HESI RN
Community Health HESI Quizlet
1. The healthcare provider is inspecting the external eye structures of a client. Which finding is a normal racial variation?
- A. Blue sclerae.
- B. Brown macules on the sclerae.
- C. Slightly yellow sclerae in an African-American client.
- D. Conjunctival pallor.
Correct answer: C
Rationale: The slightly yellow color of the sclera is a normal racial variation found in the African-American population. Blue sclerae (Choice A) are associated with osteogenesis imperfecta, not a normal racial variation. Brown macules on the sclerae (Choice B) may indicate issues like melanoma or melanosis but are not a normal racial variation. Conjunctival pallor (Choice D) suggests anemia or decreased blood flow but is not a normal racial variation.
2. A male client expresses concern about how a hypophysectomy will affect his sexual function. Which of the following statements provides the most accurate information about the physiologic effects of hypophysectomy?
- A. Removing the source of excess hormone should restore the client's libido, erectile function, and fertility.
- B. Potency will be restored, but the client will remain infertile.
- C. Fertility will be restored, but impotence and decreased libido will persist.
- D. Exogenous hormones will be needed to restore erectile function after the adenoma is removed.
Correct answer: A
Rationale: Choice A is the most accurate statement regarding the physiologic effects of hypophysectomy on sexual function. The client's sexual problems are directly related to excessive hormone levels. Removing the source of excess hormone secretion through hypophysectomy should allow the client to return to a normal physiologic pattern, which includes restoring libido, erectile function, and fertility. Choices B, C, and D are incorrect. Choice B incorrectly states that the client will remain infertile, which is not necessarily true after a hypophysectomy. Choice C inaccurately suggests that fertility will be restored while impotence and decreased libido will persist, which is not aligned with the expected outcomes of hypophysectomy. Choice D is incorrect because exogenous hormones are typically not needed to restore erectile function after the adenoma is removed; rather, the removal of the source of excessive hormone secretion should address the sexual function concerns.
3. A 10-year-old child with hemophilia is admitted to the hospital with joint pain and swelling. What should the healthcare provider do first?
- A. Apply ice to the affected joint
- B. Administer pain medication
- C. Elevate the affected limb
- D. Administer factor VIII as prescribed
Correct answer: D
Rationale: Administering factor VIII as prescribed is the priority intervention for a child with hemophilia experiencing joint pain and swelling. Hemophilia is a genetic disorder that impairs the blood's ability to clot properly, leading to prolonged bleeding. Factor VIII replacement therapy is essential as it helps restore the missing clotting factor in patients with hemophilia, thereby aiding in clot formation and preventing further bleeding. Applying ice, administering pain medication, or elevating the limb may be supportive measures but addressing the underlying cause by providing factor VIII therapy takes precedence in managing hemophilia-related joint pain and swelling.
4. The healthcare provider prescribes a sepsis protocol for a client with multi-organ failure caused by a ruptured appendix. Which intervention is most important for the nurse to include in the care plan?
- A. Ensure early ambulation
- B. Administer antibiotics as prescribed
- C. Maintain strict intake and output
- D. Monitor blood glucose levels
Correct answer: C
Rationale: In sepsis with multi-organ failure, monitoring intake and output is critical to assess renal function and fluid balance, as organ failure can cause fluid shifts and decreased kidney function. Antibiotics are essential to treat the infection, but monitoring intake and output provides real-time insight into the client's status, helping to detect early signs of worsening organ function. Early ambulation and blood glucose monitoring are important aspects of care but are not as crucial as maintaining strict intake and output in this situation.
5. Which instruction about insulin administration should Nurse Kate give to a client?
- A. Always follow the same order when drawing up different insulins into the syringe.
- B. Shake the vials before withdrawing the insulin.
- C. Store unopened vials of insulin in the refrigerator at recommended temperatures.
- D. Discard the intermediate-acting insulin if it appears cloudy.
Correct answer: A
Rationale: The correct answer is A. Consistently following the same order when drawing up different insulins helps to prevent medication errors. Option B is incorrect because shaking insulin vials could cause bubbles to form, leading to inaccurate dosing. Option C is incorrect as insulin should be stored in the refrigerator, not the freezer, to maintain its effectiveness. Option D is incorrect because cloudy appearance in intermediate-acting insulin may indicate the presence of insulin crystals, which can affect its potency, but this does not necessarily mean it should be discarded without consulting a healthcare provider.