Nursing Elites

1. A client is admitted for COPD. Which finding would require the nurse's immediate attention?

• A. Nausea and vomiting
• B. Restlessness and confusion
• C. Low-grade fever and cough
• D. Irritating cough and liquefied sputum

Correct answer: B

Rationale: Restlessness and confusion are signs of hypoxia and hypercapnia in a client with COPD, indicating that the client's condition may be deteriorating rapidly. Immediate attention is necessary to prevent further complications. Nausea and vomiting (Choice A) may be related to various factors but do not directly indicate respiratory distress. Low-grade fever and cough (Choice C) are common in COPD and may not require immediate intervention. Irritating cough and liquefied sputum (Choice D) are typical symptoms of COPD exacerbation but do not signal an immediate need for attention as restlessness and confusion.

2. What action is best for the community health nurse to take if the nurse suspects that an infant is being physically abused?

• A. Follow agency protocols to report suspected abuse.
• B. Report suspicions to the local child abuse reporting hotline.
• C. Educate the child's caregivers about growth and development issues.
• D. Call the police department to have the child removed from the home.

Correct answer: A

Rationale: When a community health nurse suspects that an infant is being physically abused, the best course of action is to follow agency protocols to report the suspected abuse. This is essential to ensure that the appropriate authorities are informed, and proper interventions can be initiated. Reporting suspicions to the local child abuse reporting hotline (Choice B) can be a part of the agency protocols but may not cover all necessary steps. Educating the child's caregivers about growth and development (Choice C) is not appropriate in cases of suspected abuse, as the immediate focus should be on the safety and well-being of the infant. Calling the police department to have the child removed from the home (Choice D) is not the primary role of the nurse; the proper authorities should handle the removal process after an investigation.

3. A community health RN believes that immunization rates in a lower socioeconomic section of the city are probably below the target set by the state health department. What action should the RN take FIRST to intervene with this health problem?

• A. Take a health history of the members of the community
• B. Initiate an immunization program for the community
• C. Review current epidemiological population data that might document a low immunization rate
• D. Refer all clients to the local health department

Correct answer: C

Rationale: The correct first action for the community health RN to take in this situation is to review current epidemiological population data that might document a low immunization rate. By doing so, the RN can gather evidence to support further intervention strategies. Option A is incorrect because taking a health history would not provide immediate data on immunization rates in the community. Option B is incorrect as initiating an immunization program without confirming the actual immunization rates may not address the specific needs of the community. Option D is incorrect as a blanket referral without assessing the situation may not be the most effective first step.

4. Which of the following statements can motivate a couple to practice family planning?

• A. Family planning helps families improve their standard of living.
• B. Family planning reduces or eliminates fear of unwanted pregnancies.
• C. Family planning affords family members time to study or pursue personal interests.
• D. All of the above

Correct answer: D

Rationale: The correct answer is D because all the listed statements provide valid reasons to motivate couples to practice family planning. Option A highlights how family planning can lead to an improvement in the standard of living by allowing families to better manage their resources. Option B emphasizes the importance of family planning in reducing or eliminating the fear of unwanted pregnancies, which can have significant emotional and financial implications for couples. Option C points out that family planning can also afford family members time to focus on personal development, such as studying or pursuing personal interests, without the added responsibilities of unplanned pregnancies. Therefore, all these factors combined can serve as strong motivators for couples to consider and practice family planning. Choices A, B, and C are incorrect because each of them individually provides a valid reason to motivate couples, making the comprehensive answer D the most appropriate.

5. A nurse is preparing to administer a tuberculosis (TB) test to a client. Which of the following is the correct method for administering this test?

• A. Intradermal injection on the forearm
• B. Subcutaneous injection on the upper arm
• C. Intramuscular injection on the deltoid
• D. Oral administration

Correct answer: A

Rationale: The correct method for administering a tuberculosis (TB) test is through an intradermal injection on the forearm. This technique allows for the proper administration of the test under the skin to assess the body's response to the TB antigen. Choices B, C, and D are incorrect because the TB test specifically requires an intradermal injection, not subcutaneous, intramuscular, or oral administration.

Similar Questions