Community

RN HESI Study
Questions
~Multiple versions
included~
1. During a two-week postoperative follow-up home visit, a female client who had gastric
bypass surgery exhibits abdominal tenderness, shoulder pain, and describes feelings of
malaise. Her vital signs are: temperature 101.8°F, blood pressure 100/50, heart rate 104
beats/minute, and respirations 18 breaths/minute. Which action should the nurse take?
a. Determine the client’s current oxygen saturation rate.
b. Instruct the client to drive to the hospital for admission
c. Recheck the client’s vital signs in 30 minutes
d. Have the client transported via ambulance to the hospital
2. An older man has become increasingly forgetful, frequently eats large quantities of food
from refrigerator, and cannot remember when he takes his medications. He has limited
mobility to weight-related osteoarthritis in both knees. When assisting the client’s wife
with a plan care for the home, which interventions should the nurse suggest? (Select all
that apply.)
a. Request a referral for motorized wheelchair to assist with mobility.
b. Keep a variety of fresh fruits and vegetables that are easily accessible.
c. Put medications into a container that organized the pills by the day and time.
d. Encourage participation in televised exercise classes to help strengthen
muscles.
e. Post a sign on refrigerator reminding the client not to eat between meals.
3. The school nurse is assessing heights, weights, and body mass indexed (BMI) of the
students who are entering high school. Because a majority of the students are found to
be overweight, the nurse plans to develop a program that addresses obesity in this age
population. Before initiating this program, what additional information is most
important for the nurse to obtain?
a. The history of obesity education in the community
b. The level of parental concern regarding childhood obesity
c. The demographic data for the student population
d. An activity report from the physical education department
4. The epidemiological triad can be used to frame strategies for the prevention of farm
machinery injuries. Which action should the nurse take to focus on the agent?
a. Teach farm workers not to smoke around farm equipment
b. Work with legislators to mandate safe tractor design
c. Translate written vehicle instructions into picture format
d. Provide rehabilitation services to injured farm hands
5. The public health nurse is creating a plan to increase state funding for a local health
clinic. Which strategy is likely to be most effective in obtaining funding for the clinic?
a. Run the health clinic economically and advertise the services the clinic provides
b. Organize concerned citizens to write letters and telephone state representatives
 c. Described to the media the valuable services provided by the community clinic
d. Engage a professional lobbyist to persuade Congress of the local clinic’s value
6. The nurse is documenting the medical history of a young adult male client who was
recently diagnosed with Type 1 diabetes mellitus (DM). He smokes 2 packs of cigarettes
daily and his father died of a heart attack at the age of 45. Which annual screening is
most important for the nurse include?
a. Peripheral neuropathy
b. Renal insufficiency
c. Retinography
d. Hyperlipidemia
7. The nurse provides teaching to a group of evacuees in a mass casualty center after a
natural flooding disaster. Which information should the nurse including in the teaching
plan? (Select all that apply.)
a. Wash all fruits and vegetables thoroughly in running tap water.
b. Identify all sexual contacts since the evacuation process
c. Take all doses of prophylactic prescriptions for diarrhea
d. Clean hands using soap, clean water, or waterless antibacterial solutions
e. Drink only boiled water or bottled oral rehydration solutions
8. A nurse is planning a nutrition class for a group of senior citizens at a community center
and wants to emphasize the amount and types of fat in some foods versus others. What
is the best teaching method for the nurse to use?
a. Display posters with foods and tell seniors about fat content
b. Determine foods most often eaten by this group and discuss the nutritional
panel of each product
c. Show a movie about cooking with foods that are low in fat but delicious
d. Ask each senior to bring a food for others to taste, then estimate the fat
contained in these foods
9. An adult male who has diabetes is laid off from his job of 15 years where he had health
care benefits. By law, he is provided with Consolidated Omnibus Budget Reconciliation
Act (COBRA) benefits. What is likely to be his greatest concern in planning for his health
care during the next year?
a. Paying for his health care
b. Obtaining quality medical care
c. Selecting a primary care provider
d. Having required lab work completed
10. A prescription for discharge is written for an elderly female client who has asked to be
discharged to her home. The client lives alone and is able to walk 10 to 15 feet with
assistance. What action should the nurse implement first?
