HESI RN
HESI Community Health
1. A client with chronic kidney disease is experiencing pruritus. Which intervention should the nurse include in the plan of care?
- A. Administer antihistamines as prescribed.
- B. Apply moisturizing lotion to the skin.
- C. Use cool water for bathing.
- D. Encourage a high-protein diet.
Correct answer: A
Rationale: Correct. Administering antihistamines as prescribed is the appropriate intervention for a client with chronic kidney disease experiencing pruritus. Antihistamines can help reduce pruritus by blocking histamine receptors, which are often prescribed for such clients. Choice B, applying moisturizing lotion, may help with dry skin but will not directly address pruritus. Choice C, using cool water for bathing, may provide some relief but does not target the underlying cause of pruritus. Choice D, encouraging a high-protein diet, is not directly related to managing pruritus in chronic kidney disease.
2. A nurse is planning a community health fair to promote cancer awareness. Which activity should be included to best engage participants?
- A. free cancer screenings
- B. lectures on cancer prevention
- C. distribution of educational materials
- D. testimonials from cancer survivors
Correct answer: A
Rationale: Offering free cancer screenings should be included in the community health fair to best engage participants. This activity provides immediate, valuable information about participants' cancer risk, making it highly engaging and actionable. While lectures on cancer prevention and distribution of educational materials are informative, they may not offer the same level of immediate engagement and impact as free screenings. Testimonials from cancer survivors, although inspiring, do not provide participants with direct information about their own cancer risk, making them less effective in engaging participants actively.
3. During a home visit, the nurse observes an elderly client with disabilities slip and fall. What action should the nurse take first?
- A. provide the client with 4 ounces of orange juice
- B. call 911 to summon emergency assistance
- C. check the client for lacerations or fractures
- D. assess the client's blood sugar level
Correct answer: C
Rationale: The correct action for the nurse to take first after an elderly client with disabilities slips and falls is to check the client for lacerations or fractures. This is crucial to assess the extent of injuries and provide appropriate medical attention promptly. Option A, providing orange juice, is not a priority in this situation and does not address the potential injuries. While calling 911 (Option B) may be necessary, assessing for immediate injuries takes precedence. Assessing the client's blood sugar level (Option D) is not the immediate priority after a fall unless there is a specific indication or suspicion of hypoglycemia.
4. A client with a history of heart failure is admitted with severe dyspnea. Which laboratory result requires immediate intervention?
- A. Blood glucose of 150 mg/dL.
- B. Serum potassium of 3.5 mEq/L.
- C. Serum creatinine of 1.0 mg/dL.
- D. Blood urea nitrogen (BUN) of 20 mg/dL.
Correct answer: C
Rationale: The correct answer is C. A serum creatinine level of 1.0 mg/dL is within the normal range. However, in a client with heart failure and severe dyspnea, fluid retention is a significant concern. An elevated serum creatinine level may indicate impaired kidney function, which can worsen fluid overload. Therefore, immediate intervention is required to prevent further complications. Choices A, B, and D are within normal ranges and not indicative of immediate intervention in this scenario.
5. The healthcare provider is caring for a client with hyperparathyroidism. Which laboratory result requires immediate intervention?
- A. Serum calcium of 11 mg/dL.
- B. Serum phosphorus of 3 mg/dL.
- C. Serum magnesium of 1.8 mg/dL.
- D. Serum albumin of 4 g/dL.
Correct answer: A
Rationale: A serum calcium level of 11 mg/dL indicates hypercalcemia, which can be a complication of hyperparathyroidism and requires immediate intervention. Hypercalcemia can lead to serious complications such as cardiac dysrhythmias, renal failure, and neurologic symptoms. Monitoring and managing serum calcium levels are crucial in clients with hyperparathyroidism. Serum phosphorus, magnesium, and albumin levels are important to assess in clients with hyperparathyroidism, but they do not require immediate intervention as hypercalcemia poses a more urgent risk.
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