Nursing Elites

1. The community health nurse is planning a series of educational courses about the healthcare system and meeting healthcare needs for the community center. Which adjunct issue should the nurse address for a group of older adults?

• A. peer concerns
• B. adult daycare
• C. retirement issues
• D. vocational concerns

Correct answer: C

Rationale: Retirement often brings specific healthcare needs and concerns that are crucial to address for older adults. While peer concerns and adult daycare could be important aspects to consider, retirement issues are more directly related to the unique healthcare needs and challenges faced by older adults. Vocational concerns are typically more relevant to individuals who are still actively engaged in the workforce, rather than retired older adults.

2. A client with a history of alcohol abuse is admitted with cirrhosis. Which finding requires immediate intervention?

• A. Jaundice.
• B. Ascites.
• C. Peripheral edema.
• D. Spider angiomas.

Correct answer: C

Rationale: Peripheral edema in a client with cirrhosis can indicate fluid overload and worsening liver function, necessitating immediate intervention to prevent further complications such as respiratory distress, cardiac issues, or renal impairment. Jaundice (choice A) is a common manifestation of cirrhosis but may not require immediate intervention unless severe. Ascites (choice B) is also a common complication of cirrhosis that may require intervention but is not as urgent as addressing peripheral edema. Spider angiomas (choice D) are typically benign skin lesions associated with cirrhosis but do not require immediate intervention unless bleeding or rupture occurs.

3. 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.

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

• A. survey employees to determine how many are smoking 2 months after the end of the program
• B. test the employees' knowledge of OTC nicotine substitute products at the end of the program
• C. ask employees to inform the group if they stop smoking and if they start smoking again
• D. design a questionnaire that identifies lifestyle changes contributing to smoking cessation

Correct answer: A

Rationale: Surveying employees to determine how many are smoking 2 months after the end of the program provides a direct assessment of the program's effectiveness. This measurement evaluates the actual behavior change related to smoking cessation. Choice B, testing knowledge of OTC nicotine substitute products, does not directly measure smoking cessation outcomes. Choice C relies on self-reporting, which may not be accurate or reliable. Choice D focuses on identifying lifestyle changes but does not directly assess the program's impact on smoking cessation.

5. A 9-year-old is hospitalized for neutropenia and is placed in reverse isolation. The child asks the nurse, 'Why do you have to wear a gown and mask when you are in my room?' How should the nurse respond?

• A. To protect myself from your germs.
• B. To protect you because you can get an infection very easily.
• C. Until your white blood cell count increases.
• D. To keep others from getting your infection.

Correct answer: B

Rationale: Reverse isolation precautions protect the client from exposure to microorganisms from others.

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