Nursing Elites

1. During a follow-up visit, a client with hypertension reports that they often forget to take their medication. What should the nurse do first?

• A. educate the client on the importance of medication adherence
• B. explore the reasons for the client's forgetfulness
• C. provide the client with a pill organizer
• D. adjust the client's medication schedule

Correct answer: B

Rationale: The correct first action for the nurse is to explore the reasons for the client's forgetfulness. By understanding the underlying causes, the nurse can provide tailored interventions to help the client improve medication adherence. Providing education on the importance of adherence (Choice A) may be necessary but should come after identifying the reasons for forgetfulness. Simply providing a pill organizer (Choice C) or adjusting the medication schedule (Choice D) does not address the root cause of the forgetfulness and may not lead to sustained improvement in adherence.

2. A community health nurse is addressing the issue of substance abuse in the community. Which intervention should be prioritized?

• A. Providing education on the dangers of substance abuse
• B. Setting up a support group for individuals struggling with addiction
• C. Partnering with local law enforcement to reduce drug availability
• D. Creating a confidential hotline for reporting substance abuse

Correct answer: D

Rationale: Creating a confidential hotline for reporting substance abuse should be prioritized because it offers a safe and accessible way for individuals to seek help and support for their substance abuse issues. This intervention allows individuals to report their concerns anonymously and seek guidance without fear of judgment or repercussions. Providing education on the dangers of substance abuse (Choice A) is important but may not be as immediately impactful as offering a direct avenue for help. Setting up a support group (Choice B) is valuable but may not reach as many individuals or provide the same level of anonymity as a confidential hotline. Partnering with law enforcement (Choice C) is crucial for addressing substance abuse issues from a legal perspective but may not directly address the immediate needs of individuals seeking help.

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. A public health nurse is assessing a community's readiness for a new smoking cessation program. Which factor is most important to evaluate?

• A. the community's smoking rates
• B. the availability of smoking cessation resources
• C. the community's attitude towards smoking
• D. the local healthcare providers' support for the program

Correct answer: C

Rationale: The most critical factor to evaluate when assessing a community's readiness for a smoking cessation program is the community's attitude towards smoking. Understanding the community's perceptions, beliefs, and behaviors related to smoking is crucial as it helps determine the level of receptiveness and potential success of the program. Assessing smoking rates (Choice A) could provide valuable epidemiological data but may not reflect the community's readiness for change. While the availability of smoking cessation resources (Choice B) is important, without considering the community's attitude, the program's effectiveness may be limited. Local healthcare providers' support (Choice D) is valuable but secondary to the community's attitude, which directly influences the program's acceptance and impact.

5. When developing a program to support caregivers of elderly patients, which topic should be prioritized in the first session?

• A. Managing medication schedules
• B. Recognizing signs of caregiver burnout
• C. Effective communication with healthcare providers
• D. Navigating insurance and financial issues

Correct answer: B

Rationale: Recognizing signs of caregiver burnout is the most critical topic to prioritize in the first session. Caregiver burnout can have detrimental effects on both the caregiver and the elderly patient's well-being. By addressing this issue early on, caregivers can learn to identify the signs of burnout, take necessary steps to prevent it, and ensure they can continue providing effective care for their loved ones. Managing medication schedules, effective communication with healthcare providers, and navigating insurance and financial issues are also important aspects to cover in the program. However, recognizing signs of caregiver burnout is essential for the overall health and quality of care provided by the caregivers.

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