the nurse is caring for a client with addisons disease which finding requires immediate intervention
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Nursing Elites

HESI RN

Community Health HESI

1. The nurse is caring for a client with Addison's disease. Which finding requires immediate intervention?

Correct answer: B

Rationale: Low blood pressure in a client with Addison's disease requires immediate intervention as it can indicate an Addisonian crisis, a life-threatening condition that necessitates prompt treatment. Hyperpigmentation of the skin is a characteristic finding in Addison's disease but does not require immediate intervention. Nausea and vomiting can be managed symptomatically in Addison's disease. While hypoglycemia needs attention, it is not the most critical finding requiring immediate intervention in this context.

2. Following an emergency Cesarean delivery, the nurse encourages the new mother to breastfeed her newborn. The client asks why she should breastfeed now. Which information should the nurse provide?

Correct answer: C

Rationale: The correct answer is C: 'To stimulate contraction of the uterus.' After delivery, breastfeeding helps in stimulating the release of oxytocin, which triggers the contraction of the uterus. This contraction is crucial to prevent uterine hemorrhage and facilitate the involution process. Choices A, B, and D are incorrect. While breastfeeding can indeed help in bonding with the baby and promoting milk production, in the immediate postpartum period after a Cesarean section, the priority is to ensure uterine contraction to prevent complications.

3. A community health nurse is planning an intervention to reduce the incidence of type 2 diabetes in the community. Which strategy is most effective?

Correct answer: A

Rationale: The most effective strategy to reduce the incidence of type 2 diabetes in the community is hosting cooking classes on preparing healthy meals. This intervention provides practical skills and education that can directly impact dietary habits, leading to a decreased risk of developing type 2 diabetes. Offering free blood glucose screenings (Choice B) may help in early detection but does not address prevention. Distributing pamphlets on diabetes prevention (Choice C) provides information but lacks the interactive and hands-on approach of cooking classes. Organizing a community walking program (Choice D) promotes physical activity, which is beneficial, but dietary changes have a more significant impact on preventing type 2 diabetes.

4. The public health nurse is evaluating resources in a rural community. Which healthcare resource is most important for the community?

Correct answer: B

Rationale: In rural areas, accessibility to trauma care is the most critical healthcare resource due to the longer emergency response times. Trauma care can be life-saving in situations where immediate medical attention is required for severe injuries. The other options, such as a family planning center, annual health fair, and weather-related disaster plan, are important but not as crucial as trauma care in addressing urgent health needs in a rural community.

5. During a home visit, the nurse observes an elderly client with disabilities slip and fall. What action should the nurse take first?

Correct answer: C

Rationale: The correct action for the nurse to take first after an elderly client with disabilities slips and falls is to check the client for lacerations or fractures. This is crucial to assess the extent of injuries and provide appropriate medical attention promptly. Option A, providing orange juice, is not a priority in this situation and does not address the potential injuries. While calling 911 (Option B) may be necessary, assessing for immediate injuries takes precedence. Assessing the client's blood sugar level (Option D) is not the immediate priority after a fall unless there is a specific indication or suspicion of hypoglycemia.

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