HESI 1
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Free HESI 1 Questions
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Refer to healthcare provider for complete evaluation
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Create a list of foods that promote wound healing
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Instruct client to apply antibiotic ointment to sores
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Send client to the emergency department for treatment
Explanation
Correct Answer: A) Refer to healthcare provider for complete evaluation
The clinical picture of pale, bluish (cyanotic) feet with poorly healing sores on the lower extremities is highly suggestive of peripheral arterial disease (PAD) or severe peripheral vascular insufficiency, possibly complicated by diabetes or other systemic conditions. This presentation requires a thorough medical evaluation including vascular assessment, wound care management, and investigation of the underlying cause.
At a community health screening fair, the most appropriate nursing intervention is to refer the client to a healthcare provider for a complete evaluation rather than initiating independent treatments. Sending the client to the emergency department is not warranted unless there are signs of acute limb ischemia or sepsis. Providing dietary advice or instructing self-application of ointment are insufficient responses to what may be a serious vascular condition.
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Axillary temperature of 100.8°F (38.2°C)
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Clear nasal drainage and cough
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Poor appetite and frequent crying
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Redness at the injection sites
Explanation
Correct Answer: A) Axillary temperature of 100.8°F (38.2°C)
While a low-grade fever is a common and expected reaction following routine immunizations, an axillary temperature of 100.8°F (38.2°C) in a 6-month-old infant exceeds the threshold that warrants notification of the healthcare provider.
In infants under 3 months, any fever requires immediate evaluation, and in infants 3–6 months, a fever at or above 100.4°F (38°C) should be reported. Redness at the injection site, mild irritability, poor appetite, and frequent crying are all common, expected, and self-limiting post-immunization reactions that do not require provider notification.
Clear nasal drainage and cough are unrelated to immunization reactions and suggest a concurrent viral illness, but are not the most critical finding to report in this context.
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The majority of suicides occur in lower socioeconomic groups
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Social support systems ensure suicide prevention
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Severe life stresses at any age is a risk factor for suicide
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Suicide discussion is dangerous with people with depression
Explanation
Correct Answer: C) Severe life stresses at any age is a risk factor for suicide
Severe life stressors — such as loss of a loved one, financial crisis, serious illness, relationship breakdown, or trauma — are well-established risk factors for suicide across all age groups and demographics. Suicide does not discriminate by age, and community education must emphasize that anyone experiencing overwhelming stress is potentially at risk.
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Ask the agency social worker to meet with the client about these concerns
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Explain that the client will be referred to government subsidized hospice care
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Assist the client in completing an application for social security disability
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Encourage the client to ventilate concerns about the financial situation
Explanation
Correct Answer: A) Ask the agency social worker to meet with the client about these concerns
The client is expressing significant financial and psychosocial concerns related to end-of-life care, lack of health insurance, and the burden of debt on the family. The most important nursing action is to refer the client to the agency social worker, who is the appropriate interdisciplinary team member trained to address financial concerns, connect clients with community resources, navigate insurance and hospice options, and provide end-of-life planning support. This is the most comprehensive and appropriate intervention. Simply encouraging the client to ventilate concerns is therapeutic but does not actively address the problem. Explaining hospice referral or assisting with social security disability applications may be appropriate follow-up steps, but coordinating with the social worker first ensures the client receives the most complete and expert assistance for their complex needs.
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Caregiver stress
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Social isolation
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Medication interactions
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Urinary incontinence
Explanation
Correct Answer: C) Medication interactions
In older adult clients with multiple comorbidities, polypharmacy is one of the most critical and potentially life-threatening concerns. Older adults are often prescribed multiple medications by different providers, significantly increasing the risk of dangerous drug interactions, adverse effects, and toxicity.
Age-related physiological changes — including decreased renal and hepatic function, reduced body water, and altered drug metabolism — further increase vulnerability to medication-related harm.
While caregiver stress, social isolation, and urinary incontinence are all important concerns in the elderly, medication interactions pose the most immediate and potentially fatal risk and must be investigated as the priority.
Explanation
Correct Answers: The IV is ahead | New rate should be 13 gtts/min
Step 1 — Determine if the IV is on time, behind, or ahead: At a rate of 1000 mL over 10 hours, the expected rate is 100 mL/hour. From 1000 to 1400 is 4 hours, so the expected volume infused should be 4 × 100 mL = 400 mL. However, 500 mL has already infused, meaning the IV is running ahead of schedule.
