Nursing Elites

1. To be an effective educator, you should:

• A. listen to people's problems and decide on the approach to meet their needs
• B. select the best strategy for health action for people to implement
• C. direct people's efforts to implement community-based projects
• D. simply tell your clients what to do for their problems/needs

Correct answer: B

Rationale: The correct answer is to select the best strategy for health action for people to implement because it empowers the community to take ownership of their health. Listening to people's problems (Choice A) is important, but the effectiveness lies in empowering them to implement solutions. Directing people's efforts (Choice C) can be directive and may not foster community ownership. Just telling clients what to do (Choice D) does not promote active participation and empowerment.

2. The community health nurse is planning a series of educational courses about the healthcare system and meeting healthcare needs for the community center. Which adjunct issue should the nurse address for a group of older adults?

• A. Peer concerns.
• B. Adult daycare.
• C. Retirement issues.
• D. Vocational concerns.

Correct answer: B

Rationale: When planning educational courses for older adults, addressing adult daycare is crucial as it is a relevant issue that can impact their daily lives and access to healthcare services. Peer concerns may not be directly related to healthcare needs, retirement issues are important but not as immediate in terms of healthcare access, and vocational concerns are more pertinent to working-age individuals.

3. The RN is making a home visit to a female client with end-stage heart disease. She has a living will and states she will never go back to the hospital. During the visit, the RN notes that the client is pale and SOB while speaking. The RN discovers 3+ edema in both ankles and bilateral pulmonary crackles. Which intervention should the RN implement first?

• A. Order a chest X-ray
• B. Obtain a peripheral O2 saturation reading
• C. Obtain an order for complete blood count
• D. Tell the patient to stay in bed

Correct answer: B

Rationale: Obtaining a peripheral O2 saturation reading is the priority intervention in this scenario. It helps assess the client's oxygenation status quickly, which is crucial in a client with signs of respiratory distress, such as shortness of breath and bilateral pulmonary crackles. Ordering a chest X-ray (Choice A) may be necessary later but does not address the immediate need for oxygen assessment. Obtaining an order for a complete blood count (Choice C) is not the priority in this situation as it does not directly address the client's respiratory distress. Instructing the patient to stay in bed (Choice D) does not address the underlying issue of potential hypoxia and respiratory compromise.

4. Building a healthy community is based on the following basic principles except:

• A. concreteness and reasoning to understand and solve problems
• B. human beings do not function independently but as a group
• C. the target of change is not individual or family but community
• D. environmental factors are more basic than institutional factors

Correct answer: D

Rationale: Building a healthy community is indeed based on principles like concreteness, group dynamics, and focusing on community-level change. However, stating that environmental factors are more basic than institutional factors is incorrect. Both environmental and institutional factors play crucial roles in community health. Environmental factors like access to healthcare, clean water, and safe housing are vital, while institutional factors such as healthcare systems, education, and governance also significantly impact community health. Therefore, the correct answer is D, as environmental factors are not more basic than institutional factors.

5. Which client has the highest risk for 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 C because homeless individuals who are alcoholics and smoke have a higher risk of developing community-acquired pneumonia due to factors like poor living conditions, compromised immune systems, and increased exposure to infections. Choice A is less likely as the teacher's profession, while involving contact with children, may not pose as high a risk as the factors in choice C. Choice B may have respiratory issues but does not have the same risk factors as choice C. Choice D, the aerobics instructor, may have a healthy lifestyle but skipping meals and a restrictive diet do not directly correlate with a higher risk of pneumonia compared to the risk factors in choice C.

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