HESI RN
HESI Community Health Questions
Question 1 of 5
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.
Question 2 of 5
An adolescent tells the school nurse that she is pregnant. Her last menstrual period was 4 months ago. She has not received any medical care. She smokes but denies any other substance use. What is the priority nursing action?
Correct Answer: B
Rationale: Prenatal care is crucial for monitoring the health of both the mother and the fetus.
Question 3 of 5
The healthcare provider is caring for a client with a chest tube. Which intervention is most important to include in the plan of care?
Correct Answer: D
Rationale: Keeping the collection chamber below the level of the chest is crucial in caring for a client with a chest tube. This positioning helps ensure proper drainage of fluids and prevents complications such as backflow of drainage into the chest cavity. Option A is incorrect as continuous suction can lead to excessive drainage and tissue damage. Option B is incorrect as clamping the chest tube during client movement can cause a buildup of pressure and compromise proper drainage. Option C is incorrect because clamping the chest tube for extended periods can impede the drainage process, leading to potential complications.
Question 4 of 5
The wife of an older adult man who has had diabetes mellitus for the past 10 years reports to the home health nurse that her husband fell yesterday while taking his daily walk in the neighborhood. He has a bruised hand and a small abrasion on his left knee. The nurse assesses that his neurologic vital signs are stable. To reduce risk for future falls, which assessment is most important for the nurse to obtain?
Correct Answer: B
Rationale: Assessing for paresthesia (numbness or tingling) in the feet can help determine if the client has a loss of sensation, which increases fall risk.
Question 5 of 5
A nurse is planning a community health fair to promote cancer awareness. Which activity should be included to best engage participants?
Correct Answer: A
Rationale: Offering free cancer screenings provides participants with immediate, valuable information about their cancer risk.
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