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 client with Raynaud's phenomenon would benefit most by which teaching intervention?

• A. Stop smoking
• B. Keep feet dry
• C. Reduce stress
• D. Avoid caffeine

Correct answer: A

Rationale: The correct answer is A: Stop smoking. Smoking causes vasoconstriction, worsening the symptoms of Raynaud's phenomenon. Quitting smoking is crucial in managing this condition effectively. Choices B, C, and D are not as directly related to the pathophysiology of Raynaud's phenomenon. While keeping feet dry and reducing stress can be beneficial for overall health, they are not as directly linked to managing Raynaud's phenomenon as smoking cessation.

3. A child and his family were exposed to Mycobacterium tuberculosis about 2 months ago. To confirm the presence or absence of an infection, it is most important for all family members to have a

• A. Chest x-ray
• B. Blood culture
• C. Sputum culture
• D. PPD intradermal test

Correct answer: D

Rationale: The PPD (purified protein derivative) intradermal test is the standard screening method for detecting tuberculosis infection. It helps identify individuals who have been infected with Mycobacterium tuberculosis. A chest x-ray (Choice A) is used to assess the extent of active disease, not for screening purposes. Blood culture (Choice B) is not typically used for tuberculosis screening. Sputum culture (Choice C) is used to confirm active tuberculosis in symptomatic individuals, not for initial screening purposes.

4. Occupational health nursing is concerned with the following except:

• A. educating workers about health
• B. immediate diagnosis of illness prevailing in the work field
• C. appropriate and effective ways of promoting health
• D. planning of administering health services

Correct answer: B

Rationale: Occupational health nursing focuses on educating workers about health, promoting health through appropriate and effective ways, and planning and administering health services in the workplace. Immediate diagnosis of illness prevailing in the work field is typically not the primary role of occupational health nursing, as it usually involves prevention, education, and health promotion rather than diagnosing acute conditions.

5. When asked to help develop interventions to combat obesity among children, the community health nurse should stress the importance of implementing which activity?

• A. Set goals that are focused on developing healthier lifestyles.
• B. Develop strict diet plans for school-aged children.
• C. Provide diet classes for obese children during school hours.
• D. Require all children to participate in organized team sports.

Correct answer: A

Rationale: The correct answer is A: Setting goals that are focused on developing healthier lifestyles. This approach is essential in combating childhood obesity as it promotes sustainable habits and behaviors. Option B, developing strict diet plans, may not be effective in the long term and could lead to unhealthy relationships with food. Option C, providing diet classes during school hours, may not address the root causes of obesity and could potentially stigmatize the children. Option D, requiring all children to participate in organized team sports, may not be feasible for all children and might not address dietary habits and sedentary behaviors.

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