HESI RN Community and Population Health Final Exam

HESI RN Community and Population Health Final Exam

Total Questions : 56

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Question 1: View

According to the Centers for Disease Control and Prevention, which diseases are reportable infectious diseases? Select all that apply.

Explanation


(A) Pediculosis: Pediculosis, commonly known as head lice, is not typically classified as a reportable infectious disease. While it is a public health concern, it does not fall under the list of diseases required to be reported to health authorities by the CDC.

(B) Bacterial conjunctivitis: Bacterial conjunctivitis, or pink eye, is not generally considered a reportable infectious disease. Although it is infectious and can spread easily, it is not usually mandated for reporting to public health authorities.

(C) Anthrax: Anthrax is a serious infectious disease caused by the bacterium Bacillus anthracis. It is considered a reportable disease due to its potential for serious public health implications, including the possibility of bioterrorism.

(D) Diphtheria: Diphtheria is a potentially life-threatening bacterial infection caused by Corynebacterium diphtheriae. It is reportable because of its severity and the need for public health intervention to control outbreaks.

(E) Tuberculosis: Tuberculosis (TB) is a serious bacterial infection caused by Mycobacterium tuberculosis. It is reportable due to its potential to cause widespread outbreaks and its significant public health implications, requiring ongoing monitoring and control measures.


Question 2: View

Community health nurses are particularly concerned with the spread of communicable diseases such as hepatitis A. Which group of Individuals should the nurse identify as being at greatest risk for contracting this type of hepatitis?

Explanation

A. Low income families living in cramped quarters: Hepatitis A is primarily spread through the fecal-oral route, often through contaminated food or water. Individuals living in overcrowded or unsanitary conditions are at a higher risk due to the increased likelihood of exposure to contaminated sources and poor hygiene practices. Thus, low-income families living in cramped quarters are particularly vulnerable to hepatitis A.

B. Sexually active persons with multiple partners: While hepatitis B and C are more commonly associated with sexual transmission, hepatitis A is less commonly spread through sexual activity. Hepatitis A transmission is more directly related to poor sanitation and hygiene rather than sexual behavior alone.

C. IV drug users who share needles: Intravenous drug users who share needles are at high risk for hepatitis B and C, not hepatitis A. Hepatitis A is not typically transmitted through blood but rather through contaminated food and water.

D. Those who have recently received a blood transfusion: Hepatitis A is not transmitted through blood transfusions. Hepatitis B and C are the types of hepatitis associated with blood transfusions. Hepatitis A is spread through ingestion of contaminated food or water.


Question 3: View

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

Explanation

A. Renal insufficiency: While annual screening for renal insufficiency is important for individuals with diabetes to detect early signs of diabetic nephropathy, it is not as directly related to the immediate risks associated with smoking and family history of heart disease.

B. Peripheral neuropathy: Screening for peripheral neuropathy is essential for diabetes management, but it is not the most critical in the context of the client's smoking history and family history of early heart disease.

C. Hyperlipidemia: Given the client’s significant risk factors—including smoking two packs of cigarettes daily and a family history of early cardiovascular events—it is crucial to screen for hyperlipidemia. Smoking and a family history of early heart attack both increase the risk of cardiovascular disease, which is often associated with high cholesterol levels. Addressing hyperlipidemia can help mitigate the risk of cardiovascular complications.

D. Retinopathy: Screening for diabetic retinopathy is important for managing diabetes and preventing vision problems. However, in the context of the client's smoking and family history, addressing hyperlipidemia is a more immediate concern related to cardiovascular health.


Question 4: View

Which annual screening should the nurse include when planning an eye health program at a preschool?

Explanation

A. Glaucoma:
Glaucoma is generally a concern for older adults rather than preschool-aged children. Screening for glaucoma typically starts later in life when the risk for this condition increases.

B. Red light reflex:
The red light reflex test is used primarily in infants and very young children to screen for conditions such as cataracts and retinoblastoma. While important, it is not usually the primary focus of annual screenings in preschool settings, which typically emphasize visual acuity.

C. Visual acuity:
Visual acuity screening is crucial for preschool-aged children to identify any issues with vision that could affect their development and learning. It helps detect problems like amblyopia (lazy eye) or refractive errors that need early intervention.

D. Conjunctivitis:
Conjunctivitis, or pink eye, is a common condition but is not typically part of routine annual eye health screenings. It is more relevant to address conjunctivitis as it arises rather than as part of an annual screening program.


Question 5: View

A nurse is interested in studying the incidence of infant death in a particular city and wants to compare that city's rate to the state's rate. Which state resource should the nurse select to gather this information?

Explanation

A. Census data:
Census data provides demographic information about populations, such as age, sex, and ethnicity, but it does not typically provide detailed statistics on specific health outcomes like infant death rates.

B. Bureau of Vital Statistics:
The Bureau of Vital Statistics collects and maintains data on vital events such as births, deaths, marriages, and divorces. This resource would provide the most accurate and comprehensive data on infant mortality rates for comparison between cities and the state.


C. Disease registry:
Disease registries track specific diseases and conditions, but they are not typically used for gathering data on general statistics such as infant death rates. They are more focused on chronic or specific conditions.

D. Department of Health:
While the Department of Health can provide a wide range of health-related information and data, the Bureau of Vital Statistics is the specific resource for detailed and accurate mortality data. The Department of Health may use this data but does not typically maintain it directly.


Question 6: View

The nurse is caring for a client with gonorrhea. The client reports having sex with multiple partners. Which response should the nurse provide?

