HESI RN
HESI Community Health
1. A client with a history of alcohol abuse is admitted with acute pancreatitis. Which laboratory result requires immediate intervention?
- A. Amylase of 120 U/L.
- B. Lipase of 150 U/L.
- C. Calcium of 8.5 mg/dL.
- D. Blood glucose of 250 mg/dL.
Correct answer: D
Rationale: The correct answer is D, 'Blood glucose of 250 mg/dL.' In a client with acute pancreatitis, elevated blood glucose levels can indicate poor control of diabetes or stress response from the acute illness. Immediate intervention is necessary to prevent complications like worsening pancreatitis, infections, or other metabolic issues. Choices A and B, 'Amylase of 120 U/L' and 'Lipase of 150 U/L,' are commonly elevated in pancreatitis but do not require immediate intervention unless significantly elevated. Choice C, 'Calcium of 8.5 mg/dL,' is within the normal range and not a priority in this scenario.
2. A client with a history of peptic ulcer disease is admitted with severe epigastric pain. Which finding requires immediate intervention?
- A. Nausea and vomiting.
- B. Hematemesis.
- C. Melena.
- D. Rebound tenderness.
Correct answer: D
Rationale: In a client with a history of peptic ulcer disease presenting with severe epigastric pain, the finding that requires immediate intervention is rebound tenderness. Rebound tenderness can indicate peritonitis, a serious condition that necessitates immediate medical attention. Nausea and vomiting, hematemesis, and melena are also concerning symptoms in a client with a history of peptic ulcer disease, but they do not signify the urgency of intervention as rebound tenderness does.
3. A client who is receiving intravenous heparin therapy has an activated partial thromboplastin time (aPTT) of 90 seconds. Which action should the nurse take?
- A. Continue the heparin infusion as prescribed.
- B. Decrease the heparin infusion rate.
- C. Increase the heparin infusion rate.
- D. Stop the heparin infusion and notify the healthcare provider.
Correct answer: D
Rationale: An aPTT of 90 seconds is significantly elevated, indicating a high risk of bleeding due to excessive anticoagulation. In this case, the heparin infusion should be stopped immediately to prevent further anticoagulation and an increased bleeding risk. Notifying the healthcare provider is essential to discuss alternative anticoagulation strategies or interventions. Continuing heparin therapy without action could lead to severe bleeding complications. Decreasing or increasing the heparin infusion rate would exacerbate the risk of bleeding, making options A, B, and C incorrect.
4. The healthcare professional is developing a teaching plan for an adolescent with a Milwaukee brace. Which instruction should the healthcare professional include?
- A. Wear the brace over a T-shirt for 23 hours a day.
- B. Remove the brace while sleeping.
- C. Wear the brace directly against the skin.
- D. Remove the brace while eating.
Correct answer: A
Rationale: The correct answer is A. A Milwaukee brace should be worn over a T-shirt for 23 hours a day to reduce friction and chafing of the skin. This ensures that the brace is not directly against the skin, which can cause discomfort and skin irritation. Choice B is incorrect because the brace should typically be worn continuously, even while sleeping, unless otherwise instructed by a healthcare provider. Choice C is incorrect as wearing the brace directly against the skin can lead to skin issues. Choice D is incorrect since the brace should not be removed while eating to maintain the prescribed wear time.
5. The nurse is developing a community health program to address the high rates of hypertension in a neighborhood. Which intervention should the nurse prioritize?
- A. conducting free blood pressure screenings
- B. distributing educational materials on hypertension
- C. holding workshops on stress management
- D. partnering with local gyms to offer discounted memberships
Correct answer: A
Rationale: Conducting free blood pressure screenings should be prioritized as it helps identify individuals with hypertension who may not be aware of their condition. Early detection allows for timely medical intervention and management. While distributing educational materials, holding stress management workshops, and partnering with local gyms are valuable interventions, they may not directly address the immediate need for identifying undiagnosed cases of hypertension in the community.
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