Nursing Elites

1. Which annual screening should the nurse include when planning eye health programs at a preschool?

• A. visual acuity
• B. red light reflex
• C. conjunctivitis
• D. glaucoma

Correct answer: A

Rationale: The correct answer is A: visual acuity. Screening for visual acuity is essential in preschoolers to identify any vision issues early on, such as nearsightedness or farsightedness, which may require corrective lenses or other interventions. Red light reflex (choice B) is a method used to assess the eyes for abnormalities, but it is not typically included in routine preschool eye health screenings. Conjunctivitis (choice C) is an eye infection and not a screening test. Glaucoma (choice D) is a condition more commonly associated with adults and the elderly, making it less relevant for preschool eye health programs.

2. The nurse is caring for a client with liver cirrhosis. Which assessment finding requires immediate intervention?

• A. Jaundice.
• B. Ascites.
• C. Peripheral edema.
• D. Spider angiomas.

Correct answer: D

Rationale: Spider angiomas are abnormal clusters of blood vessels near the skin surface and can be indicative of an underlying liver condition. In the context of liver cirrhosis, spider angiomas can suggest portal hypertension and liver dysfunction, which requires immediate intervention. Jaundice (choice A) is a common manifestation of liver cirrhosis but not typically an immediate intervention priority unless severe. Ascites (choice B) and peripheral edema (choice C) are also common in liver cirrhosis but do not require immediate intervention unless they are causing respiratory compromise or other urgent issues.

3. An older client requiring total care resides with a family consisting of two daughters who take shifts providing care around-the-clock. During a home visit, the daughters ask the nurse about resources that are available for client care while they attend a scheduled family reunion. Which information is best for the nurse to provide?

• A. propose the family seek assistance for care in the area of the reunion's location
• B. tell the caregivers to consider hiring a private duty nurse during the time away
• C. advise to have a case management evaluation of the client's home environment
• D. suggest social services be contacted to find a respite care facility for the client

Correct answer: D

Rationale: Respite care provides temporary relief for primary caregivers, allowing them to attend the reunion while ensuring the client is cared for.

4. A home health nurse is reviewing the laboratory results for several clients with heart failure. Which client finding would the nurse report to the health care provider immediately?

• A. Total cholesterol 190
• B. Glycosylated hemoglobin of 7%
• C. B-type natriuretic peptide 550 pg/ml (more than 100 is concerning)
• D. Potassium 3.7

Correct answer: C

Rationale: An elevated B-type natriuretic peptide level indicates worsening heart failure, requiring immediate attention. This biomarker reflects the severity of heart failure and helps guide treatment decisions. Total cholesterol and glycosylated hemoglobin are important for assessing cardiovascular risk and diabetes management but are not indicative of acute heart failure exacerbation. A potassium level of 3.7 falls within the normal range and does not suggest an immediate concern in the context of heart failure.

5. The healthcare professional is conducting a community assessment to identify health needs. Which method is most effective for gathering comprehensive data?

• A. conducting focus groups with community members
• B. reviewing local health department reports
• C. surveying healthcare providers in the area
• D. analyzing hospital admission records

Correct answer: A

Rationale: Conducting focus groups with community members is the most effective method for gathering comprehensive data during a community assessment. This approach allows direct interaction with community members, fostering in-depth discussions that provide insights into the specific health needs and concerns of the community. Choice B, reviewing local health department reports, may offer valuable data but might not capture the nuanced perspectives and experiences of community members. Choice C, surveying healthcare providers, provides insights from a professional standpoint but may not fully represent the community's diverse health needs. Choice D, analyzing hospital admission records, offers information on healthcare utilization but may overlook important social determinants of health and community-specific issues that can only be addressed through direct engagement with community members.

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