Nursing Elites

1. A client with a history of alcoholism is admitted to the hospital for detoxification. The nurse knows that the client's risk for withdrawal symptoms is greatest within:

• A. 2-4 hours
• B. 4-6 hours
• C. 6-12 hours
• D. 12-24 hours

Correct answer: D

Rationale: The correct answer is D: 12-24 hours. Withdrawal symptoms typically begin within 12-24 hours after the last drink. This period is when the client is at the highest risk for experiencing withdrawal symptoms. Choices A, B, and C are incorrect because they do not align with the typical timeline for alcohol withdrawal symptoms to manifest. Symptoms usually peak within the first 24 to 48 hours after the last drink, making the 12-24 hour window critical for monitoring and managing any potential withdrawal complications.

2. A community hospital is an example of which level of health care?

• A. Secondary level health care
• B. Primary health care
• C. Tertiary level care
• D. Intermediate level care

Correct answer: A

Rationale: A community hospital is categorized under secondary level health care. Secondary level health care facilities, like community hospitals, provide specialized outpatient care, diagnostic services, and treatment that are more complex than what is offered in primary health care settings. Choice B, primary health care, refers to basic and routine health care services typically provided by family doctors or general practitioners, which is not the level of care provided by community hospitals. Tertiary level care (choice C) involves highly specialized and complex medical services such as neurosurgery or organ transplants, which are beyond the scope of services provided by community hospitals. Intermediate level care (choice D) is not a recognized category in the hierarchy of health care levels.

3. Which individual has the highest risk of developing community-acquired pneumonia?

• A. A 40-year-old first-grade teacher who works with underprivileged children.
• B. A 75-year-old retired secretary with exercise-induced wheezing.
• C. A 60-year-old homeless person who is an alcoholic and smokes.
• D. A 35-year-old aerobics instructor who skips meals and eats only vegetables.

Correct answer: C

Rationale: The correct answer is the 60-year-old homeless person who is an alcoholic and smokes. This individual has the highest risk of developing community-acquired pneumonia due to factors such as homelessness, alcoholism, and smoking, which weaken the immune system and make them more susceptible to respiratory infections. Choice A is incorrect as working with underprivileged children, while potentially exposing the individual to various illnesses, does not directly increase the risk of pneumonia. Choice B is less likely as exercise-induced wheezing may suggest asthma but does not directly correlate with pneumonia risk. Choice D, an aerobics instructor who eats only vegetables and skips meals, does not have the same level of risk factors for pneumonia as the homeless person in choice C.

4. What title should be given to this occupational health nurse job description? A registered nurse who establishes a provider network, recommends treatment plans that assure quality and efficacy while controlling costs, monitors outcomes, and maintains communication among all involved.

• A. manager
• B. researcher
• C. case manager
• D. health promotion specialist

Correct answer: C

Rationale: The correct answer is C: case manager. A case manager in healthcare coordinates care, monitors outcomes, and ensures quality and cost-effectiveness. In this job description, the nurse is mainly focused on coordinating care, recommending treatment plans, monitoring outcomes, and maintaining communication among all involved, which aligns with the responsibilities of a case manager. Choices A, B, and D are incorrect because the job description does not primarily involve general management, research, or health promotion specialization.

5. 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.

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