a. Review the home medication schedule with the client and family
b. Arrange for a bedside commode to be delivered to the home
c. Meet with the case manager to plan a home safety evaluation
d. Provide the client with information about medical alert devices
11. The nurse at a migrant health center notes an increased incidence of dermatitis in
seasonal farm workers at a local fruit farm. In response to this finding, it is most
 important for the nurse to obtain which information as a part of a community
assessment?
a. Availability of fresh water for washing hands after work
b. Air pollution levels in the surrounding community
c. Number of hours of worker’s exposure to direct sunlight
d. Percentage of poisonous plants in the work fields
12. A teenage boy with a history of recurring atopic dermatitis (eczema) tells the school
nurse that he wants to play high school football. Which action should the nurse take?
a. Encourage the teenager to join the swim team instead of the football team
b. Notify the parents of problems associated with perspiration for those with
eczema
c. Tell the teenager to shower with a non-perfumed soaps immediately after
practice
d. Inform the football coach of the teenager’s skin condition and its manifestations.
13. The wife of an older adult man who has had diabetes mellitus for the past 10 years
reports to the home health nurse that her husband fell yesterday while taking his daily
walk in the neighborhood. He has a bruised hand and a small abrasion on his left knee.
The nurse assess that his neurologic vital signs are stable. To reduce risk for future falls,
which assessment is most important for the nurse to obtain?
a. Current blood sugar level
b. Degree of paresthesia in feet
c. Wound healing of knee abrasion
d. A1c glycosylated hemoglobin
14. The home health nurse visits a young male client with AIDS who has Kaposi’s sarcoma
and peripheral neuropathies. His parents, who are the care-takers, tell the nurse that
their son sleeps most of the times. The nurse assess that the client is semi-conscious
with stable vital signs, cries out in pain when turned or moved, has a Duragesic pain
patch in place, and skin lesions that are closed and dried. Which intervention should the
nurse implement?
a. Remove the Duragesic patch as directed by prescription
b. Give a complete bed bath to further assess the client
c. Discuss end-of-life decisions with the client’s parents
d. Call for ambulance transportation to the hospital immediately
15. An assessment conducted last year of the health needs of children who attended a
middle school indicated that bicycle injuries were a priority problem, so the nurse
developed a bicycle safety program. Six weeks after completion of the program, a
survey was sent to parents and students. Which finding is the best indicator that the
program was effective?
a. The number of students wearing bicycle helmets increased by 10%
b. 50% of the parents reported that their children are aware of bicycle safety
c. The number of students riding bicycles to school increased by 25%
d. 80% of the parents identified the need for an annual bicycle safety program
16. The nurse is planning a series of health screening programs for elderly African-
Americans. Which health problem should the nurse target for this population?
 a. Peripheral vascular disease
b. Sickle cell anemia
c. Decreased visual acuity
d. High blood pressure
17. The nurse is serving on a medical center committee to update goals and protocols based
on current national standards. Which goal most directly addresses the Healthy People
2020 initiative?
a. Decrease incidence of professional boundary violations
b. Reduce emergency room wait times for indigent clients
c. Encourage the use of the 5 rights of delegation
d. Standardize communication for shift-to-shift report
18. A homeless client with alcohol dependency will be dismissed from the emergency
department in 24 hours. The nurse notes that a tuberculin skin test was prescribed by
the healthcare provider. What intervention is most important for the nurse to
implement prior to discharge?
a. Identify how the client will follow-up to have the results read.
b. Give the client written information about the tuberculosis test
c. Determine if the client understands the purpose of the tuberculin test
d. Explain to the client results should be read between 48 and 72 hours
19. A Hispanic mother insists on using special candles to treat her child’s ear infection. The
nurse should demonstrate cultural accommodation by making which request?
a. Use the prescribed antibiotics and if there is no improvement, use the candles
b. Give the prescribed antibiotics in addition to using the candles.
c. Do not use the candles because of the risk of fire and subsequent burns to the
child.
d. Provide the prescribed antibiotics instead of using the candles
20. The nurse is making a home visit to female client with end stage heart disease. She has a
living will and states that she refuse to ever go back to a hospital. During the visit, the
nurse notes that the client is pale and short of breath while speaking. The nurse
discovers 3+ pitting edema in both ankles and bilateral pulmonary crackles. Which
intervention should the nurse implement first?
