HESI RN
Community Health HESI 2023
1. The healthcare professional is preparing to administer a blood transfusion to a client with anemia. Which action is most important to prevent a transfusion reaction?
- A. Check the client's vital signs before starting the transfusion.
- B. Use a blood filter when administering the transfusion.
- C. Verify the blood type and Rh factor with another healthcare professional.
- D. Administer antihistamines before starting the transfusion.
Correct answer: C
Rationale: Verifying the blood type and Rh factor with another healthcare professional is the most crucial action to prevent a transfusion reaction. Ensuring compatibility between the donor blood and the recipient is essential in preventing adverse reactions such as hemolytic transfusion reactions. Checking vital signs is important for monitoring the client during the transfusion process but does not directly prevent a transfusion reaction. Using a blood filter can help remove clots and debris but does not address the risk of a reaction due to blood type incompatibility. Administering antihistamines before the transfusion is not a standard practice to prevent transfusion reactions related to blood type incompatibility.
2. The healthcare provider is caring for a client with diabetes insipidus. Which finding indicates that the treatment is effective?
- A. Urine output is decreased.
- B. Thirst is decreased.
- C. Weight loss is observed.
- D. Urine specific gravity is within the normal range.
Correct answer: D
Rationale: In diabetes insipidus, the body loses excessive amounts of water, leading to diluted urine with low specific gravity. Therefore, when the urine specific gravity is within the normal range, it indicates that the kidneys are properly concentrating urine, which is a sign of effective treatment for diabetes insipidus. Choices A, B, and C are incorrect because in diabetes insipidus, there is polyuria (excessive urination), persistent thirst due to fluid loss, and potential weight loss due to fluid imbalance, so these findings would not indicate effective treatment.
3. The client is receiving warfarin (Coumadin) therapy. Which statement by the client indicates a need for further teaching?
- A. I will avoid eating foods high in vitamin K.
- B. I will use a soft toothbrush and an electric razor.
- C. I will keep all appointments for blood tests.
- D. I will avoid participating in contact sports.
Correct answer: D
Rationale: The correct answer is D because participating in contact sports can increase the risk of injury and bleeding in a client receiving warfarin therapy. Warfarin is a blood thinner, and activities with a higher risk of injury should be avoided to prevent bleeding complications. Choices A, B, and C are all correct statements for a client on warfarin therapy. Avoiding foods high in vitamin K helps maintain consistent anticoagulation levels, using a soft toothbrush and an electric razor reduces the risk of bleeding gums and cuts, and keeping appointments for blood tests ensures proper monitoring of the client's international normalized ratio (INR) levels.
4. A 56-year-old female client is receiving intracavitary radiation via a radium implant. Which nurse should be assigned to care for this client?
- A. A nurse who is pregnant.
- B. A nurse with Marfan syndrome who is postmenopausal.
- C. A nurse with a cold.
- D. A nurse who is lactating.
Correct answer: B
Rationale: A nurse with Marfan syndrome who is postmenopausal can safely care for the client because Marfan syndrome does not affect the ability to care for this client, and postmenopausal status minimizes the risk of radiation exposure affecting reproductive health. Choice A is incorrect because pregnancy increases the risk of radiation exposure to the fetus. Choice C is incorrect because a nurse with a cold may have a compromised immune system and should not be exposed to radiation therapy. Choice D is incorrect because lactation can increase the risk of radiation exposure to breast tissue.
5. 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
Correct answer: A
Rationale: The most important intervention for the nurse to implement prior to the discharge of a homeless client with alcohol dependency who had a tuberculin skin test prescribed is to identify how the client will follow-up to have the results read. This is crucial to ensure proper diagnosis and treatment. Providing written information (Choice B) is helpful but not as critical as ensuring the follow-up plan. Determining if the client understands the purpose of the test (Choice C) is important but not as immediate as ensuring the follow-up plan. Explaining when the results should be read (Choice D) is important, but the priority is to make sure the client has a plan in place for follow-up.
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