Nursing Elites

1. A community health action that focuses on reducing the frequency and severity of asthma in inner-city children by requiring a local incinerator to install particulate filters is an example of:

• A. downstream intervention
• B. risk management
• C. primary prevention
• D. upstream intervention

Correct answer: D

Rationale: The correct answer is D: upstream intervention. Upstream thinking addresses the root causes of health problems to create long-term solutions. In this scenario, requiring the incinerator to install particulate filters tackles the root cause of asthma triggers, which is pollution, rather than just managing the symptoms or risks associated with asthma. Choice A, downstream intervention, would focus more on treating asthma symptoms after they have already occurred rather than preventing them. Choice B, risk management, typically involves strategies to assess, control, or mitigate risks, which may not directly address the root cause. Choice C, primary prevention, usually refers to actions taken to prevent a disease or condition before it occurs, but in this case, the action is targeting the underlying cause rather than preventing asthma itself.

2. Which of the following strategies is most effective in promoting breastfeeding in a community?

• A. Providing formula samples
• B. Offering breastfeeding education and support
• C. Encouraging early weaning
• D. Promoting bottle feeding

Correct answer: B

Rationale: The most effective strategy in promoting breastfeeding in a community is offering breastfeeding education and support. This helps mothers learn about the benefits of breastfeeding, gain confidence in their ability to breastfeed, and receive necessary support to overcome challenges. Providing formula samples (Choice A) can undermine breastfeeding efforts by promoting formula feeding over breastfeeding. Encouraging early weaning (Choice C) goes against the recommendation of exclusive breastfeeding for the first six months of life. Promoting bottle feeding (Choice D) can deter mothers from initiating or continuing breastfeeding, leading to decreased breastfeeding rates.

3. The nurse is assessing a client with portal hypertension. Which of the following findings would the nurse expect?

• A. Expiratory wheezes
• B. Blurred vision
• C. Ascites
• D. Dilated pupils

Correct answer: C

Rationale: Ascites is a common finding in clients with portal hypertension. Portal hypertension results in increased pressure in the portal vein, leading to the development of ascites, which is the accumulation of fluid in the abdominal cavity. Expiratory wheezes (Choice A) are associated with respiratory conditions. Blurred vision (Choice B) is more commonly linked to eye disorders or neurological issues. Dilated pupils (Choice D) can be related to neurological conditions or drug effects, but not specifically to portal hypertension.

4. The Healthy People initiative is a national agenda that aims to:

• A. Provide healthcare to all citizens
• B. Reduce health disparities and improve the health of all Americans
• C. Promote medical research
• D. Develop new healthcare technologies

Correct answer: B

Rationale: The Healthy People initiative is a national agenda that focuses on reducing health disparities and improving the health of all Americans. Choice A is incorrect because the initiative is more about improving health outcomes and access rather than providing healthcare to all citizens. Choice C is not the main goal of the initiative, which is more about public health goals than medical research. Choice D is also not the primary aim of the Healthy People initiative, as it is more focused on setting objectives to improve public health.

5. Community organizing is an important part of the community nursing function. Given the following elements: choosing an organizational structure, identifying and recruiting members, defining mission, vision, and goals, clarifying roles and responsibilities; at which stage do these elements belong?

• A. Program maintenance-consolidation
• B. Dissemination-Reassessment
• C. Community Analysis/diagnosis
• D. Design and initiation

Correct answer: D

Rationale: The correct answer is D: Design and initiation. These elements such as choosing an organizational structure, identifying and recruiting members, defining mission, vision, and goals, and clarifying roles and responsibilities belong to the design and initiation stage of community organizing. This stage focuses on setting up the foundation and structure of the community organization. The other choices are incorrect because: A) Program maintenance-consolidation refers to maintaining and strengthening existing programs, not establishing new ones; B) Dissemination-Reassessment involves spreading information and evaluating programs already in place; C) Community Analysis/diagnosis is about assessing community needs and identifying issues, not about setting up the initial structure.

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