Explanation

A. Emphasize that using safe sex practices removes the risk of sexually transmitted infections (STIs):
While safe sex practices significantly reduce the risk of STIs, they do not eliminate it entirely. It is important to communicate that while the risk is reduced, it is not completely absent.

B. Clarify that all sexually transmitted infections (STIs) are transmitted through sexual intercourse:
This statement is not entirely accurate. While most STIs are transmitted through sexual intercourse, some can also be spread through other means, such as blood contact or from mother to child during childbirth.

C. Discuss that partners without similar symptoms may not be infected:
STIs like gonorrhea can be asymptomatic in many individuals, meaning they can still transmit the infection to others even if they do not show symptoms. This response could be misleading, as it may cause the client to mistakenly believe that partners without symptoms are not at risk.

D. Instruct the client on the importance of notifying sexual partners:
It is crucial for the client to notify all sexual partners about the infection so that they can be tested and treated if necessary. This helps prevent the further spread of the infection and ensures that partners receive appropriate care.


Question 7: View

The parish nurse notes that an older adult client has had a 5 lb (2.3 kg) weight loss since a 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?

Explanation

A. The Senior Citizen Center: The Senior Citizen Center is a resource that offers a variety of services to older adults, including social activities, meal programs, and support services. Given the client's recent weight loss and living alone, referring them to the Senior Citizen Center could provide access to resources and support that might help address potential underlying issues such as social isolation or inadequate nutrition.

B. The Social Security Administration office: The Social Security Administration (SSA) office handles matters related to social security benefits, such as retirement, disability, and survivor benefits. While important, it does not provide the kind of immediate support and services related to the client's weight loss and daily needs.

C. The Adult Day Care Center: The Adult Day Care Center provides daytime care and activities for older adults who need supervision or assistance during the day. Since the client drives and lives alone, this may not be the most appropriate referral unless there are additional concerns about daily supervision or care needs.

D. The Women, Infant, and Children (WIC) office: The WIC program provides nutrition assistance to low-income pregnant women, new mothers, and young children. It is not relevant for older adults, so this would not be the appropriate agency for addressing the client’s needs related to weight loss.


Question 8: View

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

Explanation

A. Rescreen the entire prison population in 6 weeks:
While rescreening may be necessary at some point, it is not the immediate priority. The focus should be on diagnosing and managing the individuals who have already tested positive.

B. Start the two inmates on antitubercular medications:
Starting antitubercular medications is important, but it should only be done after confirming that the individuals have active TB. The positive skin test indicates exposure but does not confirm active TB disease.

C. Refer the two inmates for chest x-rays:
A chest x-ray is crucial to determine whether the positive skin test indicates active TB disease or latent TB infection. This step is essential for accurate diagnosis and appropriate management. It helps distinguish between active TB, which requires treatment, and latent TB, which may require different management strategies.

D. Screen the prison guards for TB:
While screening the prison guards could be a part of a broader infection control plan, it is not the most immediate priority. The focus should be on further evaluating and managing the inmates who have tested positive.


Question 9: View

An adolescent tells the school nurse that she is pregnant. Her last menstrual period was 4 months ago, and she has not yet received any medical care. She smokes but denies any other substance use. Which interventions should the nurse implement? (Select all that apply.)

Explanation

A. Encourage smoking cessation:
Smoking during pregnancy can have serious consequences for both the mother and the fetus, such as increased risks of preterm birth, low birth weight, and developmental issues. Encouraging smoking cessation is crucial for improving both maternal and fetal health.

B. Arrange for childcare:
While childcare is an important consideration, it is not an immediate priority at this stage. The focus should be on ensuring the adolescent receives proper prenatal care and support for her health and the health of the baby.

C. Offer nutritional instruction:
Good nutrition is vital for a healthy pregnancy. Offering nutritional instruction helps the adolescent understand how to meet her dietary needs and those of her developing baby, contributing to better pregnancy outcomes.

D. Refer for prenatal care:
Prenatal care is essential for monitoring the health of both the mother and the fetus, providing necessary medical interventions, and offering support. Referring the adolescent for prenatal care is critical for addressing her medical needs throughout her pregnancy.

E. Teach breastfeeding methods:
While teaching breastfeeding methods is important, it is not the most immediate concern. This can be addressed later in the pregnancy or closer to delivery when the adolescent is more prepared to consider breastfeeding.

F.Notify her parents:
Unless the adolescent gives explicit consent or there are concerns for her safety or the safety of the baby, the nurse should maintain confidentiality. In many cases, the decision to notify parents is complex and requires careful consideration of the adolescent's autonomy and legal rights.


Question 10: View

A community health nurse is helping a group of nursing students plan a tertiary prevention program for a local community clinic that serves a majority Hispanic population. Which service project meets the requirement of a tertiary prevention program and would best serve this population?

Explanation

A. Teach clients about recommended immunizations for children:
Teaching about immunizations is a form of primary prevention, as it aims to prevent diseases before they occur. It is not classified as tertiary prevention.

B. Instruct teens about prevention of sexually transmitted diseases:
Instructing about the prevention of sexually transmitted diseases (STDs) is a form of secondary prevention. It focuses on preventing the spread of disease and identifying it early.

C. Take blood pressures at a local shopping mall in the community:
Measuring blood pressure is an example of secondary prevention, which involves screening for health issues to detect them early. It does not fall under tertiary prevention, which focuses on managing existing conditions.

D. Demonstrate foot care to a group of clients who have diabetes:
Demonstrating foot care to clients with diabetes is an example of tertiary prevention. It involves managing and preventing complications in individuals who already have a chronic condition (diabetes). This helps in minimizing the impact of the disease and improving the quality of life for those affected.


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