Nursing Elites

1. A client with a history of hypertension is admitted with a blood pressure of 180/110 mm Hg. Which medication should the nurse prepare to administer?

• A. Atenolol (Tenormin)
• B. Nifedipine (Procardia)
• C. Hydrochlorothiazide (Microzide)
• D. Clonidine (Catapres)

Correct answer: D

Rationale: In this scenario of severe hypertension (180/110 mm Hg), the nurse should prepare to administer Clonidine (Catapres), which is an antihypertensive medication commonly used to rapidly lower blood pressure in acute situations. Atenolol and Nifedipine are also antihypertensive medications, but Clonidine is more appropriate for immediate blood pressure reduction in this critical situation. Hydrochlorothiazide is a diuretic often used for long-term management of hypertension, not for rapid lowering of severely elevated blood pressure.

2. Following an emergency Cesarean delivery, the nurse encourages the new mother to breastfeed her newborn. The client asks why she should breastfeed now. Which information should the nurse provide?

• A. To bond with the baby.
• B. To help the baby latch on better.
• C. To stimulate contraction of the uterus.
• D. To promote milk production.

Correct answer: C

Rationale: The correct answer is C: 'To stimulate contraction of the uterus.' After delivery, breastfeeding helps in stimulating the release of oxytocin, which triggers the contraction of the uterus. This contraction is crucial to prevent uterine hemorrhage and facilitate the involution process. Choices A, B, and D are incorrect. While breastfeeding can indeed help in bonding with the baby and promoting milk production, in the immediate postpartum period after a Cesarean section, the priority is to ensure uterine contraction to prevent complications.

3. The nurse determines that a client's body weight is 105% above the standardized height-weight scale. Which related factor should the nurse include in the nursing problem, 'Imbalanced nutrition: More than body requirements'?

• A. Hypertension.
• B. Diabetes mellitus.
• C. Inadequate lifestyle changes in diet and exercise.
• D. Increased risk of chronic illnesses.

Correct answer: C

Rationale: The correct answer is C: 'Inadequate lifestyle changes in diet and exercise.' When a client's weight exceeds the standardized height-weight scale significantly, it indicates an imbalance between nutrition intake and energy expenditure, leading to 'Imbalanced nutrition: More than body requirements.' Inadequate lifestyle changes in diet and exercise directly contribute to this imbalance by promoting excessive caloric intake and reduced physical activity. Choices A, B, and D are incorrect because while conditions like hypertension, diabetes mellitus, and increased risk of chronic illnesses may be consequences of imbalanced nutrition, they are not the direct related factor that should be included in formulating the nursing problem.

4. A nurse is planning a community health fair to promote cancer awareness. Which activity should be included to best engage participants?

• A. free cancer screenings
• B. lectures on cancer prevention
• C. distribution of educational materials
• D. testimonials from cancer survivors

Correct answer: A

Rationale: Offering free cancer screenings should be included in the community health fair to best engage participants. This activity provides immediate, valuable information about participants' cancer risk, making it highly engaging and actionable. While lectures on cancer prevention and distribution of educational materials are informative, they may not offer the same level of immediate engagement and impact as free screenings. Testimonials from cancer survivors, although inspiring, do not provide participants with direct information about their own cancer risk, making them less effective in engaging participants actively.

5. To prepare a presentation on the greatest health concern facing the city, how should the health nurse begin collecting data?

• A. Review morbidity data for the city's population compiled by the Bureau of Vital Statistics
• B. Conduct a random telephone survey to determine the public's perception about health problems
• C. Survey major hospitals in the area to determine the most common reasons for admissions
• D. Call American Medical Association members to determine the most frequently treated diagnoses

Correct answer: A

Rationale: The correct answer is to review morbidity data for the city's population compiled by the Bureau of Vital Statistics. Morbidity data provides detailed and accurate information on the health issues prevalent in the city's population. This data is essential as it reflects actual health conditions rather than perceptions or specific hospital data. Conducting a telephone survey (choice B) may provide subjective opinions rather than objective data. Surveying hospitals (choice C) may only capture data on hospitalized cases and may not represent the entire population. Contacting American Medical Association members (choice D) may provide insights into medical treatments but may not reflect the overall health concerns of the city's population.

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