the nurse is assessing a client with chronic obstructive pulmonary disease copd which finding requires immediate intervention
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Nursing Elites

HESI RN

Community Health HESI

1. The healthcare provider is assessing a client with chronic obstructive pulmonary disease (COPD). Which finding requires immediate intervention?

Correct answer: C

Rationale: A respiratory rate of 26 breaths per minute is an abnormal finding and indicates that the client is experiencing respiratory distress, requiring immediate intervention. This rapid respiratory rate can signify inadequate oxygenation and ventilation. Oxygen saturation of 88% is low but not as immediately concerning as a high respiratory rate, which indicates the body is compensating for respiratory distress. The use of accessory muscles for breathing and a barrel-shaped chest are typical findings in clients with COPD but do not indicate an immediate need for intervention as they are more chronic in nature and may be seen in stable COPD patients.

2. During a prenatal class for expectant mothers, what topic should be included to ensure the health of both the mother and the baby?

Correct answer: A

Rationale: The correct answer is the importance of taking prenatal vitamins. Prenatal vitamins are crucial for the health of both the mother and the baby as they provide essential nutrients required for fetal development. While handling common discomforts of pregnancy (choice B) is important for maternal well-being, it does not directly impact the health of the baby. Preparing for labor and delivery (choice C) focuses more on the delivery process rather than the overall health of the mother and baby during pregnancy. Breastfeeding techniques (choice D) are relevant postpartum, not during the prenatal period, and do not directly impact the health of the baby during pregnancy.

3. The healthcare professional is developing a program to promote healthy eating habits in a community with high rates of obesity. Which strategy is most likely to be effective?

Correct answer: B

Rationale: Offering cooking classes that focus on healthy recipes is the most effective strategy among the choices provided. These classes not only provide valuable knowledge about nutrition but also offer hands-on experience in preparing healthy meals. This practical approach can significantly impact participants' behavior and increase the likelihood of them adopting healthier eating habits. Distributing educational pamphlets may not have the same level of engagement and interaction as cooking classes. A social media campaign, while informative, may not result in direct behavioral changes. Providing free health screenings, though beneficial for early detection, does not directly address the promotion of healthy eating habits, unlike the hands-on approach of cooking classes.

4. The healthcare provider is caring for a client with hyperparathyroidism. Which laboratory result requires immediate intervention?

Correct answer: A

Rationale: A serum calcium level of 11 mg/dL indicates hypercalcemia, which can be a complication of hyperparathyroidism and requires immediate intervention. Hypercalcemia can lead to serious complications such as cardiac dysrhythmias, renal failure, and neurologic symptoms. Monitoring and managing serum calcium levels are crucial in clients with hyperparathyroidism. Serum phosphorus, magnesium, and albumin levels are important to assess in clients with hyperparathyroidism, but they do not require immediate intervention as hypercalcemia poses a more urgent risk.

5. A client with hyperthyroidism is receiving radioactive iodine therapy. Which statement by the client indicates a need for further teaching?

Correct answer: D

Rationale: The correct answer is 'D.' The client stating 'I should expect to have no side effects' indicates a need for further teaching as it is incorrect. With radioactive iodine therapy, side effects like dry mouth, taste changes, and neck swelling are common. Choices A and B are correct statements; the client should avoid close contact with pregnant women and children due to radiation exposure, and dry mouth and taste changes are common side effects. Choice C is also correct, making D the correct answer.

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