Nursing Elites

1. In conducting a health assessment for a family with a history of cardiovascular disease, which family member should be prioritized for further evaluation and intervention?

• A. a 45-year-old father who smokes and has high cholesterol
• B. a 17-year-old daughter who is overweight and inactive
• C. a 50-year-old mother with a history of hypertension
• D. a 12-year-old son who has a normal weight and is active

Correct answer: A

Rationale: The 45-year-old father who smokes and has high cholesterol is at a higher risk for cardiovascular disease due to multiple risk factors. Smoking and high cholesterol are significant contributors to the development of cardiovascular issues. Prioritizing his evaluation and intervention is crucial to address these modifiable risk factors. The other family members, though they may have risk factors as well, do not present with the same level of immediate risk based on the information provided.

2. A nurse is developing a community health education program focused on preventing childhood obesity. Which intervention should be prioritized?

• A. Creating a school-based exercise program
• B. Distributing educational pamphlets on healthy eating
• C. Organizing a community health fair
• D. Partnering with local restaurants to offer healthy meal options

Correct answer: A

Rationale: The correct answer is A: Creating a school-based exercise program. This intervention directly addresses the need to increase physical activity among children, a crucial aspect in preventing childhood obesity. While distributing educational pamphlets on healthy eating (choice B) can be beneficial, promoting physical activity through a structured program is more effective in combating obesity. Organizing a community health fair (choice C) may raise awareness but may not lead to sustained behavior change like a structured exercise program. Partnering with local restaurants to offer healthy meal options (choice D) addresses nutrition but does not directly impact physical activity levels, which are essential in obesity prevention.

3. A client with chronic kidney disease is receiving erythropoietin therapy. Which finding indicates that the therapy is effective?

• A. Hemoglobin of 12 g/dL.
• B. Reticulocyte count of 1%.
• C. Blood pressure of 130/80 mm Hg.
• D. Serum ferritin level of 100 ng/mL.

Correct answer: A

Rationale: The correct answer is A: Hemoglobin of 12 g/dL. Erythropoietin therapy stimulates red blood cell production, leading to an increase in hemoglobin levels. A hemoglobin level of 12 g/dL indicates that the therapy is effective in managing anemia associated with chronic kidney disease. Choice B, a reticulocyte count of 1%, is not a direct indicator of the effectiveness of erythropoietin therapy. Choice C, a blood pressure of 130/80 mm Hg, is important to monitor in clients with chronic kidney disease but does not specifically indicate the effectiveness of erythropoietin therapy. Choice D, a serum ferritin level of 100 ng/mL, is related to iron stores in the body and may be monitored during erythropoietin therapy but does not directly reflect the therapy's effectiveness in increasing red blood cell production.

4. The nurse is providing discharge teaching to a client with a new diagnosis of diabetes mellitus. Which statement by the client indicates a need for further teaching?

• A. I will need to monitor my blood sugar levels daily.
• B. I will follow a diet low in carbohydrates.
• C. I will rotate the injection sites for my insulin.
• D. I will exercise regularly to help manage my diabetes.

Correct answer: B

Rationale: The correct answer is B. The statement 'I will follow a diet low in carbohydrates' indicates a need for further teaching. In diabetes mellitus, it is essential to follow a balanced diet that includes carbohydrates, proteins, and fats. Carbohydrates are a major source of energy and should be included in moderation to help manage blood sugar levels. Monitoring blood sugar levels daily (A), rotating injection sites for insulin (C), and exercising regularly (D) are all appropriate self-management strategies for individuals with diabetes mellitus.

5. What information should the nurse provide a client who has undergone cryosurgery for stage 1A cervical cancer?

• A. Expect heavy, watery vaginal discharge for 3 to 6 weeks.
• B. Use a tampon instead of a sanitary napkin.
• C. Report any severe cramping immediately.
• D. Avoid sexual intercourse for 3 to 6 weeks.

Correct answer: D

Rationale: After cryosurgery for stage 1A cervical cancer, clients should avoid sexual intercourse for 3 to 6 weeks to reduce the risk of infection. Heavy, watery vaginal discharge is expected but not the focus of post-procedure instructions. Using tampons is contraindicated as they can introduce bacteria into the healing cervix. While reporting severe cramping is important, avoiding sexual intercourse is the priority to prevent complications.

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