Nursing Elites

1. Which intervention by the community health nurse is an example of a secondary level of prevention?

• A. providing a needle exchange program at a community mental health clinic
• B. developing an educational program for clients with diabetes mellitus
• C. administering influenza vaccines to residents of a nursing home
• D. initiating contact notifications for sexual partners of an HIV client

Correct answer: C

Rationale: Administering influenza vaccines to residents of a nursing home is an example of secondary prevention. Secondary prevention aims to detect and treat a disease or condition in its early stages to prevent complications. In this case, administering influenza vaccines helps prevent the spread of the flu among vulnerable individuals. Choices A, B, and D are not examples of secondary prevention. Providing a needle exchange program (Choice A) is a harm reduction strategy (tertiary prevention). Developing an educational program for clients with diabetes mellitus (Choice B) focuses on health promotion and primary prevention. Initiating contact notifications for sexual partners of an HIV client (Choice D) is a measure to prevent further transmission of the disease but is more aligned with tertiary prevention.

2. An adolescent tells the school nurse that she is pregnant. Her last menstrual period was 4 months ago. She has not received any medical care. She smokes but denies any other substance use. What is the priority nursing action?

• A. notify her parents
• B. refer her for prenatal care
• C. teach breastfeeding methods
• D. offer nutritional instructions

Correct answer: B

Rationale: The correct answer is to refer her for prenatal care. Prenatal care is essential to monitor the health of both the mother and the fetus during pregnancy. While notifying her parents may be important for support and involvement, the priority is ensuring the adolescent receives medical care. Teaching breastfeeding methods and offering nutritional instructions are important but are not the immediate priority in this situation where prenatal care is urgently needed.

3. A female client makes routine visits to a neighborhood community health center. The nurse notes that this client often presents with facial bruising, particularly around the eyes. The nurse discusses prevention of domestic violence with the client even though the client does not admit to it. What level of prevention has the nurse applied in this situation?

• A. primary prevention
• B. secondary prevention
• C. tertiary prevention
• D. health promotion

Correct answer: A

Rationale: The nurse has applied primary prevention in this situation. Primary prevention involves efforts to prevent the occurrence of domestic violence before it starts, even if the client does not admit to the abuse. Secondary prevention focuses on early detection and intervention to reduce the harm caused by violence that is already occurring. Tertiary prevention involves actions taken to rehabilitate and support individuals who have experienced domestic violence. Health promotion encompasses a broader approach aimed at improving overall health and well-being, which may include education on domestic violence prevention but is not specific to this scenario.

4. A public health nurse is working with a community to improve vaccination rates. Which intervention is most likely to be effective?

• A. Setting up vaccination clinics in accessible locations
• B. Distributing flyers with information about vaccines
• C. Offering incentives for getting vaccinated
• D. Partnering with local businesses to promote vaccination

Correct answer: A

Rationale: Setting up vaccination clinics in accessible locations is the most effective intervention to improve vaccination rates. This intervention ensures easy access to vaccination services for community members, removing barriers such as transportation or time constraints. Distributing flyers (Choice B) may increase awareness but may not directly address access issues. Offering incentives (Choice C) might temporarily boost vaccination rates but may not lead to sustained behavior change. Partnering with local businesses (Choice D) could be beneficial for promotion but may not directly impact vaccination accessibility.

5. A community health nurse is planning a program to reduce the incidence of heart disease in the community. Which intervention should the nurse prioritize?

• A. Distributing educational materials on heart-healthy diets
• B. Organizing free cholesterol screenings
• C. Holding workshops on stress management
• D. Partnering with local gyms to offer fitness classes

Correct answer: B

Rationale: The correct answer is B: Organizing free cholesterol screenings. This intervention is crucial because it helps identify individuals at risk for heart disease by assessing their cholesterol levels. High cholesterol is a significant risk factor for heart disease, and identifying it early can lead to timely interventions and medical care. Choices A, C, and D, while beneficial for overall health, may not directly address the specific risk factor of high cholesterol associated with heart disease. Distributing educational materials on heart-healthy diets (A) could be helpful in preventing heart disease, but identifying individuals already at risk is a more urgent need. Holding workshops on stress management (C) and partnering with local gyms for fitness classes (D) are important for overall health promotion but may not target the specific risk factor of high cholesterol as directly as organizing cholesterol screenings.

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