Nursing Elites

1. A client with a history of atrial fibrillation is receiving warfarin (Coumadin) therapy. Which laboratory result indicates that the therapy is effective?

• A. International normalized ratio (INR) of 1.0.
• B. Prothrombin time (PT) of 12 seconds.
• C. Partial thromboplastin time (PTT) of 60 seconds.
• D. International normalized ratio (INR) of 2.5.

Correct answer: D

Rationale: An International Normalized Ratio (INR) of 2.5 indicates that warfarin therapy is within the therapeutic range for a client with atrial fibrillation. A lower INR (such as 1.0) would suggest subtherapeutic levels, risking blood clots. Prothrombin time (PT) and partial thromboplastin time (PTT) are not specific to monitoring warfarin therapy.

2. The nurse must delegate some aspects of a homebound client's care to a home health aide. Which intervention should the nurse delegate to the home health aide?

• A. evaluating a pressure sore
• B. applying a prosthetic device
• C. performing a sterile dressing change
• D. assessing the client's need for an elevated toilet seat

Correct answer: B

Rationale: The correct answer is B: applying a prosthetic device. Home health aides are trained and authorized to assist with the application and management of prosthetic devices for clients. Evaluating a pressure sore (choice A) requires clinical assessment and judgment typically performed by a licensed healthcare provider such as a nurse. Performing a sterile dressing change (choice C) involves aseptic technique and wound care skills that are usually performed by licensed healthcare professionals. Assessing the client's need for an elevated toilet seat (choice D) involves a level of assessment and decision-making that is beyond the scope of practice for a home health aide.

3. When planning a scoliosis screening clinic, which age group should be included?

• A. early adolescent girls
• B. late adolescent boys
• C. 7-10 year old boys
• D. preschoolers of both genders

Correct answer: A

Rationale: The correct answer is early adolescent girls. Scoliosis is most commonly diagnosed during early adolescence, with girls being more affected than boys. Including early adolescent girls in the screening clinic aligns with the age group that is at higher risk for scoliosis. Late adolescent boys (choice B) are less likely to develop scoliosis compared to early adolescent girls. 7-10 year old boys (choice C) are typically younger than the age group where scoliosis is commonly diagnosed. Preschoolers of both genders (choice D) are too young for scoliosis screening as the condition usually manifests during adolescence.

4. The healthcare professional is developing a health education program for adolescents on the dangers of smoking. Which strategy is most likely to be effective?

• A. showing graphic images of the effects of smoking
• B. inviting former smokers to share their experiences
• C. providing statistical data on smoking-related illnesses
• D. distributing pamphlets on smoking cessation resources

Correct answer: B

Rationale: Inviting former smokers to share their experiences is the most effective strategy because personal stories can have a powerful impact on adolescents and motivate them to avoid smoking. This approach makes the consequences of smoking more relatable and real, potentially influencing behavior change. Showing graphic images may be too harsh and could lead to desensitization or avoidance of the issue. Providing statistical data may not resonate as strongly with adolescents as personal stories. Distributing pamphlets, while informative, may not have the same emotional impact as hearing real-life experiences.

5. The public health nurse is evaluating resources in a rural community. Which healthcare resource is most important for the community?

• A. family planning center
• B. accessibility to trauma care
• C. annual health fair
• D. weather-related disaster plan

Correct answer: B

Rationale: In rural areas, accessibility to trauma care is the most critical healthcare resource due to the longer emergency response times. Trauma care can be life-saving in situations where immediate medical attention is required for severe injuries. The other options, such as a family planning center, annual health fair, and weather-related disaster plan, are important but not as crucial as trauma care in addressing urgent health needs in a rural community.

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