Nursing Elites

1. After assessing the health care needs of an elementary school, the nurse determines that an increased prevalence of pediculosis capitis is a priority problem. The nurse develops a 2-month program with the goal to eradicate the condition in the school. The program includes educational pamphlets sent home to parents and regular assessment of children by the school nurse. What action should the nurse implement to evaluate the effectiveness of the program?

• A. evaluate the teachers' ability to identify pediculosis capitis 2 months after initiation of the program
• B. conduct an initial examination of each child in the school to obtain baseline data
• C. survey parents 3 weeks after pamphlets are sent home to assess their understanding of the condition
• D. measure the prevalence of pediculosis capitis among the children after four months

Correct answer: D

Rationale: Measuring the prevalence of pediculosis capitis among the children after four months is the most appropriate action to evaluate the program's effectiveness. This approach provides data on the program's long-term impact and effectiveness in eradicating the condition. Option A focuses on the teachers' ability, which is not directly related to the program's effectiveness in eradicating the condition. Option B suggests conducting an initial examination, which does not provide information on the program's impact. Option C involves assessing parents' understanding, which is important but does not directly evaluate the program's effectiveness in eradicating pediculosis capitis.

2. 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.

3. The nurse is conducting a process evaluation of a prevention education program for older adults who are at risk for substance abuse. Which data source provides the information the nurse needs to conduct this process evaluation?

• A. client's score on an alcohol screening instrument
• B. results of a urine drug and alcohol screen
• C. most recent community census data
• D. documentation of client education in the nursing record

Correct answer: D

Rationale: The correct answer is D. Documentation of client education in the nursing record provides information on the implementation and progress of the educational program, which is crucial for evaluating its process. Choices A and B focus on individual client assessment rather than program evaluation. Choice C, community census data, is not directly related to evaluating the process of the prevention education program for older adults at risk for substance abuse.

4. The healthcare professional is providing education on healthy eating habits to a group of adolescents. Which strategy is most likely to be effective?

• A. lecturing about the dangers of unhealthy eating
• B. distributing pamphlets on healthy food choices
• C. involving the adolescents in meal planning and preparation
• D. showing a documentary on the benefits of a healthy diet

Correct answer: C

Rationale: Involving adolescents in meal planning and preparation is a more effective strategy as it actively engages them in the learning process. This approach allows adolescents to have hands-on experience, make informed choices, and develop a sense of ownership over their dietary decisions. Lecturing about dangers or showing documentaries may not be as engaging or interactive, making it less likely for adolescents to retain and apply the information provided. Distributing pamphlets can be informative but lacks the interactive and experiential aspect that involving them in meal planning and preparation offers.

5. The nurse obtains a pulse rate of 89 beats/min for an infant before administering digoxin (Lanoxin). What action should the nurse take?

• A. Administer the medication.
• B. Hold the medication and contact the healthcare provider.
• C. Double the dose.
• D. Increase fluid intake.

Correct answer: B

Rationale: The correct answer is to hold the medication and contact the healthcare provider. Bradycardia (pulse rate less than 100 beats/minute) is an early sign of digoxin toxicity. It is essential to withhold digoxin and notify the healthcare provider to prevent potential adverse effects. Administering the medication (Choice A) could exacerbate the toxicity. Doubling the dose (Choice C) is inappropriate and dangerous. Increasing fluid intake (Choice D) is not indicated in this situation and does not address the issue of digoxin toxicity.

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