Nursing Elites

1. A client with asthma receives a prescription for high blood pressure during a clinic visit. Which prescription should the nurse anticipate the client to receive that is least likely to exacerbate asthma?

• A. Pindolol (Visken)
• B. Carteolol (Ocupress)
• C. Metoprolol tartrate (Lopressor)
• D. Propranolol hydrochloride (Inderal)

Correct answer: C

Rationale: The correct answer is C, Metoprolol tartrate (Lopressor). Metoprolol is a beta2 blocking agent that is cardioselective and less likely to cause bronchoconstriction, making it a suitable antihypertensive option for clients with asthma. Choices A, B, and D are non-selective beta-blockers which can potentially exacerbate asthma symptoms by causing bronchoconstriction.

2. A client who is receiving intravenous heparin therapy has an activated partial thromboplastin time (aPTT) of 90 seconds. Which action should the nurse take?

• A. Continue the heparin infusion as prescribed.
• B. Decrease the heparin infusion rate.
• C. Increase the heparin infusion rate.
• D. Stop the heparin infusion and notify the healthcare provider.

Correct answer: D

Rationale: An aPTT of 90 seconds is significantly elevated, indicating a high risk of bleeding due to excessive anticoagulation. In this case, the heparin infusion should be stopped immediately to prevent further anticoagulation and an increased bleeding risk. Notifying the healthcare provider is essential to discuss alternative anticoagulation strategies or interventions. Continuing heparin therapy without action could lead to severe bleeding complications. Decreasing or increasing the heparin infusion rate would exacerbate the risk of bleeding, making options A, B, and C incorrect.

3. 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.

4. The public health nurse is preparing to administer flu vaccines at a community center. Which group should the nurse prioritize for vaccination?

• A. children under 5 years old
• B. adults aged 50-65
• C. pregnant women
• D. healthcare workers

Correct answer: C

Rationale: Pregnant women should be prioritized for flu vaccination as they are at higher risk for complications from the flu. During pregnancy, changes in the immune, heart, and lung functions make pregnant women more susceptible to severe illness from the flu. Vaccinating pregnant women not only protects them but also provides passive immunity to their newborns. Children under 5, adults aged 50-65, and healthcare workers are important groups for vaccination but do not have the same level of increased risk for flu complications as pregnant women.

5. 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.

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