Nursing Elites

1. The healthcare professional is developing a safety program for older adults at a senior center. Which topic should the professional prioritize?

• A. medication management
• B. fall prevention
• C. fire safety
• D. emergency preparedness

Correct answer: B

Rationale: Fall prevention should be prioritized for older adults as falls are a significant cause of injury and hospitalization in this population. Addressing fall prevention measures can help reduce the risk of falls and improve the overall safety and well-being of older adults. Medication management, fire safety, and emergency preparedness are also important topics, but fall prevention takes precedence due to its direct impact on the health and safety of older adults.

2. The healthcare provider is caring for a client with hypokalemia. Which assessment finding requires immediate intervention?

• A. Muscle weakness.
• B. Irregular heart rate.
• C. Increased urinary output.
• D. Decreased deep tendon reflexes.

Correct answer: D

Rationale: Decreased deep tendon reflexes are a critical finding in hypokalemia that indicates severe potassium deficiency affecting neuromuscular function. Immediate intervention is necessary to prevent life-threatening complications such as respiratory failure or cardiac arrhythmias. Muscle weakness, irregular heart rate, and increased urinary output are also associated with hypokalemia but do not pose the same level of urgency as decreased deep tendon reflexes.

3. A client with a history of coronary artery disease is admitted with chest pain. Which assessment finding requires immediate intervention?

• A. Heart rate of 90 beats per minute.
• B. Respiratory rate of 20 breaths per minute.
• C. Blood pressure of 130/80 mm Hg.
• D. Chest pain radiating to the left arm.

Correct answer: D

Rationale: Chest pain radiating to the left arm is a classic symptom of a myocardial infarction (heart attack) in individuals with coronary artery disease. This finding indicates that the heart muscle may not be receiving adequate oxygen, which requires immediate intervention to prevent further damage or complications. The other assessment findings (heart rate of 90 beats per minute, respiratory rate of 20 breaths per minute, blood pressure of 130/80 mm Hg) are within normal limits and do not suggest an acute, life-threatening condition like myocardial infarction.

4. A community health nurse is addressing the issue of domestic violence in the community. Which intervention should the nurse implement first?

• A. establishing a support group for survivors of domestic violence
• B. developing educational materials on recognizing signs of abuse
• C. partnering with local law enforcement to increase awareness
• D. conducting a community needs assessment to identify resources

Correct answer: D

Rationale: Conducting a community needs assessment is the most appropriate initial intervention when addressing domestic violence in the community. This step helps the nurse identify existing resources, gaps, and specific needs of the community related to domestic violence. By understanding the community's needs through a needs assessment, the nurse can tailor subsequent interventions effectively. Option A, establishing a support group, may be beneficial later but should not be the first step. Developing educational materials (Option B) and partnering with law enforcement (Option C) are important strategies; however, without understanding the community's specific needs through a needs assessment, the interventions may not be as targeted or effective.

5. During a home visit, the nurse observes that an elderly client has numerous bruises on her arms and appears fearful of her caregiver. What should the nurse do first?

• A. report the findings to adult protective services
• B. ask the client how she got the bruises
• C. document the observations in the client's medical record
• D. discuss the observations with the caregiver

Correct answer: B

Rationale: The initial step for the nurse should be to ask the client how she got the bruises. This approach allows the nurse to directly assess the situation, gather information from the client, and potentially uncover signs of abuse. Reporting to adult protective services should come after obtaining more details from the client to ensure appropriate action. Documenting the observations is important but should follow gathering information from the client. Discussing the observations with the caregiver may not be appropriate as the caregiver could be the source of abuse, and involving them first may jeopardize the client's safety.

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