Nursing Elites

1. A client is suspected of being poisoned and presents with symmetric, descending flaccid paralysis, blurred vision, double vision, and dry mouth. The nurse should consider these findings consistent with which potential bioterrorism agent?

• A. ricin
• B. botulism toxin
• C. sulfur mustard
• D. yersinia pestis

Correct answer: B

Rationale: The correct answer is B: botulism toxin. Botulism toxin is associated with symmetric, descending flaccid paralysis, blurred vision, double vision, and dry mouth, which are consistent with the client's presentation. Ricin (Choice A) typically presents with gastrointestinal symptoms. Sulfur mustard (Choice C) is a blistering agent causing skin, eye, and respiratory issues. Yersinia pestis (Choice D) is associated with the bubonic plague, presenting with fever, malaise, and buboes.

2. What is the term for a learning process whereby knowledge, attitudes, and practice of people are changed to improve the health status of individuals, families, or communities?

• A. Motivating
• B. Counseling
• C. Disease prevention
• D. Health education

Correct answer: D

Rationale: Health education is the correct term for the learning process that involves changing knowledge, attitudes, and practices to enhance health status. Choice A, 'Motivating,' is incorrect as it refers to inspiring action rather than the educational aspect. Choice B, 'Counseling,' focuses on providing guidance and support rather than specifically targeting knowledge and practice changes. Choice C, 'Disease prevention,' is related to strategies aimed at avoiding the occurrence of illnesses rather than the broader concept of educating for overall health improvement.

3. In the preparation of your health education plan, what is the first thing to do?

• A. Assess community needs for health education
• B. Identify the subjects for health teaching
• C. Specify your goals and objectives
• D. Identify who will provide support and the type of support to be provided

Correct answer: A

Rationale: The correct answer is A: Assess community needs for health education. This is the initial step in developing a health education plan as it helps in understanding the specific requirements of the community. Identifying subjects for teaching (choice B) comes after assessing needs. Specifying goals and objectives (choice C) is crucial but typically follows the assessment of community needs. Identifying support providers and types (choice D) is important but is not the first step in preparing a health education plan.

4. The community health nurse has been following the care for an adolescent with a history of morbid obesity, asthma, hypertension, and is 22 weeks into a pregnancy. Which of these lab reports sent to the clinic needs to be called to the teen's healthcare provider within the next hour?

• A. Hemoglobin 11 g/dL and calcium 6 mg/dL
• B. Magnesium 0.8 mEq/L and creatinine 3 mg/dL
• C. Blood urea nitrogen 28 mg/dL and glucose 225 mg/dL
• D. Hematocrit 33% and platelets 200,000

Correct answer: B

Rationale: The correct answer is B. The low magnesium level and elevated creatinine suggest possible renal dysfunction, which is concerning, especially in a pregnant client with multiple risk factors such as morbid obesity, asthma, and hypertension. Immediate attention is needed to address the potential renal issues. The other choices do not indicate such urgent conditions. Hemoglobin and calcium levels in choice A are within acceptable ranges. Choice C shows elevated blood urea nitrogen and glucose levels, which may need monitoring but not immediate attention. Choice D's hematocrit and platelet levels are also within normal ranges and do not indicate an urgent issue.

5. A female adult walks into a local community health clinic and tells the nurse that she is homeless and cannot seem to find help. Which statement indicates to the nurse that a client is feeling separated from society and helpless?

• A. "I'm feeling really isolated from everyone and scared."
• B. "I feel like I cannot get enough food to live any longer."
• C. "I know that I will always be poor so what's the use of trying?"
• D. "People like me are never respected, no matter how well we do."

Correct answer: A

Rationale: The correct answer is A. The statement "I'm feeling really isolated from everyone and scared" indicates a sense of separation from society and helplessness. This choice reflects feelings of loneliness and fear, which are common among individuals who feel disconnected and helpless. Choices B, C, and D do not directly convey a sense of isolation and helplessness. Choice B focuses on food insecurity, choice C on a resigned attitude towards poverty, and choice D on lack of respect, none of which directly address the feelings of being separated from society and helpless as indicated in the scenario.

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