HESI RN Community/ Population Health

Correct Answer: Ask the client for the contact information of recent sexual partners

Explanation

The nurse's role in cases of sexually transmitted infections (STIs), including herpes, involves supporting the client in managing their health and ensuring the infection does not spread further. The nurse should encourage the client to notify their recent sexual partners so that they can also be tested and treated if necessary. While the nurse cannot disclose confidential information without the client’s consent, asking for contact information allows the nurse to advise the client on how to inform partners in a private and respectful manner. This is part of the ethical obligation to prevent transmission and protect public health.

Why Other Options Are Wrong:

Reinforce the importance of compliance with antibiotic therapy

This is incorrect because herpes is caused by the herpes simplex virus (HSV), and antibiotics are not effective for viral infections. The appropriate treatment for herpes involves antiviral medications to help manage symptoms and reduce the frequency of outbreaks. The nurse should provide education about antiviral therapy, not antibiotics.

Notify the campus health department of the client's herpes diagnosis

This would be inappropriate without the client’s consent, as it violates the client's confidentiality. Health departments typically receive reports of certain STIs through public health systems, but client confidentiality must be maintained unless there is a legal or public health obligation to disclose the diagnosis. In most cases, the client should be informed and encouraged to report the diagnosis themselves, if necessary.

Contact the client's parents to report the herpes diagnosis

This would be a breach of confidentiality, especially since the client is an adult. In most jurisdictions, individuals over the age of 18 are entitled to confidentiality regarding their health information. The nurse should not contact the client’s parents unless the client provides explicit consent or there is a legal requirement to do so, such as in cases of significant harm to the individual or others.

Summary:

The correct answer is Ask the client for the contact information of recent sexual partners, as it respects confidentiality while ensuring that individuals who may have been exposed to the herpes virus can receive appropriate care. The other options either involve incorrect treatment recommendations or violate the client’s privacy rights

Correct Answer: I am obese it's in my genes

Explanation:

 I am obese it's in my genes

This statement is an example of rationalization, a defense mechanism in which an individual justifies or makes excuses for behaviors or feelings they feel guilty or uncomfortable about. In this case, the client is attributing their obesity to genetic factors, which provides an explanation that may absolve them from taking personal responsibility or making changes to address the issue.

Why the other options are incorrect:

 I have lots of health problems from being obese

This statement reflects the client's awareness of the health consequences of obesity. It does not involve rationalization but rather acknowledges the negative impact obesity has on their health. This is more of an expression of concern than a defense mechanism.

 I have difficulty resisting the items in vending machines

This statement suggests the client is expressing a difficulty they are facing in managing their behavior, rather than rationalizing or justifying it. It's an acknowledgment of the challenge rather than an excuse for the behavior.

 I know you don't like me because I am obese

This statement indicates that the client is projecting their own feelings of insecurity onto the nurse. It is not rationalization, but rather a defense mechanism of projection, where the client attributes their own negative feelings to others.

Summary:

Rationalization involves making excuses or justifying behavior. The statement "I am obese it's in my genes" is an example of rationalization, as it shifts the blame for obesity onto genetics rather than considering personal choices or actions. Other responses either reflect self-awareness, difficulty managing behavior, or projection.

The Correct Answer is:

C. Complete a physical and mental exam of the client.

Detailed Explanation:

The client’s disorientation, poor hygiene, and neglect suggest possible cognitive decline, such as dementia, or an acute medical condition like infection or delirium. The nurse’s first priority is to assess the client’s physical and mental status to determine immediate needs and rule out reversible causes. Once the assessment establishes the client’s condition and safety status, appropriate follow-up actions—such as notifying Adult Protective Services or contacting family—can be taken. Assessment always precedes intervention in the nursing process.

Correct Answer:Determine student's motivation to learn about healthy food choices

Explanation:

Determine student's motivation to learn about healthy food choices

In the planning phase of a health education program, the first action the nurse should take is assessment, which includes identifying the learners’ readiness and motivation to learn. Understanding what motivates the students helps the nurse tailor the program content and teaching strategies to meet their interests and needs. This foundational step ensures that the program will be relevant and engaging for the students.

Why the other options are incorrect:

 Give positive feedback to students who make appropriate choices

This is a reinforcement strategy, which is effective after healthy behaviors are taught and demonstrated. It is part of implementation or evaluation, not the initial step in planning.

