Nursing Elites

1. A county public health nurse is developing a list of interventions to address the three core functions of public health. Which of the following interventions should the nurse include as part of the assurance function?

• A. Use surveillance to investigate outbreaks of foodborne illness
• B. Monitor the incidence rates of varicella every 2 months
• C. Organize an immunization clinic for at-risk members of the community
• D. Educate the community about the health risks of alcohol use

Correct answer: C

Rationale: The correct answer is C: 'Organize an immunization clinic for at-risk members of the community.' This intervention is part of the assurance function in public health, as it ensures that the community has access to preventive health services. Choice A is related to the assessment function as it involves surveillance to investigate outbreaks. Choice B is also related to the assessment function since it involves monitoring incidence rates. Choice D is associated with the policy development function as it involves educating the community about health risks.

2. A nurse manager is preparing to complete staff performance appraisals. Which of the following principles should the nurse manager consider when completing the appraisals?

• A. Performance appraisals should be written in measurable terms
• B. Appraisal objectives should be applicable to staff at every level
• C. Performance appraisals should be based on the nurse manager's preferences
• D. Completed appraisals should be approved by a provider

Correct answer: A

Rationale: Corrected Rationale: Performance appraisals should indeed be written in measurable terms to ensure objective evaluations based on specific outcomes achieved. This allows for a clear assessment of staff performance. Choice B is incorrect because appraisal objectives should be tailored to each staff member's role and responsibilities, not necessarily applicable at every level. Choice C is incorrect as performance appraisals should be objective and based on predefined criteria, not solely on the nurse manager's preferences. Choice D is incorrect as completed appraisals usually require approval from higher-level management or HR, not necessarily a provider.

3. A healthcare provider writes a prescription for a medication dose three times the normal range. What should the nurse do?

• A. Administer the medication as prescribed
• B. Question the prescription with the provider
• C. Consult with the pharmacist about the dosage
• D. Delay the medication until verification can be made

Correct answer: B

Rationale: The correct action for the nurse in this situation is to question the prescription with the provider. Administering a medication dose three times the normal range without clarification could pose serious risks to the client. Consulting with the pharmacist about the dosage or delaying the medication until verification can be made are not the initial steps to take; the nurse should first clarify the prescription with the healthcare provider to ensure patient safety.

4. When administering IV fluids to a dehydrated patient, what is the nurse's priority assessment?

• A. Monitor the patient's electrolyte levels.
• B. Assess the patient's blood pressure regularly.
• C. Monitor the patient's heart rate every 4 hours.
• D. Check the patient's urine output hourly.

Correct answer: B

Rationale: The correct answer is to assess the patient's blood pressure regularly. Monitoring blood pressure is crucial when administering IV fluids to a dehydrated patient as it helps in evaluating the patient's fluid status. Changes in blood pressure can indicate the effectiveness of the fluid therapy, the patient's response to treatment, and the possibility of complications such as fluid overload or hypovolemia. Monitoring electrolyte levels (Choice A) is essential but not the priority when assessing a dehydrated patient receiving IV fluids. Heart rate (Choice C) should be monitored more frequently than every 4 hours in such a situation. Checking urine output (Choice D) is important but not as critical as assessing blood pressure in this scenario.

5. A health care provider asks the nurse to administer a medication with a dosage significantly higher than usual. What is the nurse's first action?

• A. Administer the medication as ordered.
• B. Question the provider and verify the dose.
• C. Administer half the dosage as a precaution.
• D. Refuse to administer the medication without clarification.

Correct answer: B

Rationale: When a health care provider orders a medication with a dosage significantly higher than usual, the nurse's initial action should be to question the provider and verify the dose. This is crucial to ensure patient safety and prevent medication errors. Administering the medication as ordered (Choice A) without clarification could potentially harm the patient if there was an error in the prescription. Administering half the dosage as a precaution (Choice C) is not a safe practice as it deviates from the prescribed order. Refusing to administer the medication without clarification (Choice D) is important, but the first step should be to seek clarification from the provider to prevent any unnecessary delays in patient care.

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