Nursing Elites

1. During the care of a client with Legionnaire's disease, which finding would require the nurse's immediate attention?

• A. Pleuritic pain on inspiration
• B. Dry mucus membranes in the mouth
• C. A decrease in respiratory rate from 34 to 24
• D. Decrease in chest wall expansion

Correct answer: D

Rationale: A decrease in chest wall expansion suggests that the client may be experiencing a serious complication, such as worsening pneumonia or respiratory failure, requiring immediate medical attention. This finding indicates a potential decrease in lung function, which could lead to respiratory distress. Pleuritic pain on inspiration may be related to the disease process but does not indicate an immediate need for intervention. Dry mucus membranes in the mouth may require attention but are not as critical as a decrease in chest wall expansion. A decrease in respiratory rate could be concerning but is not as urgent as a decrease in chest wall expansion, which directly impacts respiratory function.

2. Which of the following tools is used by community health nurses to identify the health needs of a population?

• A. Health survey
• B. Medical records
• C. Patient interviews
• D. Epidemiological studies

Correct answer: D

Rationale: Epidemiological studies are used by community health nurses to identify the health needs of a population. These studies involve investigating patterns, causes, and effects of health and disease conditions in defined populations. While health surveys, medical records, and patient interviews are valuable tools in healthcare, epidemiological studies provide a broader population-based perspective essential for understanding and addressing community health needs.

3. Prior to initiating a community health program targeting teenage smoking, what information is most important for the nurse to obtain?

• A. The incidence of smoking among the teenage population in this community.
• B. The amount of available funding for tobacco prevention education programs.
• C. The target objectives for teenage smoking described by Healthy People 2020.
• D. Satisfaction data from programs that targeted the teenage population in this community.

Correct answer: A

Rationale: The most important information for the nurse to obtain before initiating a community health program targeting teenage smoking is the incidence of smoking among the teenage population in the community. Understanding the prevalence of smoking will help in designing effective intervention strategies. Choice B about funding, while important, is secondary to understanding the scope of the issue. Choice C, the target objectives from Healthy People 2020, may provide guidance but are not as crucial as knowing the local prevalence. Choice D, satisfaction data from previous programs, does not provide essential information for planning a new program.

4. In a well-child clinic, the nurse examines many children daily. Which of the following toddlers requires further follow-up?

• A. A 13-month-old who is unable to walk
• B. A 20-month-old who is only using 2 and 3 word sentences
• C. A 24-month-old who cries during examination
• D. A 30-month-old who is only drinking from a sip cup

Correct answer: D

Rationale: The correct answer is D because a 30-month-old should have developed the skill to drink from a regular cup by this age. Drinking from a sip cup at this stage may indicate a delay in development. Choices A, B, and C are not as concerning as they can be within the range of normal development. A 13-month-old not walking yet, a 20-month-old using 2 and 3 word sentences, and a 24-month-old crying during examination are all behaviors that can fall within the spectrum of typical development for their respective ages.

5. In planning for the nursing care of the sick person in the home, the major point that the nurse must keep in mind is:

• A. who will be responsible for the patient during the nurse's absence from the home
• B. economic level of the family
• C. the availability of the nearest hospital
• D. whether or not the patient is under a private physician

Correct answer: A

Rationale: The correct answer is A because ensuring someone is responsible for the patient is crucial for continuous care. The presence of a caregiver during the nurse's absence ensures the patient's safety and well-being. Choice B, economic level of the family, is important but not the major point when planning nursing care in the home. Choice C, the availability of the nearest hospital, is significant but doesn't address the day-to-day care in the home. Choice D, whether or not the patient is under a private physician, is relevant but not as critical as ensuring someone is available to care for the patient at all times.

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