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 public health nurse is planning a smoking cessation program for a local community. Which component is most important to include in the program?

• A. information on the health risks of smoking
• B. strategies for coping with withdrawal symptoms
• C. testimonials from former smokers
• D. distribution of nicotine replacement therapy

Correct answer: B

Rationale: The most important component to include in a smoking cessation program is strategies for coping with withdrawal symptoms. Withdrawal symptoms are a significant barrier to quitting smoking, and providing effective coping strategies can greatly increase the program's success. Choice A, providing information on the health risks of smoking, may be important but addressing withdrawal symptoms is more crucial. Testimonials from former smokers (Choice C) and distribution of nicotine replacement therapy (Choice D) are helpful but not as essential as addressing withdrawal symptoms directly.

3. On a day when the temperature is expected to drop below freezing during the night, the nurse is asked to determine which homeless adults are most in need of the limited spaces available in a shelter. It is most important for which person to be admitted at night?

• A. an adult who was hit by a car 3 weeks ago
• B. a young person with diabetes mellitus
• C. a middle-aged person who has hypertension
• D. an older person who is malnourished

Correct answer: D

Rationale: Malnourished individuals are at higher risk of severe complications from cold exposure due to their weakened immune system and decreased ability to regulate body temperature. This places them at a greater risk of hypothermia and other cold-related conditions, making them the most vulnerable group in need of shelter. Choice A is not the most critical as the injury is from 3 weeks ago and should have received appropriate medical care by now. Choice B, a young person with diabetes mellitus, while vulnerable, can manage their condition with proper medication and care. Choice C, a middle-aged person with hypertension, may need monitoring but is less susceptible to immediate harm from cold exposure compared to a malnourished individual.

4. When examining sources for funding, which criteria should the nurse clarify about the program for the community group?

• A. a prescription from the healthcare provider for each visit made
• B. documentation of a skilled care service provided during the visit
• C. a copy of the client's health history and social security card
• D. a record of the preventive healthcare services provided during the visit

Correct answer: C

Rationale: The correct answer is C because when seeking funding sources for a community outreach program, it is essential to clarify aspects related to the client's personal information, such as health history and identification details. This information helps in demonstrating the need for the program and understanding the target population. Choices A, B, and D are incorrect because they focus on clinical documentation, services provided during visits, and preventive healthcare services, which are not directly related to clarifying funding criteria about the program.

5. 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.

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