a major risk factor for cardiovascular disease and hypertension, major health problems of middle-age adults. Middle-aged adults are not at greater risk for infection. Alcohol intake should be limited, but total abstinence is not required for prevention of health problems. HDL levels should be increased to help prevent cardiovascular disease.

Which instruction is beneficial for an aging Black client with hypertension? - " Check the pulse daily." - "Have an annual urinalysis." - "Record blood pressure weekly." - "Visit an ophthalmologist monthly."

"Have an annual urinalysis." Rationale: Blacks have 20% less blood flow to the kidneys because of high sodium consumption. This causes anatomical changes in the blood vessels, thereby increasing the risk of kidney failure. If the client has high protein in the urine, this is as sign of high blood pressure and can signify kidney damage. If the client has an eye-related problem, visiting an ophthalmologist should be suggested, but it is usually not monthly.

Which of these actions would the nurse perform to provide preventive and primary care to adults during a health camp? Select all that apply. - Discussing vaccinations - Discussing family planning - Mentioning adult daycare services - Instructing the health camp about self-care at home - Instructing the health camp about road safety measures

- Discussing vaccinations - Discussing family planning - Instructing the health camp about road safety measures Rationale: Day care services and instructions about self-care are associated with restorative care.

Which action does a community-based nurse do as a change agent? Select all that apply. - Empowers clients and their families to creatively solve problems - Works with clients to solve problems and helps clients identify an alternative care facility - Helps clients gain the skills and knowledge needed to provide self-care - Empowers clients to become instrumental in creating change within a health care agency - Does not make decisions but helps clients reach decisions that are best for them

- Empowers clients and their families to creatively solve problems - Works with clients to solve problems and helps clients identify an alternative care facility - Empowers clients to become instrumental in creating change within a health care agency Rationale: As an educator, the nurse helps clients gain the skills and knowledge needed for self-care. As a counselor, the nurse does not make decisions, but rather helps clients reach decisions that are best for them.

Health promotion efforts within the healthcare system should include efforts related to secondary prevention. Which activities reflect secondary prevention interventions in relation to health promotion? Select all that apply. - Encouraging regular dental checkups - Facilitating smoking cessation programs - Administering influenza vaccines to older adults - Teaching the procedure for breast self-examination - Referring clients with a chronic illness to a support group

- Encouraging regular dental checkups - Teaching the procedure for breast self-examination Rationale: Encouraging dental checkups is a secondary prevention activity because it emphasizes early detection of health problems, such as a dental caries and gingivitis. Teaching the procedure for breast self-examination is a secondary prevention activity because it emphasizes early detection problems of the breast, such as cancer. Primary: Facilitating smoking cessation programs because it emphasizes health protection against heart and respiratory diseases. Administering influenza vaccines because it emphasizes health protection against influenza. Tertiary: Referring clients with a chronic illness because it emphasizes care that is provided after illness already exists.

The nurse advises the client who drinks large amounts of coffee to avoid coffee because caffeine can have adverse effects on health. Arrange the responses in the order that the client might demonstrate while passing through the stages of health behavior change? - I am planning to quit coffee, but it will take some time - I have been drinking just a cup a day for the past several months - I have been drinking coffee for the past 10 years and haven't had any health problems - I am trying to trade coffee for green tea, but the tea doesn't taste good, so I still want coffee - I know that too much coffee can cause problems, but it heps me stay alert and focused on my work

- I have been drinking coffee for the past 10 years and haven't had any health problems - I know that too much coffee can cause problems, but it helps me stay alert and focused on my work - I am planning to quit coffee, but it will take some time - I am trying to trade coffee for green tea, but the tea doesn't taste good, so I still want coffee - I have been drinking just a cup a day for the past several months

The nurse notes that a client is in the habit of skipping breakfast and lunch and educates the client on the harmful effects of not getting enough nutrition. Which responses are signs that the client has reached the action stage of health behavior change? Select all that apply. - I still tend to skip breakfast when I'm in hurry to get to work - I can't compromise my carrier for the sake of good eating habits - I know that it's not good to skip meals, but my health seems fine - I have been having my breakfast and lunch on time for the past 6 months - I follow a proper eating schedule, but sometimes it gets in the way of my work

- I still tend to skip breakfast when I'm in hurry to get to work - I follow a proper eating schedule, but sometimes it gets in the way of my work Rationale: In the pre-contemplation stage, the client does not intend to make any changes in health behavior in the next 6 months. A client in the contemplation stage of health behavior will be more likely to accept the information. When a client has been having breakfast and lunch on time for the past 6 months, it indicates the change in health behavior has lasted quite some time, and the client is in the maintenance stage.

Which comment would the nurse say to the clinet who is not fluent in the language the nurse is speaking to initiate appropriate communication? Select all that apply. - Please tell me about the health care practices and beliefs of your community - Let me bring in an interpreter to help you understand the medical procedures better - I would like to know your personal beliefs regarding health care traditions and practices - Please let me explain our traditions and cultural practices to help you understand our health care practices - I have read up extensively about the health care practices of your community and have designed a care plan accordingly

- Please tell me about the health care practices and beliefs of your community - Let me bring in an interpreter to help you understand the medical procedures better - I would like to know your personal beliefs regarding health care traditions and practices

Which interventions should the nurse take to ensure the well-being of a community-dwelling older adult with hypertension? Select all that apply. - Suggest that the client have pap smears and mammograms - Promote dietary modifications by using varied techniques - Assess the client's current lifestyle and promote lifestyle changes - Monitor the client's blood pressure and weight, and establish blood pressure screening programs - Teach the client about correct body mechanics and the availability of mechanical appliances

- Promote dietary modifications by using varied techniques - Assess the client's current lifestyle and promote lifestyle changes - Monitor the client's blood pressure and weight, and establish blood pressure screening programs

Which points would the nurse remember when caring for a client who has a history of suicide attempts? Select all that apply. - The nurse should document the measures taken to prevent suicides. - If the client makes a suicide attempt in the hospital, this action may lead to a lawsuit. - The client may be detained for 21 days if a judge grants an involuntary detention - The primary health care facility will be responsible for failing to provide adequate supervision. - File paperwork with the court within 96 hours of the client's admission to the facility

- The nurse should document the measures taken to prevent suicides. - If the client makes a suicide attempt in the hospital, this action may lead to a lawsuit. - The primary health care facility will be responsible for failing to provide adequate supervision.