HESI 1
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Free HESI 1 Questions
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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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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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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.
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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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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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.
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Availability of family members to provide meals.
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Medication history for antipsychotic agents.
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Community resources to provide financial aid.
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Client thoughts about wanting to hurt herself.
Explanation
Correct Answer: D) Client thoughts about wanting to hurt herself.
The client's statement that she "does not deserve to eat" is a significant red flag for depression and potential self-harm or suicidal ideation. The nurse's priority is always safety first — before addressing financial concerns, meals, or medication history. Assessing whether the client has thoughts of hurting herself directly addresses the most life-threatening concern and guides the next steps in care.
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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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Low income families living in cramped quarters.
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Those who have recently received a blood transfusion.
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Sexually active persons with multiple partners.
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IV drug users who share needles.
Explanation
Correct Answer: A) Low income families living in cramped quarters.
Hepatitis A is transmitted via the fecal-oral route, primarily through contaminated food, water, and poor sanitation — not through blood or sexual contact. Low-income families living in overcrowded conditions are at the greatest risk due to limited access to clean water, sanitation, and hygiene facilities.
Reference Range: Glycosylated hemoglobin (A1C) [4% to 5.9%]
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Ask the client why the hemoglobin A1C value is out of control
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Report the laboratory value to the healthcare provider immediately
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Explore the diabetes self care regimen with the client
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Congratulate the client on excellent glycemic control
Explanation
Correct Answer: C) Explore the diabetes self care regimen with the client
A hemoglobin A1C of 9.1% is significantly elevated above the normal reference range of 4%–5.9% and above the generally accepted therapeutic target of less than 7% for most clients with type 2 diabetes. This value reflects poor blood glucose control over the past 2–3 months.
The most therapeutic and constructive nursing action is to explore the client's diabetes self-care regimen — including diet, medication adherence, physical activity, and blood glucose monitoring — to identify barriers and areas for education and improvement.
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