HESI RN Community/ Population Health

Correct Answer: Motor vehicle safety

Explanation

Motor vehicle accidents are the leading cause of death among adolescents in the United States, according to data from the CDC and the National Vital Statistics Reports. Adolescents are at increased risk due to factors such as inexperience, distracted driving (including texting), seatbelt nonuse, and risk-taking behaviors like speeding or driving under the influence. Therefore, motor vehicle safety should be the top priority in school safety education for this age group. Education should focus on safe driving habits, the importance of seatbelt use, avoiding distractions, and not riding with impaired drivers.

Why Other Options Are Wrong:

Gun safety

While firearm-related injuries are a significant cause of injury and death among adolescents, especially in certain regions or populations, they are not the leading cause. Gun safety is an important topic but ranks below motor vehicle accidents in terms of overall mortality in this age group.

 Sports injury prevention

Sports injuries are common among adolescents, but they rarely lead to death. Education on this topic is beneficial for reducing morbidity, but not a priority when considering mortality prevention.

 Substance abuse prevention

Substance use (e.g., alcohol, opioids) is a critical public health concern in adolescents and can contribute to injury and death—especially as a contributing factor in motor vehicle accidents. However, motor vehicle safety encompasses this indirectly and remains the primary cause of adolescent deaths, making it the most urgent educational priority.

Summary:

The correct answer is D. Motor vehicle safety because motor vehicle accidents remain the leading cause of death among adolescents. While gun safety, substance abuse, and sports injuries are also important, they do not surpass motor vehicle crashes in adolescent mortality statistics. Therefore, the school nurse should prioritize motor vehicle safety education in this population.

Correct Answer:Efficiency

Explanation:

 Efficiency

Efficiency refers to the optimal use of resources — such as time, money, manpower, and materials — to achieve desired outcomes. When the nurse evaluates whether resources were maximized during the implementation of the Ligtas Tigdas (measles immunization) campaign, she is assessing how well inputs were used to produce the intended health outputs. Efficiency focuses on the cost-benefit relationship and resource utilization in delivering services.

Why the other options are incorrect:

 Effectiveness

Effectiveness evaluates whether the program achieved its intended goals or outcomes, such as increasing measles vaccination coverage or reducing measles incidence. It does not focus on how well resources were used in the process.

Adequacy

Adequacy refers to the sufficiency of the program in addressing the magnitude of the health problem. It answers the question: Did the intervention reach enough people or address the issue to a sufficient extent? It is about scale, not resource optimization.

Appropriateness

Appropriateness refers to how well the intervention matches the health needs of the population. It considers the relevance and suitability of the strategy or program to the specific health problem, not how efficiently resources were used.

Summary:

When the nurse assesses whether resources were maximized in the implementation of the Ligtas Tigdas campaign, she is evaluating efficiency — how well inputs were converted into outputs. Other terms like effectiveness, adequacy, and appropriateness refer to different dimensions of program evaluation, such as goal achievement, coverage, and relevance.

The Correct Answer is:

A. Refer to healthcare provider for complete evaluation.

Detailed Explanation:

Pale, bluish feet and poorly healing sores are classic signs of peripheral arterial disease (PAD), which results from poor blood flow to the extremities. The nurse should refer the client for a full medical evaluation to confirm the diagnosis and initiate treatment. Without proper circulation, wounds cannot heal, and the client is at risk for tissue necrosis and possible amputation. Prompt evaluation allows for vascular assessment and management of underlying conditions such as diabetes or atherosclerosis.

Correct Answer: The client states they are leaving their partner.

Explanation of the correct answer:

 The client states they are leaving their partner.

The greatest risk for partner violence often occurs when the victim attempts to leave the abusive relationship. Abusers may escalate their violence in response to perceived threats to their control or power. A client expressing the intention to leave their partner is at an increased risk of retaliation, physical harm, or further abuse. This is a critical moment for the nurse to assess the client's safety and provide appropriate resources, including safety planning and referrals to domestic violence support services.

Why the other options are incorrect:

The client is at 13 weeks of gestation.

While pregnancy can increase the risk of partner violence due to hormonal and emotional changes, the greatest risk occurs when a victim attempts to leave the relationship. The pregnancy itself does not place the client at the greatest risk in this scenario, though it may influence the dynamics of the relationship.

The client is starting a new job.

Starting a new job may present challenges in an abusive relationship, such as the partner’s jealousy or controlling behavior, but it is not as immediately dangerous as the situation where the client is planning to leave the partner. However, it is still important for the nurse to assess for any signs of coercive behavior or control related to the job.

The client visits friends without the partner's knowledge.

Although secretive behaviors might be concerning in an abusive relationship, visiting friends without the partner’s knowledge is not as high-risk as stating an intention to leave the partner. However, it is still important for the nurse to assess the power dynamics in the relationship and offer safety planning if needed.

Summary:

 The client states they are leaving their partner. is the most concerning finding, as it places the client at the greatest risk for further violence or retaliation from the abuser. It is crucial for the nurse to assess safety, provide support, and help the client develop a plan to leave safely.

The Correct Answer is:

B. Ask about factors that may have caused the headache.

Detailed Explanation:

Before administering medication, the nurse must assess possible causes of the headache to determine appropriate action. Common triggers in adolescents include dehydration, skipped meals, stress, eyestrain, or lack of sleep. A thorough assessment guides safe, evidence-based care and helps identify whether the headache is benign or a symptom of an underlying condition requiring referral. Administering medication without first identifying contributing factors could mask serious problems or provide ineffective relief.

