Nursing Elites

1. A client presents at a community-based clinic with complaints of shortness of breath, headache, dizziness, and nausea. During the assessment, the nurse learns that the client is a migrant worker who 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 client's symptoms of shortness of breath, headache, dizziness, and nausea are indicative of carbon monoxide poisoning, which can result from exposure to gasoline-powered equipment like pressure washers. Asbestos (Choice A) exposure would typically present with respiratory issues and cancer but not the rapid onset of symptoms described. Silica dust (Choice B) exposure is associated with respiratory conditions like silicosis, not the multisystem symptoms in the scenario. Histoplasmosis (Choice C) is a fungal infection that primarily affects the lungs and is not related to the client's exposure to a gasoline-powered pressure washer.

2. The nurse is caring for a 75-year-old client in congestive heart failure. Which finding suggests that digitalis levels should be reviewed?

• A. Extreme fatigue
• B. Increased appetite
• C. Intense itching
• D. Constipation

Correct answer: A

Rationale: Extreme fatigue can be a sign of digitalis toxicity, especially in older adults, and warrants a review of the client's medication levels and potential adjustment. Increased appetite, intense itching, and constipation are not typically associated with digitalis toxicity and do not directly indicate a need for a review of digitalis levels.

3. The process by which an individual gains knowledge and skills to improve their health and well-being is known as:

• A. Health literacy
• B. Health education
• C. Health promotion
• D. Health behavior

Correct answer: B

Rationale: The correct answer is B: Health education. Health education is the process through which individuals acquire knowledge and skills to enhance their health and well-being. Health literacy (choice A) refers to the ability to understand and use health information, but it is not the same as the process of gaining knowledge and skills. Health promotion (choice C) involves advocating for health and implementing interventions to improve health outcomes, rather than the individual learning process. Health behavior (choice D) pertains to the actions individuals take regarding their health, not specifically the process of gaining knowledge and skills.

4. The nurse is planning a nutrition class for a group of high school students emphasizing the goals for nutrition from Healthy People 2020. Which meal selection provides the best choices in meeting these goals?

• A. pasta with cheese sauce, garlic butter bread, and vegetable juice drink
• B. a 6-oz pork chop, creamed peas, cheese sauce on potatoes, coffee
• C. vegetable lasagna, lettuce salad, a whole wheat roll, 8 oz of 2% milk
• D. bacon, lettuce, tomato sandwich, whole grain chips, 8 oz. of whole milk

Correct answer: C

Rationale: The correct answer is C because vegetable lasagna, lettuce salad, and a whole wheat roll with 2% milk align with the nutrition goals of Healthy People 2020. These choices provide a balanced meal with vegetables, whole grains, and dairy, promoting a healthier dietary pattern. Choices A, B, and D do not offer as comprehensive a selection of food groups or as healthy options as choice C, making them less aligned with the nutrition goals of Healthy People 2020.

5. As the immediate supervisor of the Rural Health Midwives, the PHN prepares a supervisory plan. Which of the following would be the PHN's activity?

• A. performing needs assessment
• B. listing supervisory activities
• C. identifying the training needs
• D. formulating objectives for supervision

Correct answer: B

Rationale: The correct answer is B: listing supervisory activities. When preparing a supervisory plan, the Public Health Nurse (PHN) needs to list the specific supervisory activities that need to be carried out. This helps in organizing and outlining the tasks that need to be accomplished to ensure effective supervision. Choices A, C, and D are incorrect because although needs assessment, identifying training needs, and formulating objectives are important aspects of supervisory planning, they are not specifically related to the act of preparing a detailed list of supervisory activities.

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