Nursing Elites

1. A public health nurse is implementing a program to improve vaccination rates among children in the community. Which intervention is most likely to be effective?

• A. Offering vaccinations at convenient locations and times
• B. Distributing educational materials about vaccines
• C. Providing incentives for getting vaccinated
• D. Hosting informational sessions for parents

Correct answer: A

Rationale: Offering vaccinations at convenient locations and times is the most effective intervention as it reduces barriers to access and makes it easier for parents to get their children vaccinated. This strategy directly addresses the issue of convenience and accessibility, which are common reasons for low vaccination rates. Distributing educational materials about vaccines (Choice B) can be helpful but may not directly address access issues. Providing incentives for getting vaccinated (Choice C) may be controversial and not sustainable in the long term. Hosting informational sessions for parents (Choice D) can be beneficial for education but may not directly improve vaccination rates as much as increasing access.

2. The healthcare provider is preparing to administer intravenous immune globulin (IVIG) to a client with Guillain-Barre syndrome. Which assessment is most important before initiating the infusion?

• A. Lung sounds and respiratory status.
• B. Skin integrity and color.
• C. Neurological status and level of consciousness.
• D. Cardiac rate and rhythm.

Correct answer: D

Rationale: The correct answer is D, "Cardiac rate and rhythm." Monitoring cardiac rate and rhythm is crucial before initiating IVIG because bradycardia is a common side effect associated with this therapy. Assessing lung sounds and respiratory status (Choice A) is important, but cardiac monitoring takes precedence due to the risk of bradycardia. Skin integrity and color (Choice B) are important assessments, but they are not directly related to potential complications of IVIG infusion. Neurological status and level of consciousness (Choice C) are also vital assessments, but monitoring cardiac function is more pertinent in this scenario.

3. A public health nurse is planning a smoking cessation program for a local community. Which component is most important to include in the program?

• A. information on the health risks of smoking
• B. strategies for coping with withdrawal symptoms
• C. testimonials from former smokers
• D. distribution of nicotine replacement therapy

Correct answer: B

Rationale: The most important component to include in a smoking cessation program is strategies for coping with withdrawal symptoms. Withdrawal symptoms are a significant barrier to quitting smoking, and providing effective coping strategies can greatly increase the program's success. Choice A, providing information on the health risks of smoking, may be important but addressing withdrawal symptoms is more crucial. Testimonials from former smokers (Choice C) and distribution of nicotine replacement therapy (Choice D) are helpful but not as essential as addressing withdrawal symptoms directly.

4. A client with a history of asthma is admitted with shortness of breath. Which assessment finding requires immediate intervention?

• A. Expiratory wheezes.
• B. Increased respiratory rate.
• C. Absence of breath sounds.
• D. Frequent coughing.

Correct answer: C

Rationale: The correct answer is C: Absence of breath sounds. This finding is concerning in a client with asthma as it may indicate a severe asthma exacerbation, airway obstruction, or pneumothorax, all of which require immediate intervention. Absence of breath sounds suggests a lack of airflow in the lungs, which is a critical sign that should prompt immediate action. Expiratory wheezes (choice A) are common in asthma and may not warrant immediate intervention unless severe. An increased respiratory rate (choice B) is expected in a client with asthma experiencing shortness of breath, but it does not indicate an immediate threat to the airway. Frequent coughing (choice D) is a common symptom in asthma exacerbations but does not signify an immediate need for intervention as it can be managed with appropriate asthma treatments.

5. A community health nurse is conducting a program evaluation for a diabetes management class. Which measure best indicates the program's effectiveness?

• A. Number of participants attending each session
• B. Participant satisfaction with the class
• C. Reduction in participants' average blood glucose levels
• D. Improvement in participants' knowledge about diabetes

Correct answer: C

Rationale: The most effective measure to indicate the program's effectiveness in a diabetes management class is the reduction in participants' average blood glucose levels. This measure directly reflects the impact of the program on managing diabetes and improving health outcomes. Choices A and B may provide valuable information but do not directly assess the program's impact on managing diabetes. Choice D, improvement in participants' knowledge about diabetes, is important but may not directly translate into improved diabetes management without actual health outcome measurements like blood glucose levels.

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