Nursing Elites

1. Several employees who have a 10-year or longer history of smoking ask the occupational nurse for assistance with smoking cessation. The RN develops a 2-month program that includes weekly group sessions on lifestyle changes and use of OTC products. Which measurement provides the best indication of the program's effectiveness?

• A. Encourage the employees to disclose if they have joined another smoking cessation group.
• B. Ask the employees to inform the group if they stop smoking and if they start back up again.
• C. Survey the employees about their smoking habits.
• D. Observe if the employees are smoking in the designated smoking areas.

Correct answer: C

Rationale: Surveying the employees about their smoking habits provides measurable data on program effectiveness. By collecting data directly from the employees through surveys, the occupational nurse can track changes in smoking habits, frequency, and quantity of cigarettes smoked. This direct feedback allows for a more accurate assessment of the program's impact on smoking cessation. Choices A and B rely on self-disclosure and may not provide reliable or objective data. Choice D does not directly measure changes in smoking habits but rather observes behavior in designated areas, which may not reflect overall smoking cessation progress.

2. The home health care agency can expect to obtain Medicare reimbursement for which home visit performed by a registered nurse (RN) or a practical nurse (PN)?

• A. Assessment of the speech pattern of a mobile adult who had a mild stroke last year.
• B. Safety teaching for an older male client whose wife complains that he uses an unsafe ladder while painting.
• C. Wound care for a client who had a postoperative infection following abdominal surgery two weeks ago.
• D. Evaluation of crutch use by a 65-year-old male client who broke his tibia while snow skiing.

Correct answer: C

Rationale: The correct answer is C because wound care for a postoperative infection is a skilled service that qualifies for Medicare reimbursement. Choices A, B, and D involve assessments, teaching, and evaluation, which may not meet the criteria for Medicare reimbursement as they do not directly involve a skilled nursing service related to a postoperative condition.

3. In addition to disturbances in mental awareness and orientation, a client with cognitive impairment is also likely to show loss of ability in

• A. Hearing, speech, and sight
• B. Endurance, strength, and mobility
• C. Learning, creativity, and judgment
• D. Balance, flexibility, and coordination

Correct answer: C

Rationale: Individuals with cognitive impairment often experience difficulties in learning new information, creative thinking, and making sound judgments. Loss of ability in hearing, speech, and sight (Choice A) is more closely related to sensory impairments rather than cognitive impairment. Endurance, strength, and mobility (Choice B) are more associated with physical capabilities rather than cognitive functions. Balance, flexibility, and coordination (Choice D) are related to motor skills and physical coordination, not cognitive impairment.

4. The nurse is preparing to discharge an elderly, recently widowed female client following a mild stroke. At this time she is able to walk with the aid of a walker. As part of the discharge planning, what referral is most important for the nurse to make?

• A. Pastoral care.
• B. Meals-on-Wheels.
• C. Grief support group.
• D. Physical therapy.

Correct answer: B

Rationale: The most important referral for the nurse to make for the elderly, recently widowed female client who had a mild stroke and limited mobility is Meals-on-Wheels. This service will ensure she receives proper nutrition and support given her circumstances. Pastoral care may provide emotional and spiritual support but is not as essential in this scenario. Grief support group could be beneficial but addressing her nutritional needs takes precedence. Physical therapy may be important for rehabilitation but ensuring proper nutrition is more critical at this time.

5. An infant weighed 7 pounds 8 ounces at birth. If growth occurs at a normal rate, what would be the expected weight at 6 months of age?

• A. Double the birth weight
• B. Triple the birth weight
• C. Gain 6 ounces each week
• D. Add 2 pounds each month

Correct answer: A

Rationale: The correct answer is A: 'Double the birth weight.' Infants typically double their birth weight by 6 months of age. This is a common milestone in healthy infant growth and development. Choice B is incorrect because tripling the birth weight would be excessive and not in line with normal growth patterns. Choice C, 'Gain 6 ounces each week,' is not accurate as infant growth is not linear each week. Choice D, 'Add 2 pounds each month,' is also incorrect as this rate of growth would be too rapid and unrealistic for healthy infant development.

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