Nursing Elites

1. The nurse is teaching a community group about risks of cardiovascular disease. Several clients ask the nurse to determine their risk. Which client should the nurse identify as having the greatest risk for cardiovascular disease?

• A. A male with a serum cholesterol level of 199 mg/dl.
• B. A female with a serum cholesterol level of 201 mg/dl.
• C. A male with a low-density lipoprotein (LDL) level of 200 mg/dl.
• D. A female with a low-density lipoprotein (LDL) level of 160 mg/dl.

Correct answer: C

Rationale: The correct answer is C. A male with a high LDL level (200 mg/dl) has a significant risk for cardiovascular disease. High levels of LDL cholesterol are associated with an increased risk of atherosclerosis and heart disease. Choices A, B, and D have serum cholesterol levels that are slightly elevated but are not as specific or directly linked to cardiovascular risk as high LDL levels. Therefore, the client with the high LDL level is at the greatest risk for cardiovascular disease.

2. The nurse is preparing an orientation class for new employees at an inner city clinic that serves a low-income population. Which information should the nurse include in the presentation to these new employees?

• A. A lack of transportation is a major barrier for the clinic's clients.
• B. Basic physiologic needs are likely to be unmet in this clinic's client population.
• C. Printed material is less effective for this population with limited reading skills.
• D. Group education classes are often poorly attended by non-compliant clients.

Correct answer: B

Rationale: The correct answer is B because addressing basic physiologic needs is crucial for low-income populations. Ensuring that basic needs such as food, shelter, and safety are met is essential for these clients to engage effectively in their healthcare. Choice A talks about transportation, which can be a barrier but may not be the major impediment. Choice C focuses on printed material and reading skills, which are important but not as fundamental as addressing basic physiologic needs. Choice D makes assumptions about client attendance based on compliance, which is not the most critical information to include in an orientation about serving a low-income population.

3. What is the most common cause of vaginal bleeding immediately after birth?

• A. Uterine atony
• B. Genital lacerations
• C. Abnormal clotting mechanism
• D. Endometritis

Correct answer: A

Rationale: Vaginal bleeding immediately after birth is most often due to uterine atony, which is the failure of the uterus to contract following delivery. This results in inadequate compression of blood vessels at the placental site, leading to hemorrhage. Genital lacerations and abnormal clotting mechanisms can also cause bleeding but are less common immediately after birth compared to uterine atony. Endometritis, inflammation of the lining of the uterus, usually presents with symptoms like fever and pelvic pain rather than immediate postpartum bleeding.

4. A nurse is practicing community health nursing when:

• A. leading a support group for obese adolescents
• B. visiting an old woman in her condominium to change her postsurgical dressing
• C. being in a clinic instructing a couple about newborn care
• D. performing any of these activities

Correct answer: D

Rationale: Correct! Community health nursing involves a broad scope of activities that focus on promoting and preserving the health of populations rather than individuals. This includes leading support groups, providing home care, and educating communities. The other options represent different aspects of nursing care such as home health nursing, wound care, and maternal-child health - which are not exclusive to community health nursing.

5. The nurse is caring for an acutely ill 10-year-old client. Which of the following assessments would require the nurse's immediate attention?

• A. Rapid bounding pulse
• B. Temperature of 38.5 degrees Celsius
• C. Profuse diaphoresis
• D. Slow, irregular respirations

Correct answer: D

Rationale: The correct answer is D, slow, irregular respirations. In an acutely ill child, this assessment can indicate impending respiratory failure or neurological compromise, necessitating immediate intervention. Rapid bounding pulse (choice A) may indicate tachycardia but is not as immediately concerning as compromised respirations. A temperature of 38.5 degrees Celsius (choice B) is elevated but may not be the most urgent concern unless accompanied by other symptoms. Profuse diaphoresis (choice C) can indicate increased sympathetic activity but is not as critical as respiratory compromise.

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