a. Explain the need for hospitalization
b. Obtain a peripheral oxygen saturation level
c. Elevate her feet above the level of her heart
d. Apply 2L of oxygen per nasal cannula
21. The nurse must delegate some aspects of a homebound client’s care to a home health
aide. Which intervention should the nurse delegate to the home health aide?
a. Evaluate a pressure sore
b. Apply a prosthetic device
c. Perform a sterile dressing change
d. Assess the client’s need for an elevated toilet seat
22. After assessing the health care needs of an elementary school, the nurse determines
that an increased prevalence of pediculosis capitis is a priority problem. The nurse
develops a 2-month program with the goal to eradicate the condition in the school. The
 program includes educational pamphlets sent home to parents and regular assessment
of children by the school nurse. What action should the nurse implement to evaluate
the effectiveness of the program?
a. Measure the prevalence of pediculosis capitis among the children after four
months
b. Survey parents 3 weeks after pamphlets are sent home to assess their
understanding of the condition.
c. Conduct an initial examination of each child in the school to obtain baseline data
d. Evaluate the teachers’ ability to identify pediculosis capitis 2 months after
initiation of the program
23. The nurse is conducting routine assessments of clients at an ambulatory clinic. Which
assessment warrants immediate interventions by the nurse?
a. Hepatovax B was prescribed for a client who is allergic to yeast
b. An INR of 2 was obtained for a client taking warfarin (Coumadin)
c. HIV screening was requested by a client having unprotected sex with two
individuals
d. Nafcillin (Unipen) was taken for ten days by a client whose infected wound is
healing
24. During a home visit, a client tells a home health nurse that he was recently diagnosed
with viral conjunctivitis. The client reports eye pain and swelling. What instructions
should the nurse provide?
a. Avoid straining or sneezing
b. Apply a cool compress
c. Keep the room well lighted
d. Drink plenty of fluids
25. To promote heart healthy eating during a school fair, the nurse presents information
about a “Mediterranean-based” approach to eating. To assess learning, the nurse
sponsors a contest and asks the children to create a rhyme that shows food that should
be limited. Which selection should the nurse choose as the winner of the contest?
a. Fish on a dish
b. Meats and sweets
c. Greens and beans
d. Berries and cherries
26. The public health nurse is called to investigate a report of several cases of chickenpox
(varicella virus) at a day care center. The day care worker states that five children have
been sent home over the past two weeks with fever and itchy blisters. Which
intervention should the nurse implement first?
a. Confirm the number of children with symptoms
b. Determine how many people have been exposed
c. Report the presence of a viral endemic at the day care center
d. Validate that the children sent home did develop chickenpox
27. Four students come to the school clinic simultaneously, seeking help from the school
nurse. In which order of priority should the nurse provide care to these students?
 (Arrange the client with the highest priority first, on top, and lowest priority last, on
bottom.)
a. A 7-year-old who has type 1 diabetes mellitus and is experiencing extreme
hunger and shakiness
b. A 12-year-old with history of asthma who is wheezing and complaining of
shortness of breath.
c. A 5-year-old who is crying uncontrollably because of an incontinent bowel
episode.
d. A 10-year-old with bleeding lacerations on both knees after falling in gym class.
B, A, D, C – 12, 7, 10, 5
28. The parish nurse notes that an elderly male client has had a 5 pound weight loss since
his 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?
a. The Adult Day Care Center
b. The Senior Citizen Center
c. The Women, Infant, and Children office
d. The Social Security Administration office
29. While presenting a workshop titled, “Improving Access to Health Services” to
community leaders, the community health nurse is asked by a city council member to
explain the reason for addressing this issue. Which statement provides the best
response?
a. The committee for “Healthy People 2020” has identified “access” as a national
goal
b. The Institute of Medicine includes “access” as one of its priority
recommendations.
c. The Community Health Improvement Process is used for issues in high risk
populations.
d. The Center for Disease Control has identified this problem as a variable in
morbidity
30. The school nurse is assessing a group of middle school students for signs of scoliosis and
discovers a female student with a noticeable unequal symmetry of the upper and lower
back. Which intervention is most important for the nurse to implement?
a. Make a referral to have the scoliosis further evaluated
b. Ask the student about her ability to participate in sports
c. Measure the degree of the thoracic and lumbar curvature
d. Review student’s health record for a recent growth spurt
31. A newly hired school nurse conducts a “windshield” survey of the geographic area
served by the school. Which method is best for the nurse to use to objectively validate
the findings obtained?
a. Obtain mortality data for the geographic area
b. Talk with teachers about their concerns for the students
c. Discuss with the PTA board their perception of school events
d. Review the previous school nurse’s anecdotal documents.
