Nursing Elites

1. A public health nurse is evaluating a program designed to reduce the incidence of diabetes in the community. Which outcome indicates that the program is successful?

• A. increased participation in diabetes education sessions
• B. higher rates of blood glucose monitoring
• C. reduced incidence of diabetes-related complications
• D. greater knowledge of diabetes prevention methods

Correct answer: C

Rationale: The correct answer is C: 'reduced incidence of diabetes-related complications.' This outcome indicates that the program is successful because it shows that individuals are effectively managing their condition, leading to fewer complications. Increased participation in education sessions (choice A) and higher rates of blood glucose monitoring (choice B) are important but are more process indicators rather than direct outcomes of improved health. Greater knowledge of prevention methods (choice D) is beneficial but may not directly reflect a reduction in diabetes incidence or complications.

2. The nurse is teaching a group of high school adolescents about safety associated with traumatic injuries. Which factor causing spinal cord injuries should the nurse discuss with the adolescents?

• A. motor vehicle accidents
• B. violent assault
• C. sports injuries
• D. falls

Correct answer: A

Rationale: The correct answer is A: motor vehicle accidents. Motor vehicle accidents are a significant cause of spinal cord injuries among adolescents due to the high impact forces involved. While violent assault, sports injuries, and falls can also lead to spinal cord injuries, statistics show that motor vehicle accidents are a leading cause in this age group. Educating adolescents about the risks and preventive measures related to motor vehicle accidents is crucial in promoting their safety and well-being.

3. A client with a history of epilepsy is admitted with status epilepticus. Which medication should the nurse prepare to administer?

• A. Acetaminophen (Tylenol)
• B. Lorazepam (Ativan)
• C. Phenytoin (Dilantin)
• D. Carbamazepine (Tegretol)

Correct answer: B

Rationale: In the management of status epilepticus, the initial medication of choice is a benzodiazepine such as lorazepam (Ativan) to rapidly terminate the seizure activity. Lorazepam acts quickly and effectively in stopping seizures. Phenytoin (Dilantin) is often used as a second-line agent for status epilepticus, and carbamazepine (Tegretol) is not typically indicated for the acute treatment of status epilepticus. Acetaminophen (Tylenol) is a pain reliever and antipyretic but is not used in the treatment of status epilepticus.

4. A school nurse is organizing a vaccination clinic for middle school students. Which vaccine is most important for the nurse to include?

• A. hepatitis B
• B. tetanus, diphtheria, and pertussis (Tdap)
• C. varicella
• D. measles, mumps, and rubella (MMR)

Correct answer: B

Rationale: The most important vaccine for the school nurse to include in the vaccination clinic for middle school students is the tetanus, diphtheria, and pertussis (Tdap) vaccine. Tdap is recommended for preteens as part of the routine vaccination schedule to protect against these serious diseases. Hepatitis B, varicella, and MMR vaccines are also important but for this specific age group, Tdap takes precedence to ensure protection against tetanus, diphtheria, and pertussis.

5. The public health nurse is creating a plan to increase state funding for a local health clinic. Which strategy is likely to be most effective in obtaining funding for the clinic?

• A. Run the health clinic economically and promote the services the clinic provides.
• B. Organize concerned citizens to write letters and call state representatives.
• C. Highlight to the media the valuable services offered by the community clinic.
• D. Hire a professional lobbyist to convince Congress of the local clinic's value.

Correct answer: B

Rationale: Organizing concerned citizens to contact state representatives is likely the most effective strategy to secure state funding for the local health clinic. By mobilizing a group of citizens who are directly impacted by the clinic's services, the public health nurse can create a strong advocacy group that can influence decision-makers. Option A, running the health clinic economically and promoting its services, may be necessary but does not directly address the funding aspect. Option C, highlighting services to the media, may raise awareness but does not guarantee funding. Option D, hiring a professional lobbyist, may be costly and may not have the same grassroots impact as organizing citizens.

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