Nursing Elites

1. A client with a history of coronary artery disease is admitted with chest pain. Which finding requires immediate intervention?

• A. Heart rate of 90 beats per minute.
• B. Blood pressure of 130/80 mm Hg.
• C. Respiratory rate of 20 breaths per minute.
• D. Chest pain radiating to the left arm.

Correct answer: D

Rationale: The correct answer is D. Chest pain radiating to the left arm can be a sign of myocardial infarction (heart attack) and requires immediate intervention. This symptom is known as a classic presentation of a heart attack and warrants urgent medical attention to prevent further cardiac damage. Choices A, B, and C are not directly indicative of an acute cardiac event and may not require immediate intervention in this scenario. While heart rate, blood pressure, and respiratory rate are important vital signs to monitor, they do not specifically indicate the urgency associated with chest pain radiating to the left arm in a patient with a history of coronary artery disease.

2. The healthcare professional is conducting a community assessment to identify health needs. Which method is most effective for gathering comprehensive data?

• A. conducting focus groups with community members
• B. reviewing local health department reports
• C. surveying healthcare providers in the area
• D. analyzing hospital admission records

Correct answer: A

Rationale: Conducting focus groups with community members is the most effective method for gathering comprehensive data during a community assessment. This approach allows direct interaction with community members, fostering in-depth discussions that provide insights into the specific health needs and concerns of the community. Choice B, reviewing local health department reports, may offer valuable data but might not capture the nuanced perspectives and experiences of community members. Choice C, surveying healthcare providers, provides insights from a professional standpoint but may not fully represent the community's diverse health needs. Choice D, analyzing hospital admission records, offers information on healthcare utilization but may overlook important social determinants of health and community-specific issues that can only be addressed through direct engagement with community members.

3. The community health nurse 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 nurse take first to intervene with this health problem?

• A. join a political action group that focuses attention on the issue in the local news media
• B. partner with a local children's hospital in setting up free 'shot' clinics in the neighborhood
• C. review current epidemiological population data that might document a low immunization rate
• D. call a meeting of citizens to inform them of the importance of having their children immunized

Correct answer: C

Rationale: The most appropriate initial action for the community health nurse to take when addressing low immunization rates in a lower socioeconomic area is to review current epidemiological data. By reviewing this data, the nurse can gather evidence that documents the low immunization rate in the community. This information is crucial to support the need for targeted interventions to increase immunization rates. Choices A, B, and D involve actions that may be important at later stages of intervention but are not the first step. Joining a political action group, partnering with a hospital for clinics, or holding a community meeting are all valuable strategies, but they should be based on evidence obtained from reviewing epidemiological data to ensure targeted and effective interventions.

4. A female client reports to the nurse that her sleep was interrupted by 'thoughts of anger towards my husband.' What type of thoughts is the client having?

• A. Obsessive.
• B. Phobic.
• C. Delusional.
• D. Paranoid.

Correct answer: A

Rationale: The correct answer is A: Obsessive. Obsessive thoughts are recurring, unwanted, and intrusive thoughts that cause distress or anxiety. In this scenario, the client is experiencing repetitive thoughts of anger towards her husband, indicating an inability to control these thoughts. Choice B, Phobic, is incorrect as phobic thoughts are related to irrational fears. Choice C, Delusional, is incorrect as delusional thoughts involve fixed false beliefs. Choice D, Paranoid, is incorrect as paranoid thoughts involve irrational suspicions and mistrust.

5. A community health nurse is addressing the issue of domestic violence in the community. Which intervention should be prioritized?

• A. Providing education on the signs of domestic violence
• B. Setting up a support group for survivors
• C. Partnering with local law enforcement to increase patrols
• D. Creating a confidential hotline for reporting abuse

Correct answer: D

Rationale: Creating a confidential hotline for reporting abuse is the most critical intervention when addressing domestic violence. A hotline offers a safe and confidential way for individuals experiencing abuse to report incidents, seek help, and access support services. This intervention prioritizes immediate safety and support for victims. Providing education on the signs of domestic violence (Choice A) is important for prevention but may not address the urgent needs of individuals currently experiencing abuse. Setting up a support group for survivors (Choice B) is valuable for emotional support but may not reach those who are not yet identified as survivors. Partnering with local law enforcement to increase patrols (Choice C) focuses more on the law enforcement response rather than providing a direct avenue for victims to seek help and support.

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