Nursing Elites

1. The nurse is evaluating the effectiveness of a community health program aimed at reducing teen pregnancy rates. Which outcome indicates the program was successful?

• A. increased attendance at health education classes
• B. decreased number of repeat pregnancies among teens
• C. higher number of teens seeking prenatal care
• D. greater use of contraception among teens

Correct answer: D

Rationale: The correct answer is D: greater use of contraception among teens. This outcome indicates successful prevention of pregnancies by demonstrating that teens are taking proactive steps to avoid unintended pregnancies. Increased attendance at health education classes (choice A) may show improved knowledge but does not directly measure the prevention of pregnancies. While a decreased number of repeat pregnancies among teens (choice B) is positive, it does not necessarily indicate prevention of initial pregnancies. A higher number of teens seeking prenatal care (choice C) is important for maternal and fetal health but does not directly reflect the prevention of teen pregnancies.

2. A community hospital is an example of which level of health care?

• A. Secondary level health care
• B. Primary health care
• C. Tertiary level care
• D. Intermediate level care

Correct answer: A

Rationale: A community hospital is categorized under secondary level health care. Secondary level health care facilities, like community hospitals, provide specialized outpatient care, diagnostic services, and treatment that are more complex than what is offered in primary health care settings. Choice B, primary health care, refers to basic and routine health care services typically provided by family doctors or general practitioners, which is not the level of care provided by community hospitals. Tertiary level care (choice C) involves highly specialized and complex medical services such as neurosurgery or organ transplants, which are beyond the scope of services provided by community hospitals. Intermediate level care (choice D) is not a recognized category in the hierarchy of health care levels.

3. A female adult walks into a local community health clinic and tells the nurse that she is homeless and cannot seem to find help. Which statement indicates to the nurse that a client is feeling separated from society and helpless?

• A. "I'm feeling really isolated from everyone and scared."
• B. "I feel like I cannot get enough food to live any longer."
• C. "I know that I will always be poor so what's the use of trying?"
• D. "People like me are never respected, no matter how well we do."

Correct answer: A

Rationale: The correct answer is A. The statement "I'm feeling really isolated from everyone and scared" indicates a sense of separation from society and helplessness. This choice reflects feelings of loneliness and fear, which are common among individuals who feel disconnected and helpless. Choices B, C, and D do not directly convey a sense of isolation and helplessness. Choice B focuses on food insecurity, choice C on a resigned attitude towards poverty, and choice D on lack of respect, none of which directly address the feelings of being separated from society and helpless as indicated in the scenario.

4. A 4-month-old child taking digoxin (Lanoxin) has a blood pressure of 92/78; resting pulse of 78; respirations 28, and a potassium level of 4.8 mEq/L. The client is irritable and has vomited twice since the morning dose of digoxin. Which finding is most indicative of digoxin toxicity?

• A. Bradycardia
• B. Lethargy
• C. Irritability
• D. Vomiting

Correct answer: A

Rationale: Bradycardia (abnormally slow heart rate) is a key sign of digoxin toxicity. In this scenario, the child's symptoms of irritability, vomiting, along with the resting pulse of 78 despite being on digoxin, suggest an impending bradycardia due to digoxin toxicity. Lethargy can also be a sign, but in this case, the child is irritable rather than lethargic. Vomiting, though a symptom, is not as specific to digoxin toxicity as bradycardia. Irritability, while present, is not the most indicative finding of digoxin toxicity compared to bradycardia.

5. What title should be given to this occupational health nurse job description? A registered nurse who functions in a comprehensive executive role to set goals, formulate policy, and direct and evaluate the health service.

• A. manager
• B. researcher
• C. health educator
• D. health promotion specialist

Correct answer: A

Rationale: The correct answer is 'manager.' In the job description provided, the role involves setting goals, formulating policy, and directing and evaluating health services, which aligns with the responsibilities of a manager. A 'researcher' primarily focuses on conducting research, a 'health educator' specializes in educating individuals about health-related topics, and a 'health promotion specialist' concentrates on promoting health and wellness initiatives. Therefore, 'manager' is the most suitable title for the described role.

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