32. The local health department needs to prioritize the distribution of influenza vaccinations
due to a limited supply. In determining which individuals should receive the limited
available vaccine, which person should the public health nurse ask to return to the clinic
later when more vaccine is available?
a. A 60-year-old with diabetes and agoraphobia
b. An 80-year-old resident in an Alzheimer’s unit
c. A 65-year-old aide working in a nursing home.
d. An 8-year-old girl with poorly-controlled asthma
33. A nurse designs a series of four weekly classes for client with Type 2 diabetes. Which
information should the nurse use as an outcome evaluation for the classes?
a. Parking convenience for attendees continued to be a major concern
b. Demonstrating by the use of a blood glucose meter was an effective teaching
strategy
c. Fasting blood glucose average readings were 20% lower at the end of the
classes
d. Discussion of food exchanges and calories was a well attended class
34. On a repeat home visit to see an 84-year-old widow, the nurse discovers that the client
is unkempt, smells of stale urine, and does not recognize her neighbors or the nurse.
What action should the nurse take first?
a. Complete a physical and mental exam of the client
b. Call Adult Protective Services to obtain emergency nursing home placement.
c. Seek the family’s assistance in caring for the client
d. Call the client’s pharmacy to determine what medications she is taking
35. The community health nurse believes that immunization rates in a lower-socioeconomic
section of the city are probably below the target set by the state health department.
What action should the nurse take first to intervene with this health problem?
a. Join a political action group that focuses attention on the issue in the local news
media
b. Partner with a local children’s hospital in setting up free “shot” clinics in the
neighborhood
c. Review current epidemiological population data that might document a low
immunization rate
d. Call a meeting of citizens to inform them of the important of having their
children immunized
36. An older adult male with a history of type 2 diabetes mellitus (DM2) is seen in the
community health clinic for an annual physical examination. Which nursing action
should be included in assessing for long-term complications of diabetes? (Select all that
apply.)
a. Obtain venous sample for liver enzymes
b. Obtain urine specimen to assess for albumin
c. Test lower extremities for changes in sensation
d. Auscultate for adventitious breath sounds
e. Palpate pedal pulses and foot temperatures
37. A nurse identifies the clinic receptionist as having the role of gatekeeper for the clinic.
What statement by the receptionist is indicative of a gatekeeper in a community
setting?
a. “You may talk with the RN if you need information about how clients purchase
car seats.”
b. “Over 85% of the clients treated at this clinic are women of Hispanic of Asian
heritage.”
c. “The clinic standards are determined by those set forth by American Academy of
Obstetrics.”
d. “Monthly, we see more than 200 women for prenatal visits and venereal disease
for treatment.”
38. The nurse is developing a health class curriculum for students aged 11 through 14 years
of age. Which content topic is most important for the nurse to emphasize in the
curriculum for these students?
a. Reduction of risk-taking behaviors
b. Promotion of healthy dietary habits
c. Participation in physical exercise
d. Recognition of personal identity
39. A client is admitted to the emergency department with flu-like symptoms. Which
intervention should the nurse to obtain to rule out exposure to anthrax-spores?
a. Determine the client’s occupation
b. Inquire about previous vaccination for smallpox.
c. Obtain a twenty-four diet history
d. Identify the client’s personal contacts over the past week
40. A male migrant farm worker who lives in a mobile home with several other workers
visits the Migrant Health Care Center. He reports increasing episodes of dizziness,
headaches, abdominal cramps, and difficulty breathing. What nursing action has the
highest priority?
