Nursing Elites

1. A public health nurse is working with a community to develop a disaster response plan. Which of the following is the priority action?

• A. Identifying available resources and services
• B. Conducting disaster drills
• C. Educating the community about disaster preparedness
• D. Developing a communication plan

Correct answer: A

Rationale: Identifying available resources and services is the priority action when developing a disaster response plan. This step is crucial as it helps the community understand what resources and services are already in place and what additional support may be needed during a disaster. Conducting disaster drills, educating the community about disaster preparedness, and developing a communication plan are important steps in disaster preparedness but come after identifying available resources and services. Without knowing the available resources, it would be challenging to effectively plan and respond to a disaster.

2. A community health nurse is conducting a neighborhood discussion group about disaster planning. What information regarding transmission of anthrax should the nurse provide to the group?

• A. Infection is acquired when anthrax spores enter a host.
• B. Mature anthrax bacteria live dormant on inanimate objects.
• C. Spores cannot survive for extended periods outside a living host.
• D. Anthrax is transmitted by respiratory droplets from person to person.

Correct answer: A

Rationale: The correct information the nurse should provide is that anthrax infection occurs when spores enter a host. Choice B is incorrect as mature anthrax bacteria do not live dormant on inanimate objects. Choice C is incorrect as anthrax spores can survive for extended periods outside a living host. Choice D is incorrect as anthrax is not transmitted by respiratory droplets from person to person.

3. A community that uses the resources of a neighborhood church to provide a latchkey children program, to sponsor prayer/support groups for people who are ill, and to grow a community health garden that sends vegetables to elderly shut-ins is engaged in what kind of activity?

• A. disease prevention
• B. health protection
• C. risk management
• D. health balance

Correct answer: B

Rationale: In this scenario, the community activities described focus on supporting and promoting overall well-being, which aligns with the concept of health protection. Choice A, disease prevention, is incorrect as the activities are more about supporting health rather than preventing specific diseases. Choice C, risk management, does not fit as the activities are not primarily about managing risks. Choice D, health balance, is not the most appropriate choice as the activities are aimed at protecting and enhancing health rather than achieving a balance.

4. Which one of the following statements, if made by the client, indicates teaching about Inderal (propranolol) has been effective?

• A. ''I may experience seizures if I stop the medication abruptly.''
• B. ''I may experience an increase in my heart rate for a few weeks.''
• C. ''I can expect to feel nervousness the first few weeks.''
• D. ''I can have a heart attack if I stop this medication suddenly.''

Correct answer: D

Rationale: The correct answer is D. Stopping Inderal (propranolol) abruptly can cause rebound hypertension, angina, and even a myocardial infarction (heart attack), so it is crucial to taper off the medication under medical supervision. Choices A, B, and C are incorrect because they do not reflect the serious consequences associated with abrupt discontinuation of propranolol.

5. The nurse is caring for a client admitted to the hospital with right lower lobe (RLL) pneumonia. On assessment, the nurse notes crackles over the RLL. The client has significant pleuritic pain and is unable to take in a deep breath in order to cough effectively.

• A. Impaired gas exchange related to acute infection and sputum production
• B. Ineffective airway clearance related to sputum production and ineffective cough
• C. Ineffective breathing pattern related to acute infection
• D. Anxiety related to hospitalization and role conflict

Correct answer: B

Rationale: The client's inability to effectively clear the airway due to pain and sputum production hinders the cough mechanism, making 'Ineffective airway clearance' the most appropriate nursing diagnosis. Although impaired gas exchange may occur due to the pneumonia, the immediate issue is the inability to clear the airway. 'Ineffective breathing pattern' does not address the specific issue of airway clearance. 'Anxiety' is not the priority when the focus should be on the physical complications of pneumonia.

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