Nursing Elites

1. A public health nurse is planning a campaign to increase immunization rates among children in a low-income community. Which intervention should the nurse prioritize?

• A. Provide free immunizations at local schools
• B. Create educational materials about vaccine safety
• C. Organize a community forum to discuss immunization concerns
• D. Partner with local media to promote the importance of vaccines

Correct answer: A

Rationale: The correct answer is A: Provide free immunizations at local schools. This intervention directly addresses financial barriers and increases accessibility for families in low-income communities. By offering free immunizations at local schools, the nurse can ensure that more children receive the necessary vaccines without worrying about the cost. Choice B, creating educational materials, may be helpful but may not directly address the financial barriers that low-income families face. Choice C, organizing a community forum, can be beneficial for addressing concerns but may not result in immediate action to increase immunization rates. Choice D, partnering with local media, can help raise awareness but may not directly provide the solution of making immunizations more accessible by removing financial barriers.

2. A client with a history of atrial fibrillation is receiving warfarin (Coumadin) therapy. Which laboratory result indicates that the therapy is effective?

• A. International normalized ratio (INR) of 1.0.
• B. Prothrombin time (PT) of 12 seconds.
• C. Partial thromboplastin time (PTT) of 60 seconds.
• D. International normalized ratio (INR) of 2.5.

Correct answer: D

Rationale: An International Normalized Ratio (INR) of 2.5 indicates that warfarin therapy is within the therapeutic range for a client with atrial fibrillation. A lower INR (such as 1.0) would suggest subtherapeutic levels, risking blood clots. Prothrombin time (PT) and partial thromboplastin time (PTT) are not specific to monitoring warfarin therapy.

3. A homeless client with alcohol dependency will be dismissed from the emergency department in 24 hours. The nurse notes that a tuberculin skin test was prescribed by the healthcare provider. What intervention is most important for the nurse to implement prior to discharge?

• A. Identify how the client will follow-up to have the results read
• B. Give the client written information about the tuberculosis test
• C. Determine if the client understands the purpose of the tuberculin test
• D. Explain to the client results should be read between 48 and 72 hours

Correct answer: A

Rationale: The most important intervention for the nurse to implement prior to the discharge of a homeless client with alcohol dependency who had a tuberculin skin test prescribed is to identify how the client will follow-up to have the results read. This is crucial to ensure proper diagnosis and treatment. Providing written information (Choice B) is helpful but not as critical as ensuring the follow-up plan. Determining if the client understands the purpose of the test (Choice C) is important but not as immediate as ensuring the follow-up plan. Explaining when the results should be read (Choice D) is important, but the priority is to make sure the client has a plan in place for follow-up.

4. The nurse is caring for a client with Addison's disease. Which finding requires immediate intervention?

• A. Hyperpigmentation of the skin.
• B. Low blood pressure.
• C. Nausea and vomiting.
• D. Hypoglycemia.

Correct answer: B

Rationale: Low blood pressure in a client with Addison's disease requires immediate intervention as it can indicate an Addisonian crisis, a life-threatening condition that necessitates prompt treatment. Hyperpigmentation of the skin is a characteristic finding in Addison's disease but does not require immediate intervention. Nausea and vomiting can be managed symptomatically in Addison's disease. While hypoglycemia needs attention, it is not the most critical finding requiring immediate intervention in this context.

5. The healthcare provider is assessing a client who has a nasogastric tube to low intermittent suction. Which finding indicates that the client may have developed hypokalemia?

• A. Muscle weakness and cramps.
• B. Nausea and vomiting.
• C. Constipation.
• D. Increased blood pressure.

Correct answer: A

Rationale: Muscle weakness and cramps are characteristic signs of hypokalemia, a condition marked by low levels of potassium in the blood. Potassium is essential for proper muscle function, and its deficiency can lead to muscle weakness and cramps. In the context of a client with a nasogastric tube to low intermittent suction, the loss of potassium through suctioning can contribute to the development of hypokalemia. Nausea and vomiting (choice B) are more commonly associated with gastrointestinal issues rather than hypokalemia. Constipation (choice C) is not a typical finding of hypokalemia; instead, it can be a sign of other gastrointestinal problems. Increased blood pressure (choice D) is not a direct manifestation of hypokalemia; in fact, low potassium levels are more commonly associated with decreased blood pressure.

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