a. Ask about the length of his workday and frequency of rest breaks
b. Gather information about the client’s recent exposure to pesticides
c. Determine the number and age of persons living in the mobile home
d. Obtain a blood sample to assess for possible lead pain exposure
41. A nurse has started a group for senior citizens in a church setting. The group decides
that their first project will be to begin a program for home-bound members. Which
program outcome is the best measure of the project’s effectiveness?
a. Average annual income for the home bound members
b. Number of home-bound seniors who are visited
c. Calls received showing interest in the program
d. Number of church members who are over 65
42. During a visit to the community health clinic, a 45-year-old native American female, who
has a body mass index (BMI) of 35, complains of changes in her vision. Which condition
is most important for the nurse to be aware of based on family history?
a. Alcoholism
b. Tuberculosis
 c. Cataracts
d. Diabetes mellitus
43. One hundred families in a community refuse to have their children immunized because
of religious beliefs. When one documented case of whooping cough occurs within this
aggregate, which intervention should the nurse implement?
a. Quarantine the one hundred family aggregate
b. Immunize all members of the one hundred families
c. Quarantine all family members of the child with whooping cough
d. Immunize all children under age 5 in the one hundred family aggregate
44. A 93-year-old client with a number of co-morbidities is assessed by the home health
nurse. What problem is most important for the nurse to investigate further?
a. Social isolation
b. Medication interactions
c. Urinary incontinences
d. Caregiver stress
45. Which interventions should the nurse implement to help prevent a client from getting a
vector-born infectious disease?
a. Encourage the client to get immunizations prior to international travel.
b. Discuss the importance of wearing insect repellent when camping
c. Instruct the client to drink only bottled water when traveling abroad
d. Demonstrate the correct way to remove ticks imbedded in the skin
46. A home health nurse is reviewing the laboratory results for several clients with a history
of heart failure (HF). Which client finding should the nurse report to the healthcare
provider immediately?
a. Total cholesterol 190 mg/dl.
b. B-type natriuretic peptide 550 pg/ml.
c. Glycosylated Hemoglobin of 7%
d. Potassium 3.7 mEq/L
47. The community health nurse who works in a town that has a large chemical plant is
concerned about the occurrence of a natural disaster related to chemical exposure.
Which action is most important for the nurse to take?
a. Evaluate company safety procedures for prevention of chemical exposures
b. Elicit the company’s participation in a disaster preparedness program.
c. Determine the antidotes for the chemicals produced by the company
d. Inform employees of their potential risk for a chemical exposure incident.
48. A community group proposes building a new well-child clinic because this year’s
demographics reflect that a large percentage of the population is less than 19 years of
age. Which question indicates that the nurse understands the potential gaps in these
data?
a. What is the distribution of males to females within this population?
b. What percentage of the population was under 19 years of age in each of the 5
previous years?
c. How will the large percentage of under 19-year-olds affect the community’s
dependency ration?
 d. How can the income level of the families within the community be determined?
49. During a community health screening fair for older adults, the nurse observes that a
woman has pale, bluish feet. With sores on both lower extremities that are healing
poorly. Which intervention should the nurse implement?
a. Create a list of foods that promote wound healing.
b. Send client to the emergency room for treatment.
c. Refer to healthcare provider for complete evaluation
d. Instruct client to apply antibiotic ointment to sores
50. The nurse caring for a 62-year-old African-American male client arranges a time for the
client’s wife, 80-year-old mother, three children, and sister to meet with the healthcare
provider to discuss the client’s medical condition. Which cultural variation is the nurse
including when providing care for this client?
a. Social spacing
b. Cultural repatterning
c. Social organization
d. Environmental control
51. The RN care-manager at the public department is making a home visit to a client with
four children under the age of 6. The client is a single mother and the family is living
below poverty level. Which intervention should the nurse include as a primary level
prevention measure?
a. Enroll the client in the Women, Infant, and Children program
b. Counsel the client on available birth control methods
c. Provide the client with a listing for local healthcare providers.
d. Provide the client with the local bus schedule.

----------------------------------- VERSION B -----------------------------------

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? Gather additional data by taking a health history and
measuring vital signs
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
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? Provide
supportive nursing care until antitoxin is available
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? Have you shared any needles
or had sex with your friend?"
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
6. Which intervention should the public health nurse implement when attempting to address one
of the leading health indicators of Healthy People 2020? Design and implement a no smoking
campaign at the local high school
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
-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."

