Nursing Elites

1. The healthcare provider is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which intervention is most important?

• A. Restrict fluids to 1,000 mL per day.
• B. Administer a vasopressin antagonist.
• C. Monitor intake and output.
• D. Encourage a high-sodium diet.

Correct answer: B

Rationale: Administering a vasopressin antagonist is the most critical intervention for a client with SIADH. SIADH is characterized by excessive release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. A vasopressin antagonist helps manage the symptoms by blocking the effects of ADH, promoting water excretion, and restoring electrolyte balance. Restricting fluids (choice A) may exacerbate hyponatremia, monitoring intake and output (choice C) is important but not the most critical intervention, and encouraging a high-sodium diet (choice D) is contraindicated in SIADH due to the risk of worsening hyponatremia.

2. A public health nurse is evaluating a program designed to reduce the incidence of sexually transmitted infections (STIs) among teenagers. Which outcome indicates that the program is successful?

• A. increased attendance at educational sessions on STIs
• B. higher rates of condom use among teenagers
• C. more teenagers seeking testing for STIs
• D. greater knowledge of STI prevention methods

Correct answer: B

Rationale: The correct answer is B: higher rates of condom use among teenagers. This outcome indicates that the teenagers are adopting safer sexual practices, which can effectively reduce the incidence of STIs. Increased attendance at educational sessions (Choice A) may show interest but does not directly reflect behavior change. More teenagers seeking testing for STIs (Choice C) indicates awareness but not necessarily prevention. Greater knowledge of STI prevention methods (Choice D) is valuable but does not guarantee behavioral change like increased condom use.

3. The nurse is documenting the medical history of a young adult who was recently diagnosed with type 1 diabetes mellitus. The client smokes 2 packs of cigarettes a day, and his father died of a heart attack at the age of 45. Which annual screening is most important for the nurse to include?

• A. peripheral neuropathy
• B. renal insufficiency
• C. retinopathy
• D. hyperlipidemia

Correct answer: D

Rationale: The most important annual screening for the nurse to include is hyperlipidemia. Given the client's smoking history, family history of premature heart disease, and the increased risk of cardiovascular complications associated with diabetes, screening for hyperlipidemia is crucial. This screening is essential in assessing the client's risk of developing cardiovascular disease, which is a significant concern in this case. Peripheral neuropathy (choice A) is a common long-term complication of diabetes but may not be the most immediate concern in this scenario. Renal insufficiency (choice B) is also a complication of diabetes, but given the client's high cardiovascular risk, hyperlipidemia screening takes priority. Retinopathy (choice C) is an important complication of diabetes affecting the eyes, but in this case, focusing on cardiovascular risk assessment through hyperlipidemia screening is more critical.

4. The nurse is developing a workshop on cancer prevention for a group of adults at a wellness bar. Which recommendation should the nurse include in the workshop?

• A. Know the four warning signs of cancer
• B. Maintain a healthy weight and exercise regularly
• C. Refrain from alcohol
• D. Obtain at least 6 to 10 hours of sleep per night

Correct answer: B

Rationale: Maintaining a healthy weight and exercising regularly are crucial recommendations in cancer prevention. These habits help reduce the risk of developing cancer by promoting overall health and reducing factors associated with cancer development. Knowing the warning signs of cancer (Choice A) is important for early detection but does not directly prevent cancer. While refraining from alcohol (Choice C) is beneficial for some cancers, it is not as universally applicable as maintaining a healthy weight and exercising. Getting adequate sleep (Choice D) is essential for overall health but is not as directly linked to cancer prevention as maintaining a healthy weight and regular exercise.

5. A public health nurse is evaluating a program designed to reduce childhood obesity. Which outcome indicates that the program is successful?

• A. increased participation in physical activities
• B. higher attendance at nutrition education sessions
• C. reduced rates of childhood obesity
• D. greater knowledge of healthy eating habits

Correct answer: C

Rationale: The correct answer is C: reduced rates of childhood obesity. A reduction in childhood obesity rates is a direct indicator that the program is successful in achieving its goal. Increased participation in physical activities (choice A) and higher attendance at nutrition education sessions (choice B) are positive outcomes, but they do not directly measure the program's effectiveness in reducing obesity. Greater knowledge of healthy eating habits (choice D) is important but does not guarantee a decrease in obesity rates. Therefore, the most significant outcome to determine the success of a childhood obesity reduction program is a reduction in obesity rates.

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