HESI RN
HESI Community Health Questions
Question 1 of 5
While assessing a client receiving a blood transfusion, which finding requires immediate intervention?
Correct Answer: C
Rationale: A heart rate of 90 beats per minute requires immediate intervention when assessing a client receiving a blood transfusion. This finding can indicate a potential transfusion reaction, such as a hemolytic reaction or fluid overload, which requires prompt evaluation and management to prevent serious complications. While a temperature of 100.4°F (38°C) may indicate a mild fever, it is not typically an immediate concern during a blood transfusion. A blood pressure of 110/70 mm Hg is within the normal range, and complaints of feeling cold can be addressed but do not indicate an urgent need for intervention compared to the critical nature of a potential transfusion reaction indicated by an elevated heart rate.
Question 2 of 5
After coronary artery bypass graft surgery, a male client is admitted to the coronary care unit. Which nursing diagnosis is of the highest priority?
Correct Answer: B
Rationale: Impaired gas exchange is the highest priority nursing diagnosis because it directly impacts the client's oxygenation. Following coronary artery bypass graft surgery, ensuring adequate oxygen exchange is crucial for the client's recovery. Ineffective breathing pattern, although important, may not be as critical as impaired gas exchange in the immediate postoperative period. Acute pain, while significant, can be managed effectively with appropriate interventions and is not as emergent as addressing impaired gas exchange. Risk for infection is also a valid concern post-surgery, but ensuring optimal gas exchange takes precedence to prevent complications associated with inadequate oxygenation.
Question 3 of 5
The client, who is 6 weeks pregnant, is being educated by the nurse on prenatal care. Which statement indicates that the client comprehends the nurse's instructions?
Correct Answer: D
Rationale: The correct answer is D. During pregnancy, it is crucial to avoid taking any medication without consulting a healthcare provider to prevent harm to the developing fetus. Choices A, B, and C are important aspects of prenatal care but do not specifically address the potential risks associated with taking medications during pregnancy.
Question 4 of 5
The healthcare provider is caring for a client with a chest tube. Which observation indicates that the chest tube is functioning effectively?
Correct Answer: B
Rationale: Intermittent bubbling in the suction control chamber is the correct observation indicating effective functioning of the chest tube. This bubbling signifies that the suction system is working correctly and maintaining the desired negative pressure in the pleural space. Continuous bubbling in the water-seal chamber suggests an air leak, which is not a normal finding. No fluctuation (tidaling) in the water-seal chamber may indicate a blockage or lack of communication between the pleural space and the water-seal, which is not ideal. Drainage of clear, pale yellow fluid from the chest tube is a normal finding, but it does not specifically indicate the effectiveness of the chest tube function.
Question 5 of 5
A community health nurse is developing a program to increase physical activity among adults in the community. Which intervention is most likely to be successful?
Correct Answer: B
Rationale: Organizing free community exercise classes is the most likely successful intervention as it provides a structured and accessible opportunity for adults to engage in physical activity. This choice directly offers a practical solution by providing a regular and organized setting for individuals to participate in physical activity. Distributing flyers about the benefits of exercise, while informative, may not lead to actual participation. Partnering with local gyms to offer discounts relies on individuals taking the initiative to sign up for gym memberships, which may not be feasible for everyone. Hosting a health fair with information booths is informative but may not directly address the need for increased physical activity among adults in the community.