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? Conduct a windshield survey
of the geographic areas served by the school

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? Low immunization rate of children
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? 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) 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
-Lung cancer
14. Which presentation of an infectious disease is acquired through an indirect transmission? -
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
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
-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
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? - African-American ethnicity
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? 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?
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
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 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? 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? 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
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)
-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 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? 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
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? 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
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? Schedule an appointment with the healthcare provider for prompt evaluation
33. 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?
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)?
Apply the skin patch behind the ear 12 hours before your trip."
35. A client presents at a community-based clinic with complaints of shortness of breath,
headache, dizziness, and nausea. During the assessment, the nurse learns that the client is a
migrant worker who often uses a gasoline-powered pressure washer to clean equipment and farm
buildings. Which type of poisoning is the most likely etiology of this client's symptoms? carbon
monoxide
36. The nurse is conducting a process evaluation of a prevention education program for older
adults who are risk for substance abuse. Which data source provides the information the nurse
needs to conduct this process evaluation? documentation of client education in the nursing record
37. A 17-year old unmarried, pregnant client with drug addiction is a high school dropout,
homeless, and has a history of past abuse arrives at the clinic for her first prenatal visit. Which
findings should the nurse document as health risk factors for the client? (Select all that apply) a.
age
c. drug addiction
d. history of abuse
e. pregnancy
f. homelessness
38. The nurse is designing a community health project based on a report provided by the World
Health Organization that describes healthcare problems in the United States. Which healthcare
issue should the nurse give the highest priority when planning the project? number of people
without access to healthcare
39. The nurse working in a community health clinic that serves recent Somali immigrants notes
that most mothers refuse to give permission for routine immunizations of their preschoolers.
Which individual is likely to have the most influential on these women's perceptions about their
children's healthcare needs? tribal chief
40. The community health nurse is planning a series of educational courses about the healthcare
system and meeting healthcare needs for the community center. Which adjunct issue should the
nurse address for a group of older adults. retirement issues
41. A female adult walks into a local community health clinic and tells the nurse that she is
homeless and cannot seem to find help. Which statement indicates to the nurse that a client is
feeling separated from society and helpless? "I'm feeling really isolated from everyone and
scared."
42. A community health nurse is planning to implement an outreach program for a community
group. Which criteria should the nurse clarify about the program when examining sources for
funding? offers healthcare services to community members in local factories, schools, and
churches
43. The home health nursing director is conducting an educational program for registered nurses
and practice nurses about Medicare reimbursement. To obtain payment for Medicare services,
what must be included in the client's record? documentation of a skilled care service provided
during the visit
44. The home health care agency can expect to obtain Medicare reimbursement for which home
visit performed by a registered nurse or a practical nurse? wound care for a client who had
postoperative infection following abdominal surgery two weeks ago
45 The nurse is administering the measles, mumps, rubella (MMR) vaccine to a 12-month old
child during the well-baby visit. Which age range should the nurse advise the parents to plan for
their child to receive the MMR booster based on the current recommendations and guidelines by
the CDC? 4-6 years of age
46. The occupational health nurse is completing a yearly self-evaluation. Which activity should
the nurse document as an example of proficient performance criteria in professionalism? .
maintains chairmanship of the hospital nursing council
47. Which factors influence an occupational health nurse's role in the workplace? (Select all that
apply) skill level
c. role perception
f. commitment to the company occupational health and safety program
48. What title should be given to this occupational health nurse job description?
A registered nurse with expertise in health promotion, illness and injury prevention, risk
reduction, and adult learning principles. health promotion specialist
49. What title should be given to this occupational health nurse job description? An advanced
practice nurse who provides workers with primary care services with an emphasis on the
diagnosis and management of common acute illnesses/injuries and stable chronic diseases.
