an older adult client visits the community health clinic and reports the onset of pain redness and swelling of the right eye which question is most im
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Nursing Elites

HESI RN

Community Health HESI

1. An older adult client visits the community health clinic and reports the onset of pain, redness, and swelling of the right eye. Which question is most important for the clinic nurse to ask the client?

Correct answer: B

Rationale: The most important question for the nurse to ask the client is whether they have started any new prescriptions. New medications can have side effects that include eye issues, so it is crucial to determine if there is a potential link. Asking about discharge from the eye (Choice A) may be relevant but does not address the possibility of medication side effects. Inquiring about immunizations (Choice C) and handwashing frequency (Choice D) is important for overall health but is less directly related to the eye symptoms described by the client.

2. A client who is receiving intravenous heparin therapy has an activated partial thromboplastin time (aPTT) of 90 seconds. Which action should the nurse take?

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.

3. The healthcare professional is developing a program to promote healthy eating habits in a community with high rates of obesity. Which strategy is most likely to be effective?

Correct answer: B

Rationale: Offering cooking classes that focus on healthy recipes is the most effective strategy among the choices provided. These classes not only provide valuable knowledge about nutrition but also offer hands-on experience in preparing healthy meals. This practical approach can significantly impact participants' behavior and increase the likelihood of them adopting healthier eating habits. Distributing educational pamphlets may not have the same level of engagement and interaction as cooking classes. A social media campaign, while informative, may not result in direct behavioral changes. Providing free health screenings, though beneficial for early detection, does not directly address the promotion of healthy eating habits, unlike the hands-on approach of cooking classes.

4. A client with chronic kidney disease is experiencing pruritus. Which intervention should the nurse include in the plan of care?

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.

5. During a prenatal class for expectant mothers, what topic should be included to ensure the health of both the mother and the baby?

Correct answer: A

Rationale: The correct answer is the importance of taking prenatal vitamins. Prenatal vitamins are crucial for the health of both the mother and the baby as they provide essential nutrients required for fetal development. While handling common discomforts of pregnancy (choice B) is important for maternal well-being, it does not directly impact the health of the baby. Preparing for labor and delivery (choice C) focuses more on the delivery process rather than the overall health of the mother and baby during pregnancy. Breastfeeding techniques (choice D) are relevant postpartum, not during the prenatal period, and do not directly impact the health of the baby during pregnancy.

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