Step 2 — Calculate remaining volume and time: Remaining volume = 1000 − 500 = 500 mL. Remaining time = 10 hours total − 4 hours elapsed = 6 hours remaining.
Step 3 — Calculate new drip rate: Using the formula: (Volume remaining ÷ Time remaining in minutes) × Drop factor = gtts/min. Time remaining = 6 hours × 60 minutes = 360 minutes. (500 mL ÷ 360 minutes) × 15 gtts/mL = 7500 ÷ 360 = 20.8 gtts/min, rounded to 21 gtts/min.
Note: The IV is ahead, and the new rate should be 21 gtts/min to complete the remaining 500 mL in the remaining 6 hours.
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Serum total cholesterol level
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Annual flu vaccination status
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Weight and height measurement
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Long bone density testing
Explanation
Correct Answer: C) Weight and height measurement
Weight and height measurements are the most fundamental and universally applicable screening tools for elementary school-aged children. They are used to calculate BMI (Body Mass Index), which helps identify children at risk for obesity, undernutrition, and related health conditions such as type 2 diabetes and cardiovascular disease — all of which are increasingly prevalent in pediatric populations.
These measurements are non-invasive, inexpensive, and appropriate for all children regardless of individual risk factors. Serum cholesterol testing and long bone density testing are more specialized, invasive, and not standard screenings for the general elementary school population. Annual flu vaccination status is important but is a tracking measure rather than a health risk screening parameter.
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State law
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Nurse Practice Act
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The facility's nursing procedure manual
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American Nurse Association (ANA) Code of Ethics
Explanation
Correct Answer: A) State law
Reporting of suspected elder abuse is governed by state law, which mandates specific requirements for who must report, to whom reports must be made, the timeframe for reporting, and the legal protections afforded to reporters. Nurses are mandatory reporters of suspected abuse in all U.S. states, and the specific reporting obligations and procedures are defined by individual state statutes.
The Nurse Practice Act governs the scope of nursing practice. The facility's procedure manual provides internal guidance but is subordinate to state law. The ANA Code of Ethics provides ethical principles but does not carry the legal authority or specific reporting requirements that state law provides.
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Explain that reporting the infection to health agencies is required
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Urge the client to have regular STI screening every two years
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Discuss that partners without similar symptoms may not be infected
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Provide counseling that most contraceptives protect against infection
Explanation
Correct Answer: A) Explain that reporting the infection to health agencies is required
Chlamydia is a notifiable sexually transmitted infection, meaning healthcare providers are legally required to report confirmed cases to local and state health departments. This is a public health measure designed to track the spread of STIs, facilitate contact tracing, and ensure that sexual partners are notified and treated to prevent further transmission. The nurse must inform the client of this legal requirement.
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Provide supplemental oxygen to improve cognitive symptoms
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Provide the family with lead education and regular developmental and behavioral surveillance
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Monitor blood lead levels at 1 month, then every 3 to 4 months
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Ask the parent about the age of their home and any home remedies that may have been taken
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Initiate chelation therapy immediately due to elevated lead levels
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Refer to social services if necessary
Explanation
Correct Answers: B) Provide the family with lead education and regular developmental and behavioral surveillance, C) Monitor blood lead levels at 1 month, then every 3 to 4 months, D) Ask the parent about the age of their home and any home remedies that may have been taken, and F) Refer to social services if necessary
A blood lead level of 7 μg/dL exceeds the CDC reference value of 3.5 μg/dL, requiring follow-up and conservative management. Family education about lead sources and reducing exposure is the cornerstone of management at this level. Regular developmental and behavioral surveillance is essential because even low lead levels can impair neurodevelopment, attention, and academic performance.
Follow-up blood lead level monitoring at 1 month and then every 3–4 months tracks exposure trends over time. Asking about the age of the home is critical since homes built before 1978 are likely to contain lead-based paint, the most common source of childhood lead poisoning. Inquiring about home remedies is important as some cultural preparations contain lead.
Social service referral ensures the family receives support in identifying and eliminating lead sources in the environment.
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