clinician nurse practitioner
50. What title should be given to this occupational health nurse job description? A registered
nurse who establishes a provider network, recommends treatment plans that assure quality and
efficacy while controlling costs, monitors outcomes, and maintains communication among all
involved. case manager
51. What title should be given to this occupational health nurse job description? A registered
nurse who functions in a comprehensive executive role to set goals, formulate policy, and direct
and evaluate the health service. a. manager
52. What title should be given to this occupational health nurse job description? A registered
nurse who teaches and prepares nursing students to function as expert clinicians/practitioners,
administrators, educators, researchers, or consultants to the work site. health educator
53. What title should be given to this occupational health nurse job description? A registered
nurse who develops researchable questions, conducts research, and communicates the findings to
occupational and environmental health nurses, other peers, and the public. researcher
54. What title should be given to this occupational health nurse job description? A registered
professional nurse who has knowledge and experience in occupational and environmental health
nursing and is able to communicate effectively, both orally and in writing, and possesses good
administrative, consultative, and listening skills nurse consultant
55. The nurse-manager is planning to transform safety ideas into prevention and protection
strategies in the work place. What committee should review and plan policies and education
about safety in the work place? quality assurance committee
56. Several employees who have a 10 year or longer hx of smoking ask the occupation nurse for
assistance w/ smoking cessation. The RN develops a 2 mo program that includes weekly group
sessions on lifestyle changes and use of OTC products. Which measurement provides the best
indication of theprogram's effectiveness? Ask the employee to inform the group if they stop
smoking and if they start back up again.
57. 100 families in a community refuse to have their children immunized b/c of religion. When
1 documented case of whooping cough occurs w/i the aggregate, which intervention should the
RN implement? Quarantine all family members of the child w/ whooping cough.
58. A RN has started a group for senior citizens in a church setting. The group decides that their
first project will be a program for home-bound members. Which program outcome is the best
measure of the project's effectiveness? Number of home bound seniors who are visited.

---------------------- VERSION 3 --------------------------

Community Health Leadership Hesi
1. Where should you initiate preventive measures for kids with dental caries- WIC Program
2. After numerous patient teachings, a man with Parkinsons disease still cant instill his eye
drops – Ask a family member to help.
3. A school nurse wants to initiate a presentation to parents regarding 25% of the schools
children being obese – Determine the parent’s involvement and how much they’re
concerned about their children’s health problem.
4. A school nurse wants to do a program about children’s health risks, what should she
consider – Height and weight ©
5. What pt. should be seen first – A man with Gunshot wound with a pulse ox of 90%
6. Nurse see’s pt with NGT drinking glass of water after the UAP leaves room – take the
glass and speak with the UAP
7. A nurse observes a wife of a pt in bed with the pt. – close the door and give them privacy
8. Charge nurse is drunk and smells of alcohol – report it to the nurse supervisor
9. The clinic receptionist is considered a gatekeeper – “you can speak with the RN about
purchasing a car seat” ©
10. Flu vaccines are low, which client should you tell to come back later when there is
enough vaccine – diabetic client with agoraphobia
11. A nurse took a sleeping pill 4 hours ago – send her home
12. A nurse forgot her glasses at home and she lives a hour away – send her home to get her
glasses.
13. In preparing for a bioterrorism attack, which should the nurse consider – Tuleremia
14. A nurse is referring a patient with Ancanthosis nicigricans to a family doctor – body
mass index
15. Patients postoperative with different drains, who should nurse assess first – 40ml dark
cloudy urine x4 hours.(c)
16. Who should nurse see first – African American baby that’s spitting up and has lost 6oz in
the past week
17. Patient wants to get off birth control & have a baby, she has a family history of diabetes
& she was treated for Chlamydia 6 months ago, what causes the most concern –
Chlamydia
18. What pt should be considered for involuntary commitment to the psych ward – (1) Pt
who hasn’t eaten in 3 days & thinks that he is Jesus. (2) A women who mumbles in
corner about killing herself. (3) A man who says that the communist are telling him to
kill the Catholics.
19. A nurse & social worker talking loudly about a pt referral but there are no patients
around the nurse’s station – tell them to go to a private work station to talk. ©
20. A nurse tells a UAP to collect a sputum sample, the nurse should first – determine if UAP
is capable of doing the task & if she’s done it before.
21. An experienced UAP working at an antepartal clinic, what can she do – take initial VS &
urine dipstick.
22. Nurse caring for a 65 year old African American male, she sets up a meeting with his
wife, 3 kids, and mother, to talk to the MD. What cultural variance is the nurse
demonstrating – Social organization
23. A charge nurse gets report about a lot of concerns, which one is most important – water
spill on the floor.
