Nursing Elites

1. Which individual has the highest risk of developing community-acquired pneumonia?

• A. A 40-year-old first-grade teacher who works with underprivileged children.
• B. A 75-year-old retired secretary with exercise-induced wheezing.
• C. A 60-year-old homeless person who is an alcoholic and smokes.
• D. A 35-year-old aerobics instructor who skips meals and eats only vegetables.

Correct answer: C

Rationale: The correct answer is the 60-year-old homeless person who is an alcoholic and smokes. This individual has the highest risk of developing community-acquired pneumonia due to factors such as homelessness, alcoholism, and smoking, which weaken the immune system and make them more susceptible to respiratory infections. Choice A is incorrect as working with underprivileged children, while potentially exposing the individual to various illnesses, does not directly increase the risk of pneumonia. Choice B is less likely as exercise-induced wheezing may suggest asthma but does not directly correlate with pneumonia risk. Choice D, an aerobics instructor who eats only vegetables and skips meals, does not have the same level of risk factors for pneumonia as the homeless person in choice C.

2. A community health nurse is conducting a neighborhood discussion group about disaster planning. What information regarding transmission of anthrax should the nurse provide to the group?

• A. Infection is acquired when anthrax spores enter a host.
• B. Mature anthrax bacteria live dormant on inanimate objects.
• C. Spores cannot survive for extended periods outside a living host.
• D. Anthrax is transmitted by respiratory droplets from person to person.

Correct answer: A

Rationale: The correct information the nurse should provide is that anthrax infection occurs when spores enter a host. Choice B is incorrect as mature anthrax bacteria do not live dormant on inanimate objects. Choice C is incorrect as anthrax spores can survive for extended periods outside a living host. Choice D is incorrect as anthrax is not transmitted by respiratory droplets from person to person.

3. A nurse organizes a community action group to help resolve health problems in a low-income neighborhood with a large population of recent immigrants from Africa. What problem should the nurse address first?

• A. High rate of unemployment.
• B. Low immunization rate of children.
• C. Provision of substandard health care.
• D. Access to bilingual care providers.

Correct answer: B

Rationale: The correct answer is B: Low immunization rate of children. Addressing low immunization rates is crucial as it directly impacts the health of children and the community by preventing the spread of infectious diseases. Option A, high rate of unemployment, though important for overall well-being, is not the most immediate health concern. Option C, provision of substandard health care, is a significant issue but may not be as urgent as ensuring children are immunized. Option D, access to bilingual care providers, is important for effective communication but is not as critical as addressing low immunization rates in this scenario.

4. A 67-year-old client is admitted with substernal chest pain with radiation to the jaw. His admitting diagnosis is Acute Myocardial Infarction (MI). The priority nursing diagnosis for this client during the immediate 24 hours is

• A. Constipation related to immobility
• B. High risk for infection
• C. Impaired gas exchange
• D. Fluid volume deficit

Correct answer: C

Rationale: The correct answer is C: Impaired gas exchange. In a client with an acute myocardial infarction, impaired gas exchange is a priority nursing diagnosis due to compromised heart function, which affects oxygenated blood circulation. Close monitoring and interventions are crucial to ensure adequate oxygenation. Choices A, B, and D are incorrect: A) Constipation related to immobility is not the priority in this acute situation; B) High risk for infection is not the immediate concern related to the client's primary diagnosis; D) Fluid volume deficit, while important, is not the priority compared to addressing impaired gas exchange in acute MI.

5. BCG vaccine is supplied in:

• A. freeze-dried form in a sealed glass ampule
• B. liquid form in a sealed glass ampule
• C. liquid form in a vial
• D. both 2 and 3

Correct answer: A

Rationale: The correct answer is A. BCG vaccine is commonly supplied in freeze-dried form, not in liquid form. Therefore, choices B and C are incorrect. Option D is also incorrect as the vaccine is not supplied in liquid form in a glass ampule.

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