Nursing Elites

1. The public health RN is called to investigate a report of several cases of varicella at a daycare center. The daycare workers state that 5 children have been sent home over the past 2 weeks with fever and itchy blisters. Which intervention should the RN implement first?

• A. Validate that the children who were sent home had chickenpox.
• B. Ask the parents to take the child to see their pediatrician.
• C. Ask the parents to not send the child back to daycare until after 6 weeks.
• D. Tell the parents to send the child back to daycare; it was a mistake they were sent home.

Correct answer: A

Rationale: The correct answer is to validate that the children who were sent home had chickenpox. This is crucial in confirming the presence of varicella, which is necessary for appropriate management and control of the outbreak. Option B is not the first intervention because the focus initially is on verifying the cases within the daycare center. Option C is incorrect as it suggests a prolonged exclusion period without confirming the diagnosis. Option D is inappropriate and potentially harmful, as sending a child back without proper assessment can lead to further spread of the infection.

2. Which one of the following statements, if made by the client, indicates teaching about Inderal (propranolol) has been effective?

• A. ''I may experience seizures if I stop the medication abruptly.''
• B. ''I may experience an increase in my heart rate for a few weeks.''
• C. ''I can expect to feel nervousness the first few weeks.''
• D. ''I can have a heart attack if I stop this medication suddenly.''

Correct answer: D

Rationale: The correct answer is D. Stopping Inderal (propranolol) abruptly can cause rebound hypertension, angina, and even a myocardial infarction (heart attack), so it is crucial to taper off the medication under medical supervision. Choices A, B, and C are incorrect because they do not reflect the serious consequences associated with abrupt discontinuation of propranolol.

3. The nurse has just admitted a client with severe depression. From which focus should the nurse identify a priority nursing diagnosis?

• A. Nutrition
• B. Elimination
• C. Activity
• D. Safety

Correct answer: D

Rationale: In severe depression, the priority nursing diagnosis is safety. Individuals with severe depression are at risk of self-harm or suicide. Ensuring the client's safety by implementing measures to prevent harm to themselves or others is crucial. While nutrition, elimination, and activity are important aspects of care, ensuring the client's immediate safety takes precedence in this situation.

4. Which of the following is the most effective way to prevent the spread of communicable diseases in a community?

• A. Regular health check-ups
• B. Isolation of infected individuals
• C. Immunization programs
• D. Public health education

Correct answer: C

Rationale: Immunization programs are the most effective way to prevent the spread of communicable diseases. Vaccinations help build immunity against specific diseases, reducing the likelihood of an outbreak. Regular health check-ups (Choice A) are important for individual health but do not directly prevent the spread of diseases on a community level. Isolation of infected individuals (Choice B) is a containment measure rather than prevention for the entire community. Public health education (Choice D) is valuable in raising awareness but may not be as effective as immunization programs in directly preventing the spread of communicable diseases.

5. A client with peptic ulcer disease is receiving ranitidine (Zantac). The nurse should monitor the client for which of the following side effects?

• A. Hypertension
• B. Constipation
• C. Diarrhea
• D. Hypotension

Correct answer: C

Rationale: The correct answer is C: Diarrhea. Ranitidine, which is used to treat peptic ulcer disease, can lead to gastrointestinal disturbances such as diarrhea. Choices A, B, and D are incorrect. Hypertension and hypotension are not common side effects of ranitidine. Constipation is also not a typical side effect associated with ranitidine use.

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