24. A pt tells the nurse that she doesn’t want a male nurse – reassign the nurse
25. Which pt is most at risk to get pneumonia – homeless person who is an alcoholic and
smoker. ©
26. Nurse wants to start an outreach program, what should she explain when she’s trying to
receive funding for the program – that the program will help people in nearby factories,
schools, churches.
27. The RN is assisting the MD with a thoracent, & the ED dept calls to say that a pt with
agina needs to be admitted ASAP. An LVN & UAP are available to help, what should
RN do – tell PN to assist with thoracentisis, RN take report on agina pt, UAP get room
ready for new for pt.
28. A hospital is thinking about getting new equipment, what is cost efficient for the hospital
to consider – can other units in the hospital use the equipment.
29. A nurse is giving test to detect influenza, the test is 99% accurate. The test has a high rate
of – sensitivity
30. A nurse does a community health fair about cardio, how can the nurse determine if the
teachings were effective upon an assessment 6 months later – 10% reduction in cardiac
death. ©
31. Who are at the greatest risk to get Hepatitis A – a family living in a crammed area
32. How can the charge nurse decrease role ambiguity among the staff nurses – explain the
role
33. A nurse wants to do research on infant death rate, where would she go – Bureau of vital
statistics.
34. Which resources will benefit a rural community – trauma health center
35. A charge nurse will intervene if she notices – a clerk taking (telephone) orders from the
MD.
36. Female pt goes to local community health clinic, she’s homeless and cant seem to find
help, which statement indicates that she’s separated from society and hopeless – “Im
feeling isolated from everyone and scared”
37. How can a hospital determine how many beds they may need in a community – if there is
a recreational lake in the community.
38. What could a hospital do to prevent lawsuits- Risk Management ©
39. Which bioterrorism agent is at high risk for use as a potential biological weapon that is
readily transmitted by several portals of entry? anthrax
40. Which client has the highest risk for developing community-acquired pneumonia? a 60-year
old homeless person who is an alcoholic and smokes
41. A 16-year old female client returns to the clinic because she is pregnant for the third time by
a new boyfriend. Which vaccine should the nurse plan to administer? hepatitis B
42. The nurse is assisting with the triage of clients at a large community disaster and find a man
lying on the ground, who states that the blast threw him out of a second story window. Which
action should the nurse implement first? place the nurse's hands around the client's neck to
stabilize
43.A female client makes routine visits to a neighborhood community health center. The nurse
notes that this client often presents with facial bruising, particularly around the eyes. The nurse
discusses prevention of domestic violence with the client even though the client does not admit
to being battered. What level of prevention has the nurse applied in this situation? secondary
prevention
44. The nurse is preparing an orientation class for new employees at an inner city clinic that
serves a low-income population. Which information should the nurse include in the presentation
to these new employees? basica physiologic needs are likely to be unmet in this clinic's client
population
45. The nurse is planning a nutrition class for a group of high school students emphasizing the
goals for the nutrition from Healthy People 2020. Which meal selection provides the best choices
in meeting these goals? vegetable lasagna, lettuce salad, a whole wheat roll, 8 oz of 2% milk
46. The nurse is screening children at a local community health clinic for infectious diseases.
Which child is at highest risk for hepatitis B virus? a newborn
47. The nurse is planning an immunization campaign targeting the children of migrant farm
workers in the community. Which data should the nurse review before exploring solution options
when developing this program plan? target population data
48. The nurse plans to implement a community health program targeting teenage smoking. Prior
to initiating this program, which information is most important for the nurse to obtain? the
incidence of smoking among the teenage population in this community
49. The nurse is designing a home health care program for disabled children. Which factor
should be considered when assessing reimbursement for services from private insurance
companies? approval by the network healthcare provider
50. A community health nurse is conducting a neighborhood discussion group about disaster
planning. What information regarding transmission of anthrax should the nurse provide to the
group? infection is acquired when anthrax spores enter a host
51. A client is suspected of being poisoned and presents with symmetric, descending flaccid
paralysis, blurred vision, double vision, and dry mouth. The nurse should consider these findings
consistent with which potential bioterrorism agent? botulism toxin