Nursing Elites

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

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

Correct answer: B

Rationale: The correct answer is the 45-year-old father who is overweight and has high cholesterol. He possesses multiple risk factors for diabetes, indicating a need for prioritized evaluation and intervention. The mother's hypertension, the daughter's inactivity, and the son's normal weight and activity level are important factors to consider but do not present as immediate red flags for diabetes risk compared to the father's combination of being overweight and having high cholesterol.

2. A client with a history of peptic ulcer disease is admitted with severe epigastric pain. Which finding requires immediate intervention?

• A. Nausea and vomiting.
• B. Hematemesis.
• C. Melena.
• D. Rebound tenderness.

Correct answer: D

Rationale: In a client with a history of peptic ulcer disease presenting with severe epigastric pain, the finding that requires immediate intervention is rebound tenderness. Rebound tenderness can indicate peritonitis, a serious condition that necessitates immediate medical attention. Nausea and vomiting, hematemesis, and melena are also concerning symptoms in a client with a history of peptic ulcer disease, but they do not signify the urgency of intervention as rebound tenderness does.

3. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy. Which finding indicates that the therapy is effective?

• A. The client is able to expectorate secretions easily.
• B. The client's oxygen saturation is 92%.
• C. The client's respiratory rate is 20 breaths per minute.
• D. The client's arterial blood gases show a pH of 7.35.

Correct answer: C

Rationale: In a client with COPD receiving oxygen therapy, an effective response is indicated by a respiratory rate of 20 breaths per minute. This suggests that the client is effectively oxygenating while maintaining an appropriate respiratory rate. Choices A, B, and D are incorrect because expectorating secretions easily, having an oxygen saturation of 92%, and arterial blood gases showing a pH of 7.35 are not specific indicators of the effectiveness of oxygen therapy in COPD. Oxygen saturation of 92% may still be suboptimal in COPD, and arterial blood gases showing a pH of 7.35 may not necessarily reflect the overall effectiveness of oxygen therapy.

4. A community health nurse is helping a group of nursing students plan a tertiary prevention program for a local community clinic that serves a majority Hispanic population. Which service project meets the requirement of a tertiary prevention program and would best serve this population?

• A. teaching clients about recommended immunizations for children
• B. demonstrating foot care to a group of clients who have diabetes
• C. taking blood pressures at a local shopping mall in the community
• D. instructing teens about prevention of sexually transmitted diseases

Correct answer: B

Rationale: The correct answer is B. Tertiary prevention focuses on managing and improving health outcomes for existing conditions, such as diabetes. Demonstrating foot care to clients with diabetes aligns with this level of prevention by helping to prevent complications and promote better health outcomes. Choices A, C, and D do not specifically target existing conditions or chronic diseases, which are the focus of tertiary prevention programs.

5. The client with the sexually transmitted disease HPV reports having had prior sexually transmitted infections. Which response should the nurse provide?

• A. Emphasize that using safe sex practices removes the risk of transmission.
• B. Instruct the client of the importance of notifying sexual partners.
• C. Reassure that complications will not occur if infection is treated.
• D. Provide counseling that most contraceptives prevent against infection.

Correct answer: B

Rationale: Instructing the client about the importance of notifying sexual partners is crucial when dealing with sexually transmitted infections like HPV. This helps prevent the spread of the infection to others and promotes responsible sexual behavior. Choices A, C, and D are incorrect because while using safe sex practices is important, notifying sexual partners is more immediate and directly related to preventing the spread of the infection. Reassuring about complications and discussing contraceptives do not address the immediate need to notify partners.

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