Nursing Elites

1. A client presents at a community-based clinic with complaints of shortness of breath, headache, often uses a gasoline-powered pressure washer to clean equipment and farm buildings. Which type of poisoning is the most likely etiology of this client's symptoms?

• A. asbestos
• B. silica dust
• C. histoplasmosis
• D. carbon monoxide

Correct answer: D

Rationale: The correct answer is D, carbon monoxide poisoning. This client's symptoms of shortness of breath and headache are consistent with carbon monoxide exposure, which can result from using gasoline-powered equipment in poorly ventilated areas. Asbestos (choice A) is linked to respiratory issues but does not typically present with these acute symptoms. Silica dust (choice B) exposure is associated with lung damage, not the symptoms described. Histoplasmosis (choice C) is a fungal infection and would not typically manifest with the symptoms presented by the client.

2. The nurse is developing a series of childbirth preparation classes for primigravida women and their significant others. What is the priority expected outcome for these classes?

• A. Participants can identify at least three coping strategies to use during labor.
• B. Participants can list signs of labor and when to come to the hospital.
• C. Participants can describe three pain relief measures to use during labor.
• D. Participants can perform three relaxation techniques to use during labor.

Correct answer: A

Rationale: The priority expected outcome for childbirth preparation classes is for participants to be able to identify coping strategies to use during labor. This is crucial as coping strategies can help women manage pain, stress, and anxiety during childbirth. Choice B is important but does not focus on coping strategies needed during labor. Choice C is relevant but focuses solely on pain relief measures which are a part of coping strategies. Choice D is also relevant but does not encompass all aspects of coping with labor effectively.

3. The school nurse is developing an individualized healthcare plan for a student with type 1 diabetes. Which component is most important to include in the plan?

• A. a schedule for blood glucose monitoring
• B. a list of low-carbohydrate snacks
• C. a contact list of healthcare providers
• D. a log for recording insulin administration

Correct answer: A

Rationale: The correct answer is A: a schedule for blood glucose monitoring. Regular blood glucose monitoring is essential in managing type 1 diabetes as it helps in monitoring blood sugar levels, adjusting treatment plans, and preventing complications such as hypoglycemia or hyperglycemia. Choice B, a list of low-carbohydrate snacks, while important for managing blood sugar levels, is not as critical as consistent blood glucose monitoring. Choice C, a contact list of healthcare providers, though important for emergency situations, is not the most crucial component in managing daily care. Choice D, a log for recording insulin administration, is valuable for tracking insulin doses but does not directly address the immediate need for monitoring blood glucose levels.

4. An elderly client with a history of falls is being discharged from the hospital. Which intervention should the home health nurse implement to reduce the client's risk of falling at home?

• A. Install grab bars in the bathroom
• B. Provide a walker for ambulation
• C. Educate the client on fall prevention strategies
• D. Refer the client to a physical therapist

Correct answer: A

Rationale: Installing grab bars in the bathroom is crucial to reducing the elderly client's risk of falling at home. Grab bars provide physical support and stability, especially in areas like the bathroom where slips and falls are common among older adults. While providing a walker for ambulation (Choice B) can assist with mobility, it may not directly address the environmental hazards at home. Educating the client on fall prevention strategies (Choice C) is important but may not be sufficient if the physical environment is not modified to reduce fall risks. Referring the client to a physical therapist (Choice D) may help improve strength and balance but does not directly address the immediate environmental risk of falling at home.

5. After assessing the health care needs of an elementary school, the nurse determines that an increased prevalence of pediculosis capitis is a priority problem. The nurse develops a 2-month program with the goal to eradicate the condition in the school. The program includes educational pamphlets sent home to parents and regular assessment of children by the school nurse. What action should the nurse implement to evaluate the effectiveness of the program?

• A. evaluate the teachers' ability to identify pediculosis capitis 2 months after initiation of the program
• B. conduct an initial examination of each child in the school to obtain baseline data
• C. survey parents 3 weeks after pamphlets are sent home to assess their understanding of the condition
• D. measure the prevalence of pediculosis capitis among the children after four months

Correct answer: D

Rationale: Measuring the prevalence of pediculosis capitis among the children after four months is the most appropriate action to evaluate the program's effectiveness. This approach provides data on the program's long-term impact and effectiveness in eradicating the condition. Option A focuses on the teachers' ability, which is not directly related to the program's effectiveness in eradicating the condition. Option B suggests conducting an initial examination, which does not provide information on the program's impact. Option C involves assessing parents' understanding, which is important but does not directly evaluate the program's effectiveness in eradicating pediculosis capitis.

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