 Help students recognize the value of making healthy food choices

While this is a key educational goal, it comes after understanding students' current attitudes and motivations. It is part of the teaching process, not the initial planning step.

Provide students with resources about making wise choices independently

Providing resources is important for promoting self-efficacy and independence, but it occurs after the educational content has been taught and is not the first planning step.

Summary:

Before any teaching or resource distribution, the nurse must first assess the students’ motivation to learn about healthy food choices. This ensures the educational program is appropriate and effective for the target group. The other actions follow after establishing the baseline of learners' readiness and interest.

Correct Answer: Client 4 and Client 5

Explanation: Client 4 is presenting with symptoms indicative of tuberculosis (TB), including fever, productive cough, weight loss, and blood-tinged sputum. The Mantoux tuberculin skin test result of greater than 10 mm induration is a significant finding, confirming possible exposure to Mycobacterium tuberculosis. Tuberculosis is classified as a nationally notifiable disease. Health care providers are required to report cases of TB to public health authorities to ensure that proper isolation, treatment, and contact tracing can be initiated to prevent further transmission.

Client 5 has tested positive for chlamydia following their partner's diagnosis. Chlamydia is one of the most common sexually transmitted infections and is nationally notifiable in many countries, including the U.S. A positive test result for Chlamydia trachomatis must be reported to public health authorities to ensure that appropriate follow-up measures, including partner notification and treatment, can be implemented to prevent the further spread of the infection.

Why Other Options Are Wrong:

Client 1: Client 1 is experiencing a sore throat with fever and was tested for Group A streptococcus (strep throat), but the rapid antigen test was negative. Strep throat is not a nationally notifiable disease unless a case of invasive group A streptococcal infection occurs, such as bacteremia or necrotizing fasciitis. Since the client’s test was negative, no notification is necessary.

Client 2: Client 2 has a lead level of 12 mcg/dL. While lead poisoning is a serious health concern, it is generally monitored through local or state public health reporting systems, not always as a nationally notifiable disease. Lead poisoning reporting requirements may vary by state or jurisdiction, but it is not typically classified for national notification.

Client 3: Client 3 is diagnosed with herpes zoster (shingles). Herpes zoster is not a nationally notifiable condition. Although it can be painful and require medical management, it does not require public health reporting unless it leads to complications like disseminated zoster or occurs in an immunocompromised individual.

Summary:

The correct answers are Client 4 and Client 5 because tuberculosis and chlamydia are both nationally notifiable diseases. The other clients do not present conditions that require national notification.

Correct Answer:Housing quality

Explanation:

Housing quality

A windshield survey is an observational tool used by nurses during a community assessment to gather visual information about a community's environment. The nurse drives or walks through the community to observe various factors, including housing quality. This helps the nurse assess the physical and environmental conditions of the community, such as the state of the homes, infrastructure, and overall living conditions, which can impact community health.

Why the other options are incorrect:

Demographic data

Demographic data (e.g., age, gender, income) is usually collected through official records, surveys, or databases and is not part of the windshield survey, which focuses on visual observations rather than statistical data collection.

Mortality rate

The mortality rate is an epidemiological measure of deaths within a population and is typically derived from health statistics, not through direct observation. This data would be collected through health records or statistical analysis, not from a windshield survey.

Informant interviews

While informant interviews can be a valuable part of a community assessment, they are not part of a windshield survey. Informant interviews involve conversations with community members or leaders to gather qualitative data, whereas the windshield survey involves direct observation of the community's physical environment.

Summary:

In a windshield survey, the nurse should focus on observable aspects of the community, such as housing quality, which provides insights into the living conditions and environmental health factors. Other options, like demographic data, mortality rates, and informant interviews, are important for a comprehensive community assessment but are not part of the windshield survey itself.

Correct Answer: Collect data to identify learners' current knowledge base.

Explanation:

The first step in planning any educational program is to assess the needs of the target audience, which includes identifying their current knowledge base. Understanding what the young adults already know about STI prevention will help the nurse tailor the program to address any gaps in their knowledge. This ensures that the program is relevant and effective, providing the information that the learners need most. Collecting data about their knowledge will allow the nurse to adapt the content and teaching methods accordingly.

Why Other Options Are Wrong:

Arrange for computer-assisted learning.

While computer-assisted learning can be an effective teaching tool, it should not be the first action taken. The program should be designed based on the needs and preferences of the target audience, which can be identified by collecting data on their current knowledge base. Once the needs are assessed, the nurse can then determine if computer-assisted learning is the most suitable method.

