Nursing Elites

1. A client with a history of myocardial infarction is prescribed aspirin therapy. Which instruction should the nurse include in the client's teaching plan?

• A. Take aspirin with food.
• B. Take aspirin at the same time every day.
• C. Avoid taking aspirin with alcohol.
• D. Discontinue aspirin if you experience ringing in your ears.

Correct answer: C

Rationale: The correct instruction for the nurse to include in the client's teaching plan is to avoid taking aspirin with alcohol. Combining aspirin with alcohol can increase the risk of gastrointestinal bleeding and other complications. Taking aspirin with food helps reduce stomach upset, but it is not the most crucial instruction in this scenario. While taking aspirin at the same time every day can help with consistency, it is not as critical as avoiding alcohol. Discontinuing aspirin if experiencing ringing in the ears is important to address potential side effects, but it is not directly related to preventing complications when combining with alcohol.

2. A client with a history of chronic obstructive pulmonary disease (COPD) is admitted with pneumonia. Which finding requires immediate intervention?

• A. Oxygen saturation of 88%
• B. Respiratory rate of 24 breaths per minute
• C. Heart rate of 90 beats per minute
• D. Productive cough with green sputum

Correct answer: D

Rationale: In a client with COPD admitted with pneumonia, a productive cough with green sputum indicates a potential bacterial infection. Green sputum is commonly associated with bacterial pneumonia, which requires immediate intervention with appropriate antibiotics. Monitoring oxygen saturation, respiratory rate, and heart rate are essential in COPD patients, but the presence of green sputum suggests an urgent need for targeted treatment to address the underlying infection. Oxygen saturation of 88% is concerning but may not directly indicate the need for immediate intervention in the absence of other critical symptoms. Respiratory rate of 24 breaths per minute and a heart rate of 90 beats per minute are within normal limits and may not be indicative of an acute issue requiring immediate intervention in this context.

3. A community health nurse is applying for a federal grant to support a smoking cessation educational program. In which order should the nurse prioritize these nursing activities? Arrange in order top to bottom.

• A. Determine the target aggregate that will be served by the program
• B. Consider pros and cons of different methods of data gathering
• C. Select and train the data collection personnel
• D. All of the above

Correct answer: D

Rationale: The correct answer is 'D' - All of the above. The nurse should first determine the target aggregate that will be served by the program to understand the specific population in need. Subsequently, they should consider the pros and cons of different methods of data gathering to ensure the most appropriate data collection strategies are employed. Finally, selecting and training the data collection personnel is essential for the successful implementation of the program. These steps provide a logical progression from identifying the target group to analyzing the collected data. Choices A, B, and C are all crucial steps that must be taken in sequence to effectively develop and implement the smoking cessation educational program.

4. A public health nurse is planning an educational campaign to reduce the incidence of hypertension in the community. Which group should be the primary target of this campaign?

• A. adolescents
• B. young adults
• C. middle-aged adults
• D. older adults

Correct answer: C

Rationale: The correct answer is C, middle-aged adults. Middle-aged adults are at a higher risk for developing hypertension due to lifestyle factors and aging. Targeting this group for preventive measures such as dietary changes, exercise, and stress management can have a significant impact on reducing the incidence of hypertension. Choices A, B, and D are less appropriate targets as adolescents generally have lower rates of hypertension, young adults are less likely to be affected by hypertension at this stage, and older adults may already have established hypertension or comorbidities that could make prevention more challenging.

5. What information should the nurse provide a client who has undergone cryosurgery for stage 1A cervical cancer?

• A. Expect heavy, watery vaginal discharge for 3 to 6 weeks.
• B. Use a tampon instead of a sanitary napkin.
• C. Report any severe cramping immediately.
• D. Avoid sexual intercourse for 3 to 6 weeks.

Correct answer: D

Rationale: After cryosurgery for stage 1A cervical cancer, clients should avoid sexual intercourse for 3 to 6 weeks to reduce the risk of infection. Heavy, watery vaginal discharge is expected but not the focus of post-procedure instructions. Using tampons is contraindicated as they can introduce bacteria into the healing cervix. While reporting severe cramping is important, avoiding sexual intercourse is the priority to prevent complications.

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