Nursing Elites

1. A client presents at a community-based clinic with complaints of shortness of breath, headache, often uses a gasoline-powered pressure washer to clean equipment and farm buildings. Which type of poisoning is the most likely etiology of this client's symptoms?

• A. asbestos
• B. silica dust
• C. histoplasmosis
• D. carbon monoxide

Correct answer: D

Rationale: The correct answer is D, carbon monoxide poisoning. This client's symptoms of shortness of breath and headache are consistent with carbon monoxide exposure, which can result from using gasoline-powered equipment in poorly ventilated areas. Asbestos (choice A) is linked to respiratory issues but does not typically present with these acute symptoms. Silica dust (choice B) exposure is associated with lung damage, not the symptoms described. Histoplasmosis (choice C) is a fungal infection and would not typically manifest with the symptoms presented by the client.

2. The instructor is teaching a prenatal class about the importance of folic acid. Which outcome indicates that the teaching was effective?

• A. participants can list foods high in folic acid
• B. participants plan to take folic acid supplements daily
• C. participants understand the risks of folic acid deficiency
• D. participants demonstrate how to read nutrition labels for folic acid content

Correct answer: B

Rationale: The correct answer is B because planning to take folic acid supplements daily is a proactive step towards preventing folic acid deficiency and reducing the risk of neural tube defects in pregnancy. While choice A is important for dietary knowledge, the direct action of taking supplements is more effective. Choice C, understanding the risks, is good but does not ensure action. Choice D, reading nutrition labels, is helpful but doesn't guarantee intake of folic acid.

3. The healthcare provider is caring for a client with a chest tube following thoracic surgery. Which intervention should the healthcare provider include in the plan of care?

• A. Clamp the chest tube for 30 minutes every 2 hours.
• B. Milk the chest tube to ensure patency.
• C. Keep the drainage system at the level of the chest.
• D. Ensure that the chest tube is not clamped or kinked.

Correct answer: D

Rationale: Ensuring that the chest tube is not clamped or kinked is essential to maintain proper drainage and prevent complications. Clamping the chest tube can lead to a buildup of pressure in the pleural space, causing potential harm to the client. Milking the chest tube is not recommended as it can cause damage to the delicate tubing. Keeping the drainage system at the level of the chest ensures proper drainage by gravity, preventing backflow of fluids, but ensuring the tube is not clamped or kinked takes precedence in this scenario.

4. The healthcare provider is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which intervention is most important?

• A. Restrict fluids to 1,000 mL per day.
• B. Administer a vasopressin antagonist.
• C. Monitor intake and output.
• D. Encourage a high-sodium diet.

Correct answer: B

Rationale: Administering a vasopressin antagonist is the most critical intervention for a client with SIADH. SIADH is characterized by excessive release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. A vasopressin antagonist helps manage the symptoms by blocking the effects of ADH, promoting water excretion, and restoring electrolyte balance. Restricting fluids (choice A) may exacerbate hyponatremia, monitoring intake and output (choice C) is important but not the most critical intervention, and encouraging a high-sodium diet (choice D) is contraindicated in SIADH due to the risk of worsening hyponatremia.

5. The nurse is designing a community health project based on a report provided by the World Health Organization that describes healthcare problems in the United States. Which healthcare issue should the nurse give the highest priority when planning the project?

• A. overuse of diagnostic technology
• B. government-based health insurance
• C. the neonatal and infant mortality rates
• D. number of people without access to healthcare

Correct answer: D

Rationale: The correct answer is D: number of people without access to healthcare. Ensuring access to healthcare is fundamental to addressing a wide range of health issues and is a priority for improving overall community health. Option A, overuse of diagnostic technology, though important, is not the highest priority when considering basic access to healthcare. Option B, government-based health insurance, is relevant but may not directly address the issue of lack of access for all individuals. Option C, neonatal and infant mortality rates, is crucial but addressing access to healthcare for all individuals is a more immediate and foundational concern for the community health project.

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