HESI (Health and Environmental Sciences Institute) Health Assessment Practice Test

A nurse observes periorbital edema in a patient. What should the nurse inquire about first?

1. History of exophthalmos

2. Presence of hyperthyroidism

3. History of heart failure

4. Symptoms of blepharitis

The correct answer is: History of heart failure

Periorbital edema, or swelling around the eyes, can be indicative of various underlying conditions, so it is crucial for the nurse to gather pertinent information. Inquiring about the patient's history of heart failure is particularly important because heart failure can lead to fluid retention and generalized edema, which may manifest as periorbital swelling. Since the eyes are a common area for fluid accumulation, understanding the patient’s cardiovascular health history helps the nurse assess whether the edema is related to systemic issues, such as congestive heart failure. This line of questioning allows the nurse to determine if the edema is due to fluid overload as a result of impaired heart function, which could significantly alter the patient's management and treatment plan. Having this information enables timely interventions and helps ensure that any underlying cardiovascular issues are addressed appropriately.