Nursing Elites

1. A public health nurse working in a rural area is developing a program to improve health for the local population. Which of the following actions should the nurse plan to take?

• A. Provide anticipatory guidance classes to parents through public schools.
• B. Have a nurse from outside the community provide health lectures at the county hospital.
• C. Encourage rural residents to focus health spending on tertiary health interventions.
• D. Launch a media campaign to increase awareness about industrial pollution.

Correct answer: A

Rationale: Providing anticipatory guidance classes to parents through public schools is the most appropriate action for the public health nurse in a rural area. This approach allows the nurse to address early prevention strategies, which are crucial in promoting health in rural populations. Choice B is incorrect because having a nurse from outside the community may not fully understand the local needs and dynamics. Choice C is wrong as focusing health spending on tertiary interventions is not cost-effective or preventive. Choice D is also incorrect because while increasing awareness about industrial pollution is important, it may not directly address the health needs of the local rural population.

2. A nurse has administered medications to a group of clients. For which of the following client situations should the nurse complete an incident report?

• A. Administering acetaminophen to an NPO client
• B. Administering insulin lispro to an NPO client
• C. Administering medication to the incorrect client
• D. Administering anticoagulants without checking INR

Correct answer: B

Rationale: The correct answer is B because administering insulin lispro to an NPO client can lead to hypoglycemia due to the lack of food to balance the medication. This situation poses a serious risk to the client's safety and should be documented in an incident report. Choice A is not as critical as insulin administration for an NPO client. Choice C is also serious but does not pose an immediate risk to the client's health. Choice D, administering anticoagulants without checking the INR, is important but does not require an incident report unless adverse effects occur, as it may not immediately endanger the client's life.

3. What is the main symptom of left-sided heart failure?

• A. Shortness of breath
• B. Edema
• C. Increased heart rate
• D. Decreased urine output

Correct answer: A

Rationale: Shortness of breath is the main symptom of left-sided heart failure because it results from pulmonary congestion due to fluid buildup in the lungs. Edema, increased heart rate, and decreased urine output are associated with right-sided heart failure rather than left-sided heart failure.

4. What is the appropriate intervention for fluid overload?

• A. Restrict fluid intake
• B. Administer diuretics
• C. Monitor vital signs
• D. All of the above

Correct answer: D

Rationale: The appropriate intervention for fluid overload involves a combination of measures, including restricting fluid intake to prevent further fluid accumulation, administering diuretics to help the body eliminate excess fluids, and closely monitoring vital signs to assess the patient's response to treatment. Therefore, all of the above options are correct. Restricting fluid intake alone may not be sufficient to address existing fluid overload without additional measures like diuretic therapy. Monitoring vital signs is essential to evaluate the effectiveness of the interventions and the patient's overall condition.

5. How should a healthcare professional assess and manage a patient with ascites?

• A. Monitor abdominal girth and administer diuretics
• B. Administer pain relief and monitor fluid intake
• C. Restrict fluid intake and encourage bed rest
• D. Administer albumin and check electrolyte levels

Correct answer: A

Rationale: Correct! When managing a patient with ascites, monitoring abdominal girth is crucial as it helps assess the extent of fluid retention. Administering diuretics is also essential to help reduce fluid buildup in the body, thereby managing ascites effectively. Option B is incorrect as pain relief is not the primary intervention for ascites. Option C is incorrect as restricting fluid intake can worsen the condition by causing dehydration and further fluid imbalances. Option D is incorrect as administering albumin and checking electrolyte levels are not first-line interventions for managing ascites; these interventions may be considered in specific cases but are not the initial steps in managing ascites.

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