Nursing Elites

1. A government office worker is seen in the emergency room after opening an envelope containing a powder-like substance which is being tested for anthrax. Which discharge instruction should the nurse provide the client concerning inhalation anthrax?

• A. return to the emergency room if flu-like symptoms develop within 42 days
• B. notify co-workers to get the anthrax vaccine at the public health department
• C. isolation from friends and family members is recommended for 3 weeks
• D. cleanse all surfaces touched with pre-moistened antibacterial wipes

Correct answer: A

Rationale: The correct answer is to instruct the client to return to the emergency room if flu-like symptoms develop within 42 days. Flu-like symptoms can be an early sign of inhalation anthrax, and prompt medical intervention is crucial. Choice B is incorrect because the focus should be on the affected individual seeking medical attention rather than vaccinating others. Choice C is incorrect as isolation from friends and family members is not a standard recommendation for inhalation anthrax. Choice D is also incorrect as cleansing surfaces is important for infection control but may not be the priority when facing potential exposure to anthrax.

2. The healthcare provider is assessing a client who has returned from hemodialysis. Which finding requires immediate intervention?

• A. Weight gain of 1 pound.
• B. Dizziness.
• C. Fatigue.
• D. Muscle cramps.

Correct answer: D

Rationale: After hemodialysis, muscle cramps can indicate an electrolyte imbalance, such as low potassium or magnesium levels, which requires immediate intervention to prevent potential complications like cardiac arrhythmias. Weight gain of 1 pound, dizziness, and fatigue are common post-hemodialysis symptoms that may not necessarily require immediate intervention unless they are severe or persisting.

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

• A. free blood pressure screenings
• B. lectures on heart-healthy diets
• C. distribution of pamphlets on heart disease
• D. cooking demonstrations of healthy recipes

Correct answer: A

Rationale: Offering free blood pressure screenings should be included in the community health fair to best engage participants. This activity provides immediate, valuable information about participants' cardiovascular health. Blood pressure screenings are interactive, engaging, and offer personalized insights that can motivate individuals to take action towards improving their heart health. Lectures on heart-healthy diets, distribution of pamphlets, and cooking demonstrations, although beneficial, may not have the same level of immediate impact and engagement as the hands-on experience of getting one's blood pressure checked.

4. The nurse identifies a client's needs and formulates the nursing problem of 'Imbalance nutrition: Less than body requirements, related to mental impairment and decreased intake, as evidenced by increasing confusion and weight loss of more than 30 pounds over the last 6 months.' Which short-term goal is best for this client?

• A. Eat 50% of six small meals each day by the end of the week.
• B. Gain 5 pounds by the end of the month.
• C. Have increased caloric intake.
• D. Show improved nutritional status.

Correct answer: A

Rationale: The correct short-term goal for the client in this scenario is option A: 'Eat 50% of six small meals each day by the end of the week.' This goal is specific, measurable, and time-bound, which aligns with the SMART criteria for goal setting in nursing care. It addresses the client's nutritional needs directly, focusing on increasing meal frequency to meet body requirements and counteract weight loss. Option B, 'Gain 5 pounds by the end of the month,' is not as suitable as it lacks specificity and a short-term timeline, making it less achievable within the immediate care plan. Option C, 'Have increased caloric intake,' is vague and does not provide a measurable target for the client to work towards. Option D, 'Show improved nutritional status,' is a broad goal that lacks the specificity needed for effective short-term goal setting in nursing care. Therefore, option A is the most appropriate choice for this client's short-term goal.

5. During a follow-up visit, a client with hypertension reports that they often forget to take their medication. What should the nurse do first?

• A. educate the client on the importance of medication adherence
• B. explore the reasons for the client's forgetfulness
• C. provide the client with a pill organizer
• D. adjust the client's medication schedule

Correct answer: B

Rationale: The correct first action for the nurse is to explore the reasons for the client's forgetfulness. By understanding the underlying causes, the nurse can provide tailored interventions to help the client improve medication adherence. Providing education on the importance of adherence (Choice A) may be necessary but should come after identifying the reasons for forgetfulness. Simply providing a pill organizer (Choice C) or adjusting the medication schedule (Choice D) does not address the root cause of the forgetfulness and may not lead to sustained improvement in adherence.

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