Nursing Elites

1. In a community clinic where a recent case of tuberculosis (TB) has been diagnosed, which client who attended the clinic is at the highest risk for presenting with TB?

• A. a young adult who works as a daycare worker
• B. an adult who works in a corporate office
• C. an adolescent who attends the community high school
• D. an adult with a history of alcoholism and homelessness

Correct answer: D

Rationale: Individuals who are homeless and have a history of alcoholism are at the highest risk for presenting with TB in this scenario. Homeless individuals often live in crowded conditions with poor ventilation, increasing the likelihood of TB transmission. Additionally, alcoholism can weaken the immune system, making individuals more susceptible to developing TB. The other options, such as a daycare worker, an office worker, or a high school student, do not inherently carry the same level of risk factors for TB transmission as being homeless with a history of alcoholism.

2. When planning a community health fair to promote mental health awareness, which activity should be included to best engage participants?

• A. free mental health screenings
• B. lectures on mental health topics
• C. distribution of mental health resources
• D. interactive workshops on stress management

Correct answer: A

Rationale: The best activity to engage participants in a community health fair promoting mental health awareness is to offer free mental health screenings. This activity not only attracts participants but also provides them with immediate, valuable information about their mental health status. Free screenings can help raise awareness, encourage early detection of mental health issues, and prompt participants to seek further assistance if needed. Lectures, while informative, may not be as engaging or impactful as the personalized feedback individuals receive from screenings. Distributing resources is helpful, but active engagement through screenings is more effective in promoting awareness and encouraging action. Interactive workshops on stress management are beneficial but might not provide the same level of individualized insight into mental health as screenings do.

3. During a follow-up visit, a client with hypertension reports that they often forget to take their medication. What should the nurse do first?

• A. educate the client on the importance of medication adherence
• B. explore the reasons for the client's forgetfulness
• C. provide the client with a pill organizer
• D. adjust the client's medication schedule

Correct answer: B

Rationale: The correct first action for the nurse is to explore the reasons for the client's forgetfulness. By understanding the underlying causes, the nurse can provide tailored interventions to help the client improve medication adherence. Providing education on the importance of adherence (Choice A) may be necessary but should come after identifying the reasons for forgetfulness. Simply providing a pill organizer (Choice C) or adjusting the medication schedule (Choice D) does not address the root cause of the forgetfulness and may not lead to sustained improvement in adherence.

4. 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.

5. 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.

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