Nursing Elites

1. Community health nurses are particularly concerned with the source of communicable diseases such as hepatitis A. Which group of individuals have a higher risk of contracting that type of hepatitis?

• A. IV drug users who share needles
• B. low-income families living in cramped quarters
• C. those who have recently received a blood transfusion
• D. sexually active persons with multiple partners

Correct answer: B

Rationale: The correct answer is B. Hepatitis A is often spread through close personal contact and poor sanitary conditions, which are more common in low-income, cramped living situations. IV drug users sharing needles are at higher risk of hepatitis B and C due to bloodborne transmission. Those who have recently received a blood transfusion are at risk of hepatitis C or other bloodborne infections. Sexually active persons with multiple partners are at risk of hepatitis B, which can be transmitted through sexual contact.

2. The healthcare provider is preparing to administer an intravenous antibiotic to a client with a central venous catheter. Which action is most important?

• A. Flush the catheter with heparin.
• B. Change the dressing at the insertion site.
• C. Check for blood return before administering the antibiotic.
• D. Use sterile technique when accessing the catheter.

Correct answer: D

Rationale: Using sterile technique when accessing the catheter is crucial to prevent infection in clients with a central venous catheter. This action helps maintain asepsis and reduces the risk of introducing pathogens into the catheter system. Flushing the catheter with heparin helps prevent occlusion but is not as crucial as ensuring sterile technique. Changing the dressing at the insertion site is important for assessing the site's condition but does not directly impact the administration of the antibiotic. Checking for blood return is essential to ensure proper catheter function, but sterile technique takes precedence to prevent infections.

3. The nurse is caring for a client with cirrhosis of the liver. Which laboratory result requires immediate intervention?

• A. Serum albumin of 3.5 g/dL.
• B. Prothrombin time (PT) of 12 seconds.
• C. Hemoglobin of 10 g/dL.
• D. Serum ammonia level of 180 mcg/dL.

Correct answer: D

Rationale: The correct answer is D, the serum ammonia level of 180 mcg/dL. An elevated serum ammonia level indicates hepatic dysfunction and can lead to hepatic encephalopathy, which is a medical emergency requiring immediate intervention. Options A, B, and C are within normal ranges or slightly abnormal values for clients with cirrhosis and do not pose an immediate threat. Serum albumin levels may indicate malnutrition, prothrombin time may reflect liver synthetic function, and hemoglobin levels can be affected by various factors but do not require immediate intervention in this scenario.

4. The healthcare professional is planning a health fair to promote cancer awareness and prevention. Which activity is most likely to increase participation?

• A. offering free cancer screenings
• B. distributing pamphlets on cancer prevention
• C. hosting a guest speaker who is a cancer survivor
• D. providing informational booths on different types of cancer

Correct answer: A

Rationale: Offering free cancer screenings is the most likely activity to increase participation in the health fair. Providing direct services such as screenings not only attracts participants but also promotes early detection, which is crucial in cancer prevention. Distributing pamphlets, hosting a guest speaker, or providing informational booths are informative but may not have the same impact in driving participation as the opportunity for free screenings.

5. The healthcare provider is caring for a client with a chest tube. Which observation indicates that the chest tube is functioning effectively?

• A. Continuous bubbling in the water-seal chamber.
• B. Intermittent bubbling in the suction control chamber.
• C. No fluctuation (tidaling) in the water-seal chamber.
• D. Drainage of clear, pale yellow fluid from the chest tube.

Correct answer: B

Rationale: Intermittent bubbling in the suction control chamber is the correct observation indicating effective functioning of the chest tube. This bubbling signifies that the suction system is working correctly and maintaining the desired negative pressure in the pleural space. Continuous bubbling in the water-seal chamber suggests an air leak, which is not a normal finding. No fluctuation (tidaling) in the water-seal chamber may indicate a blockage or lack of communication between the pleural space and the water-seal, which is not ideal. Drainage of clear, pale yellow fluid from the chest tube is a normal finding, but it does not specifically indicate the effectiveness of the chest tube function.

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