HESI RN
Community Health HESI
1. Which annual screening should the nurse include when planning eye health programs at a preschool?
- A. visual acuity
- B. red light reflex
- C. conjunctivitis
- D. glaucoma
Correct answer: A
Rationale: The correct answer is A: visual acuity. Screening for visual acuity is essential in preschoolers to identify any vision issues early on, such as nearsightedness or farsightedness, which may require corrective lenses or other interventions. Red light reflex (choice B) is a method used to assess the eyes for abnormalities, but it is not typically included in routine preschool eye health screenings. Conjunctivitis (choice C) is an eye infection and not a screening test. Glaucoma (choice D) is a condition more commonly associated with adults and the elderly, making it less relevant for preschool eye health programs.
2. The nurse is assessing a client with a suspected deep vein thrombosis (DVT). Which finding supports this diagnosis?
- A. Positive Homan's sign.
- B. Unilateral leg swelling.
- C. Bilateral calf pain.
- D. Redness and warmth in the affected leg.
Correct answer: D
Rationale: The correct answer is D: Redness and warmth in the affected leg. These are classic signs of deep vein thrombosis (DVT) and support the diagnosis. Choice A, Positive Homan's sign, is an outdated and unreliable test for DVT, so it is not the best choice. Choice B, Unilateral leg swelling, can be seen in DVT but is less specific compared to redness and warmth. Choice C, Bilateral calf pain, is not a typical finding in DVT, as the pain in DVT is usually unilateral.
3. A client with a history of alcohol abuse is admitted with cirrhosis. Which finding requires immediate intervention?
- A. Jaundice.
- B. Ascites.
- C. Peripheral edema.
- D. Spider angiomas.
Correct answer: C
Rationale: Peripheral edema in a client with cirrhosis can indicate fluid overload and worsening liver function, necessitating immediate intervention to prevent further complications such as respiratory distress, cardiac issues, or renal impairment. Jaundice (choice A) is a common manifestation of cirrhosis but may not require immediate intervention unless severe. Ascites (choice B) is also a common complication of cirrhosis that may require intervention but is not as urgent as addressing peripheral edema. Spider angiomas (choice D) are typically benign skin lesions associated with cirrhosis but do not require immediate intervention unless bleeding or rupture occurs.
4. An 80-year-old client is given morphine sulfate for postoperative pain. Which concomitant medication should the nurse question that poses a potential development of urinary retention in this geriatric client?
- A. Nonsteroidal anti-inflammatory agents.
- B. Antihistamines.
- C. Tricyclic antidepressants.
- D. Antibiotics.
Correct answer: C
Rationale: The correct answer is C: Tricyclic antidepressants. Drugs with anticholinergic properties, such as tricyclic antidepressants, can exacerbate urinary retention associated with opioids in older clients. Nonsteroidal anti-inflammatory agents (Choice A) do not typically cause urinary retention. Antihistamines (Choice B) may cause urinary retention but are not the primary concern in this scenario. Antibiotics (Choice D) are not associated with an increased risk of urinary retention compared to tricyclic antidepressants.
5. The nurse is teaching a group of new mothers about infant care. Which topic should the nurse prioritize?
- A. signs of infant dehydration
- B. proper diaper changing techniques
- C. immunization schedule
- D. breastfeeding positions
Correct answer: A
Rationale: The correct answer is A: signs of infant dehydration. Recognizing signs of dehydration is crucial for ensuring the health and well-being of infants. Dehydration can be life-threatening for infants if not addressed promptly. While proper diaper changing techniques, immunization schedules, and breastfeeding positions are also important topics in infant care, being able to identify signs of dehydration takes precedence as it requires immediate attention to prevent serious consequences.
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