a client with a history of diabetes mellitus is admitted with diabetic ketoacidosis dka which finding requires immediate intervention
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HESI RN

Community Health HESI Quizlet

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

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. A public health nurse is working with a community to improve access to healthcare services. Which intervention is most likely to be effective?

Correct answer: A

Rationale: Setting up mobile clinics in underserved areas is the most effective intervention to improve access to healthcare services. Mobile clinics directly bring healthcare services to the community, making it convenient for residents to access care without having to travel long distances. Distributing flyers may increase awareness but may not address the barriers to access. Offering transportation vouchers helps with one aspect of access but does not directly provide healthcare services. Partnering with local businesses for discounts may not address the primary issue of physical access to healthcare services in underserved areas.

3. A client who is receiving total parenteral nutrition (TPN) has an elevated blood glucose level. Which action should the nurse take first?

Correct answer: D

Rationale: The correct first action for a client receiving TPN with an elevated blood glucose level is to check the TPN infusion rate. Elevated blood glucose levels in clients receiving TPN can be due to incorrect infusion rates leading to increased glucose delivery. By checking the TPN infusion rate, the nurse can verify if the rate is appropriate and make necessary adjustments. Stopping the TPN infusion abruptly could lead to complications from sudden nutrient deprivation. Administering insulin as prescribed may be necessary but should come after ensuring the correct TPN infusion rate. Notifying the healthcare provider is important but addressing the immediate need to check the infusion rate takes priority to manage hyperglycemia effectively.

4. After assessing the health care needs of an elementary school, the nurse determines that an increased prevalence of pediculosis capitis is a priority problem. The nurse develops a 2-month program with the goal to eradicate the condition in the school. The program includes educational pamphlets sent home to parents and regular assessment of children by the school nurse. What action should the nurse implement to evaluate the effectiveness of the program?

Correct answer: D

Rationale: Measuring the prevalence of pediculosis capitis among the children after four months is the most appropriate action to evaluate the program's effectiveness. This approach provides data on the program's long-term impact and effectiveness in eradicating the condition. Option A focuses on the teachers' ability, which is not directly related to the program's effectiveness in eradicating the condition. Option B suggests conducting an initial examination, which does not provide information on the program's impact. Option C involves assessing parents' understanding, which is important but does not directly evaluate the program's effectiveness in eradicating pediculosis capitis.

5. Because this year's demographics reflect that a large percentage of the population is less than 19 years of age, a community group proposes building a new well-child clinic. Which question indicates that the nurse understands the potential gaps in this data?

Correct answer: A

Rationale: Option A is the correct answer because understanding the percentage of the population under 19 years of age in each of the previous five years helps to determine if the high percentage of youth is a consistent trend or a recent change. This information is crucial for assessing the need for a new well-child clinic. Choices B, C, and D are incorrect because they do not directly address the gaps in the data related to the age distribution trend over time, which is essential for making an informed decision about the necessity of the proposed clinic.

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