HESI 1
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Free HESI 1 Questions
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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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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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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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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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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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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.
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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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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