The Correct Answer is:

C. Clear nasal drainage and cough.

Detailed Explanation:

Clear nasal drainage and cough are not typical post-immunization reactions and may indicate a respiratory infection rather than a vaccine-related response. The mother should report these symptoms because the infant may have coincidentally developed an upper respiratory illness requiring evaluation. Vaccines may cause mild, short-term effects such as low-grade fever, irritability, or localized redness—but respiratory symptoms are unrelated and warrant further assessment.

Correct Answer: Zoster

Explanation

The zoster vaccine is recommended for older adults to prevent herpes zoster (shingles), a painful viral infection caused by the reactivation of the varicella-zoster virus. The CDC recommends the recombinant zoster vaccine (Shingrix) for all adults aged 50 and older, regardless of whether they had chickenpox or received a previous live zoster vaccine. Since the risk of shingles increases with age and can lead to complications such as postherpetic neuralgia, this vaccine is a key preventive measure in older adults.

Why Other Options Are Wrong:

Rotavirus is not recommended for older adults. This vaccine is given to infants to prevent severe diarrheal illness caused by the rotavirus. It is administered orally to infants at 2 and 4 months (or 2, 4, and 6 months, depending on the vaccine type).

 Inactivated poliovirus (IPV) is not routinely recommended for older adults. It is part of the childhood immunization schedule and is primarily given to children under 6 years old. Adults only need this vaccine if they are traveling to areas with polio outbreaks or at occupational risk.

 Human papillomavirus (HPV) vaccine is not typically recommended for older adults. It is primarily given to adolescents and young adults (up to age 26) to prevent HPV-related cancers. Some adults aged 27–45 may consider vaccination based on individual risk, but it is not a routine recommendation for older adults.

Summary:

The correct answer is D. Zoster, as shingles prevention is a key health priority in older adults. The other vaccines—rotavirus, inactivated poliovirus, and HPV—are primarily recommended for infants, children, or younger adults and do not apply to routine immunization for the older population.

Correct Answer:Their services are provided on an out-patient basis

Explanation:

 Their services are provided on an out-patient basis

Primary health care facilities focus on health promotion, disease prevention, early diagnosis, and basic curative and rehabilitative care. Services in these facilities are typically offered on an out-patient basis, meaning patients are not admitted for overnight stays. Examples of primary facilities include barangay health stations, rural health units (RHUs), and health centers. These facilities serve as the first point of contact for individuals seeking health care.

Why the other options are incorrect:

 They are usually government-run

While many primary health care facilities are government-run, not all are. Some are operated by non-governmental organizations (NGOs), private entities, or local communities. Therefore, this statement is only partially true and does not apply universally.

They are training facilities for health professionals

Training of health professionals typically takes place in tertiary-level or specialized institutions such as teaching hospitals. Primary facilities focus on delivering essential health services rather than serving as academic or training institutions.

 A community hospital is an example of this level of health facilities

A community hospital is categorized as a secondary-level facility. Secondary facilities provide more specialized care than primary facilities and often include inpatient services and more advanced diagnostic tools. Therefore, it is not accurate to describe a community hospital as a primary facility.

Summary:

Primary health care facilities provide out-patient services focused on preventive, promotive, and basic curative care. This level of health care is the first point of contact for individuals and emphasizes accessibility and community orientation. While many are government-run, the defining feature is their out-patient nature and basic scope of services.

Correct Answer: Migrant Clinicians Network (MCN)

Explanation of the correct answer:

Migrant Clinicians Network (MCN)

The Migrant Clinicians Network (MCN) is a nonprofit organization that focuses specifically on the health care needs of migrant workers, including addressing issues related to tuberculosis (TB) and other health conditions that disproportionately affect this population. The MCN provides resources, tools, and support for clinicians working with migrant workers to improve care, including monitoring medication compliance for TB treatment in this population.

Why the other options are incorrect:

Agency for Healthcare Quality and Research (AHRQ)

The AHRQ is a government agency that focuses on improving the quality, safety, efficiency, and effectiveness of healthcare in the United States. While they provide valuable research and resources on healthcare delivery, they do not specifically focus on the healthcare needs of migrant workers or on TB treatment, making this resource less relevant for monitoring TB medication compliance in migrant workers.

Centers for Disease Control and Prevention (CDC)

While the CDC plays a critical role in public health and provides guidelines for TB treatment and monitoring, it is more of a regulatory and advisory body, not specifically designed to provide direct support for clinicians in managing the unique needs of migrant workers. However, the CDC guidelines would still be relevant to the nurse in terms of overall TB treatment protocol, but MCN is more directly focused on migrant populations.

 U.S. Preventive Services Task Force (USPSTF)

The USPSTF provides recommendations on preventive services, such as screenings and counseling, to improve the health of the population. While TB screening could fall under their recommendations, the USPSTF does not specifically address the medication compliance of migrant workers or provide resources for managing ongoing treatment for specific groups like MCN does.

Summary:

Migrant Clinicians Network (MCN) is the best resource for assisting with medication compliance for TB treatment in migrant workers because it is specifically designed to address the unique health challenges of this population.