Nursing Elites

1. What influences health status?

• A. lifestyle choices and community resources
• B. availability of health technology like diagnostic machines
• C. presence of toxic environmental conditions
• D. all of the above

Correct answer: D

Rationale: Health status is influenced by a combination of lifestyle choices, community resources, health technology like diagnostic machines, and environmental conditions. Each of these factors plays a role in determining an individual's overall health. Choice A is correct as lifestyle choices (such as diet, exercise, and smoking habits) and access to community resources (like healthcare facilities, support groups, and recreational spaces) are important determinants of health. Choice B is correct as the availability of health technology, including diagnostic machines, can impact early detection and treatment of health conditions. Choice C is correct as exposure to toxic environmental conditions (such as pollution, contaminated water, or hazardous waste) can have adverse effects on health. Therefore, the correct answer is D because all of these factors collectively influence health status.

2. As community health nurses engage in the process of community empowerment, it is essential that they:

• A. gather data from the community
• B. form partnerships with people in the community
• C. make decisions for the people in the community
• D. accept responsibility for people's actions

Correct answer: B

Rationale: In the process of community empowerment, community health nurses should form partnerships with the community rather than making decisions for them, gathering data alone, or accepting responsibility for their actions. Forming partnerships ensures that the community is actively involved in decision-making processes, leading to sustainable and effective outcomes. Gathering data is important but not the central aspect of empowerment, while accepting responsibility for people's actions is not a core principle of empowerment but rather promoting accountability within the community.

3. As a client who is terminally ill has been receiving high doses of an opioid analgesic for the past month and becomes unresponsive to verbal stimuli as death approaches, what orders would the nurse expect from the healthcare provider?

• A. Decrease the analgesic dosage by half
• B. Discontinue the analgesic
• C. Continue the same analgesic dosage
• D. Prescribe a less potent drug

Correct answer: C

Rationale: Continuing the same dosage of analgesic is appropriate to manage pain effectively as death nears and the client becomes unresponsive. The primary goal of palliative care in end-of-life situations is to ensure comfort, regardless of the client's level of consciousness. Decreasing the analgesic dosage or discontinuing it could lead to inadequate pain relief, which goes against the principles of palliative care. Prescribing a less potent drug may also compromise pain management in this critical stage. Therefore, maintaining the same analgesic dosage is the most appropriate action to provide comfort and alleviate suffering.

4. A child and his family were exposed to Mycobacterium tuberculosis about 2 months ago. To confirm the presence or absence of an infection, it is most important for all family members to have a

• A. Chest x-ray
• B. Blood culture
• C. Sputum culture
• D. PPD intradermal test

Correct answer: D

Rationale: The PPD (purified protein derivative) intradermal test is the standard screening method for detecting tuberculosis infection. It helps identify individuals who have been infected with Mycobacterium tuberculosis. A chest x-ray (Choice A) is used to assess the extent of active disease, not for screening purposes. Blood culture (Choice B) is not typically used for tuberculosis screening. Sputum culture (Choice C) is used to confirm active tuberculosis in symptomatic individuals, not for initial screening purposes.

5. The Healthy People project is designed to:

• A. track health care trends to anticipate insurance liabilities, especially for poor and urban populations
• B. demonstrate that social factors have a significant impact on individual and community health
• C. follow health indicators such as activity, substance use, mental health, and environmental issues
• D. demonstrate that access to health care in the United States is adequate for all populations

Correct answer: C

Rationale: The Healthy People project is designed to follow health indicators such as activity, substance use, mental health, and environmental issues to improve public health outcomes. Choice A is incorrect because the project focuses on public health indicators rather than insurance liabilities. Choice B is incorrect as the project actually acknowledges the significant impact of social factors on health. Choice D is incorrect because one of the main goals of the Healthy People project is to identify and address disparities in access to healthcare, not to demonstrate that access is adequate for all populations.

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