Nursing Elites

1. A client with a history of diabetes mellitus is admitted with diabetic ketoacidosis (DKA). Which finding requires immediate intervention?

• A. Blood glucose of 200 mg/dL.
• B. Serum bicarbonate of 20 mEq/L.
• C. Blood pressure of 140/90 mm Hg.
• D. Urine output of 50 mL in 4 hours.

Correct answer: D

Rationale: In a client with diabetic ketoacidosis (DKA), urine output of 50 mL in 4 hours indicates oliguria, which is a concerning sign of decreased renal perfusion and potential renal failure. This finding requires immediate intervention to prevent further deterioration of kidney function.\n\nChoice A (Blood glucose of 200 mg/dL) is elevated but not the most urgent concern in this scenario. Choice B (Serum bicarbonate of 20 mEq/L) reflects metabolic acidosis, which is expected in DKA but does not require immediate intervention. Choice C (Blood pressure of 140/90 mm Hg) is slightly elevated but not acutely concerning in the context of DKA.

2. The healthcare provider is preparing to administer an intravenous antibiotic to a client with a central venous catheter. Which action is most important?

• A. Flush the catheter with heparin.
• B. Change the dressing at the insertion site.
• C. Check for blood return before administering the antibiotic.
• D. Use sterile technique when accessing the catheter.

Correct answer: D

Rationale: Using sterile technique when accessing the catheter is crucial to prevent infection in clients with a central venous catheter. This action helps maintain asepsis and reduces the risk of introducing pathogens into the catheter system. Flushing the catheter with heparin helps prevent occlusion but is not as crucial as ensuring sterile technique. Changing the dressing at the insertion site is important for assessing the site's condition but does not directly impact the administration of the antibiotic. Checking for blood return is essential to ensure proper catheter function, but sterile technique takes precedence to prevent infections.

3. When examining sources for funding, which criteria should the nurse clarify about the program for the community group?

• A. a prescription from the healthcare provider for each visit made
• B. documentation of a skilled care service provided during the visit
• C. a copy of the client's health history and social security card
• D. a record of the preventive healthcare services provided during the visit

Correct answer: C

Rationale: The correct answer is C because when seeking funding sources for a community outreach program, it is essential to clarify aspects related to the client's personal information, such as health history and identification details. This information helps in demonstrating the need for the program and understanding the target population. Choices A, B, and D are incorrect because they focus on clinical documentation, services provided during visits, and preventive healthcare services, which are not directly related to clarifying funding criteria about the program.

4. During a home visit, the nurse finds that an elderly client has multiple expired medications. What should the nurse do first?

• A. instruct the client to dispose of the expired medications
• B. review the client's current medication regimen
• C. contact the client's healthcare provider
• D. educate the client on the dangers of taking expired medications

Correct answer: B

Rationale: The correct first action for the nurse to take when finding multiple expired medications in an elderly client's home is to review the client's current medication regimen. This step is crucial to identify any potential issues, ensure the client is taking the correct medications, and understand why the expired medications were not used. Instructing the client to dispose of the expired medications (Choice A) can come after understanding the current medication situation. Contacting the client's healthcare provider (Choice C) may be necessary but reviewing the medication regimen should be the initial step. Educating the client on the dangers of taking expired medications (Choice D) is important but should be done after addressing the immediate concern of reviewing the current medications.

5. A community health nurse is working with a local organization to address food insecurity. Which action should the nurse prioritize?

• A. organizing a food drive to collect non-perishable items
• B. creating a community garden to grow fresh produce
• C. establishing a weekly meal program for those in need
• D. partnering with local businesses to donate food

Correct answer: C

Rationale: The correct answer is establishing a weekly meal program for those in need. This action prioritizes providing consistent and reliable access to food for individuals experiencing food insecurity. While organizing a food drive (Choice A) and partnering with local businesses to donate food (Choice D) are helpful, they may not offer a sustainable solution for ongoing food needs. Creating a community garden (Choice B) may promote self-sufficiency and access to fresh produce, but it may not address the immediate food needs of individuals who are food insecure. Therefore, establishing a weekly meal program is the most effective choice to ensure regular access to food for those in need.

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