Nursing Elites

1. A first-grade boy is sent to the school nurse after he fainted while playing tag during recess. When he arrives in the clinic he is alert and oriented and his vital signs include temperature of 97.8°F, pulse 96 bpm, respirations 15 breaths/minute, and blood pressure 80/56 mmHg. Which intervention is most important for the nurse to implement?

• A. request transport of the child to his pediatrician's office
• B. call the child's parents and send him home for the day
• C. compare the child's body mass index to normal values
• D. measure the child's pulse and blood pressure every 15 minutes

Correct answer: D

Rationale: In this scenario, the most important intervention for the nurse to implement is to measure the child's pulse and blood pressure every 15 minutes. The child experienced a syncopal episode (fainting) which could be due to various reasons, including dehydration or cardiac issues. Monitoring vital signs frequently will help detect any changes that may indicate underlying health issues. Requesting transport to the pediatrician's office or sending the child home without continuous monitoring may not provide immediate assessment and intervention. Comparing the child's body mass index to normal values is not relevant in addressing the immediate concern of monitoring vital signs after a syncopal episode.

2. A community health nurse is developing a program to increase physical activity among adults in the community. Which intervention is most likely to be successful?

• A. distributing flyers about the benefits of exercise
• B. organizing free community exercise classes
• C. partnering with local gyms to offer discounts
• D. hosting a health fair with information booths

Correct answer: B

Rationale: Organizing free community exercise classes is the most likely successful intervention as it provides a structured and accessible opportunity for adults to engage in physical activity. This choice directly offers a practical solution by providing a regular and organized setting for individuals to participate in physical activity. Distributing flyers about the benefits of exercise, while informative, may not lead to actual participation. Partnering with local gyms to offer discounts relies on individuals taking the initiative to sign up for gym memberships, which may not be feasible for everyone. Hosting a health fair with information booths is informative but may not directly address the need for increased physical activity among adults in the community.

3. When developing a program to support caregivers of elderly patients, which topic should be prioritized in the first session?

• A. Managing medication schedules
• B. Recognizing signs of caregiver burnout
• C. Effective communication with healthcare providers
• D. Navigating insurance and financial issues

Correct answer: B

Rationale: Recognizing signs of caregiver burnout is the most critical topic to prioritize in the first session. Caregiver burnout can have detrimental effects on both the caregiver and the elderly patient's well-being. By addressing this issue early on, caregivers can learn to identify the signs of burnout, take necessary steps to prevent it, and ensure they can continue providing effective care for their loved ones. Managing medication schedules, effective communication with healthcare providers, and navigating insurance and financial issues are also important aspects to cover in the program. However, recognizing signs of caregiver burnout is essential for the overall health and quality of care provided by the caregivers.

4. 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.

5. The nurse is designing a community health project based on a report provided by the World Health Organization that describes healthcare problems in the United States. Which healthcare issue should the nurse give the highest priority when planning the project?

• A. overuse of diagnostic technology
• B. government-based health insurance
• C. the neonatal and infant mortality rates
• D. number of people without access to healthcare

Correct answer: D

Rationale: The correct answer is D: number of people without access to healthcare. Ensuring access to healthcare is fundamental to addressing a wide range of health issues and is a priority for improving overall community health. Option A, overuse of diagnostic technology, though important, is not the highest priority when considering basic access to healthcare. Option B, government-based health insurance, is relevant but may not directly address the issue of lack of access for all individuals. Option C, neonatal and infant mortality rates, is crucial but addressing access to healthcare for all individuals is a more immediate and foundational concern for the community health project.

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