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. A nurse is planning a community event to raise awareness about mental health. Which activity should be included to best engage participants?

• A. lectures by mental health professionals
• B. interactive workshops on stress management
• C. distribution of mental health resources
• D. screenings for depression and anxiety

Correct answer: B

Rationale: Interactive workshops on stress management should be included to best engage participants in a community event about mental health. Unlike lectures by mental health professionals, workshops actively involve participants, allowing for interaction and practical skill-building. While distributing mental health resources and providing screenings for depression and anxiety are important components, interactive workshops offer a more engaging and hands-on approach, empowering individuals with skills they can use to manage their mental health effectively.

3. A client with a history of chronic kidney disease is receiving erythropoietin therapy. Which finding indicates that the therapy is effective?

• A. Hemoglobin of 12 g/dL.
• B. Reticulocyte count of 1%.
• C. Blood pressure of 130/80 mm Hg.
• D. Serum ferritin level of 100 ng/mL.

Correct answer: A

Rationale: The correct answer is A. A hemoglobin level of 12 g/dL is an indicator of effective erythropoietin therapy as it shows an increase in red blood cell production. Reticulocyte count (choice B) reflects the bone marrow's response to anemia but does not directly confirm the effectiveness of erythropoietin therapy. Blood pressure (choice C) and serum ferritin level (choice D) are not specific indicators of the effectiveness of erythropoietin therapy for chronic kidney disease.

4. The client with congestive heart failure (CHF) is receiving discharge instructions. Which statement by the client indicates a need for further teaching?

• A. I will weigh myself daily and report a weight gain of more than 2 pounds in 24 hours.
• B. I will take my diuretic medication in the morning.
• C. I will call my healthcare provider if I experience increased shortness of breath.
• D. I will drink at least 3 liters of fluid each day.

Correct answer: D

Rationale: The correct answer is D. Drinking at least 3 liters of fluid each day may be contraindicated for a client with CHF due to the risk of fluid overload. This can exacerbate heart failure symptoms and lead to complications. Options A, B, and C are all appropriate statements that demonstrate understanding of managing CHF and seeking appropriate medical attention when needed.

5. A community health nurse is conducting a program evaluation for a diabetes management class. Which measure best indicates the program's effectiveness?

• A. Number of participants attending each session
• B. Participant satisfaction with the class
• C. Reduction in participants' average blood glucose levels
• D. Improvement in participants' knowledge about diabetes

Correct answer: C

Rationale: The most effective measure to indicate the program's effectiveness in a diabetes management class is the reduction in participants' average blood glucose levels. This measure directly reflects the impact of the program on managing diabetes and improving health outcomes. Choices A and B may provide valuable information but do not directly assess the program's impact on managing diabetes. Choice D, improvement in participants' knowledge about diabetes, is important but may not directly translate into improved diabetes management without actual health outcome measurements like blood glucose levels.

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