Develop content appropriate to learner needs.

While developing content that is tailored to the learners' needs is crucial, it is important to first gather information about the learners' existing knowledge. This ensures that the content is not only appropriate but also addresses areas that need further education. Developing content should come after the data collection phase to ensure it is relevant.

 Identify topics with health department nurses.

Collaboration with health department nurses can help in identifying key topics, but this should occur after assessing the target audience's knowledge. The nurse should first understand what the young adults know and need, and then collaborate with experts to design the program. This ensures that the program is tailored to the learners and is aligned with professional guidelines.

Summary:

The correct answer is Collect data to identify learners' current knowledge base, as this is the foundational step in creating an effective educational program. Once the nurse understands the learners’ needs, they can develop appropriate content, choose suitable teaching methods, and collaborate with others as needed to ensure the program is effective in promoting STI prevention.

Correct Answer: Determine if the student sees his provider on a regular basis.

Explanation:

A student who is using a rescue inhaler two to three times per day likely has poorly controlled asthma. The first step in managing this situation should be ensuring that the student has appropriate medical management, including regular visits with their healthcare provider. Asthma guidelines suggest that frequent use of a rescue inhaler indicates inadequate asthma control, and the provider can adjust treatment plans, such as changing the type or dosage of medication, to better control the asthma. This action ensures that the student is receiving the appropriate treatment to reduce reliance on the rescue inhaler.

Why Other Options Are Wrong:

Encourage the student's parent to identify and reduce environmental triggers. While addressing environmental triggers is important in asthma management, it is not the first priority if the student's asthma is poorly controlled. The priority should be to assess the medical management of the condition, as frequent use of the inhaler often indicates that the medication regimen needs adjustment, which is something the healthcare provider can address.

 Review breathing exercises with the student. Breathing exercises can be helpful in improving lung function and managing symptoms, but they are secondary to ensuring proper asthma control through medication and medical management. The student's asthma appears to be uncontrolled, so medical management should be assessed first before focusing on complementary techniques like breathing exercises.

Discuss the manifestations of asthma with the student's teacher. While educating the teacher is important for managing the student's asthma in the school environment, it should come after addressing the underlying issue of poorly controlled asthma. The student's asthma control needs to be optimized through medical management before educational strategies are put in place

Summary:

The correct answer is determining if the student sees their provider on a regular basis. Frequent use of a rescue inhaler typically indicates poor asthma control, and the primary focus should be on evaluating and optimizing the medical management of the condition. Other interventions, such as addressing environmental triggers and educating the teacher, are important but should come after ensuring that the student's asthma is appropriately managed by a healthcare provider.

Correct Answer: Circulate air using a fan

Explanation

Acute air hunger in a hospice client is a common symptom, particularly in those nearing the end of life, and it is often associated with conditions such as dyspnea (shortness of breath). Circulating air using a fan has been shown to provide comfort and alleviate the sensation of air hunger by creating a cool breeze that can help reduce the feeling of breathlessness. Additionally, the fan's airflow may help with dry mouth, a common symptom in terminally ill patients, providing overall relief and comfort.

Why Other Options Are Wrong:

 Obtain ABGs

While arterial blood gases (ABGs) provide valuable information about a patient’s respiratory status, they are not necessary for immediate intervention in a hospice setting where the goal is comfort care. Acute air hunger in a hospice patient is often managed without the need for invasive testing such as ABGs. The focus should be on symptom management rather than diagnostic testing at this stage.

Administer prednisone PO

Prednisone, a corticosteroid, is sometimes used in certain respiratory conditions to reduce inflammation, but oral steroids are typically not indicated for acute air hunger unless the underlying condition warrants it (e.g., exacerbation of an inflammatory lung disease). However, it would not be the first-line intervention for acute symptom relief in a hospice setting.

Place the client in a prone position

In most cases, prone positioning (lying face down) is not recommended for patients with dyspnea or air hunger. Prone positioning can compromise breathing further and is generally used for other purposes, such as improving oxygenation in patients with specific conditions (e.g., ARDS), but it is not suitable for the comfort of a hospice patient with air hunger. A more appropriate position would be sitting up or in a semi-Fowler's position to enhance breathing.

Summary:

The correct answer is C. Circulate air using a fan because it provides immediate comfort for acute air hunger by helping alleviate the sensation of breathlessness. The other options are less directly related to comfort management in a hospice setting and are not appropriate for immediate symptom relief.