Nursing Elites

1. A community health nurse is addressing the issue of domestic violence in the community. Which intervention should be prioritized?

• A. Providing education on the signs of domestic violence
• B. Setting up a support group for survivors
• C. Partnering with local law enforcement to increase patrols
• D. Creating a confidential hotline for reporting abuse

Correct answer: D

Rationale: Creating a confidential hotline for reporting abuse is the most critical intervention when addressing domestic violence. A hotline offers a safe and confidential way for individuals experiencing abuse to report incidents, seek help, and access support services. This intervention prioritizes immediate safety and support for victims. Providing education on the signs of domestic violence (Choice A) is important for prevention but may not address the urgent needs of individuals currently experiencing abuse. Setting up a support group for survivors (Choice B) is valuable for emotional support but may not reach those who are not yet identified as survivors. Partnering with local law enforcement to increase patrols (Choice C) focuses more on the law enforcement response rather than providing a direct avenue for victims to seek help and support.

2. A 6-year-old child is alert but quiet when brought to the emergency center with periorbital ecchymosis and ecchymosis behind the ears. The nurse suspects potential child abuse and continues to assess the child for additional manifestations of a basilar skull fracture. What assessment finding would be consistent with the basilar skull fracture?

• A. Blurred vision.
• B. Shoulder pain.
• C. Abdominal pain.
• D. Rhinorrhea or otorrhea with halo sign.

Correct answer: D

Rationale: The correct answer is D: Rhinorrhea or otorrhea with halo sign. Raccoon eyes (periorbital ecchymosis) and Battle's sign (ecchymosis behind the ear) are signs of a basilar skull fracture, indicating the need to assess for possible meningeal tears that manifest as a halo sign with cerebrospinal fluid (CSF) leakage from the ears or nose. Choices A, B, and C are incorrect because blurred vision, shoulder pain, and abdominal pain are not typically associated with a basilar skull fracture.

3. A client with a history of heart failure is admitted with severe dyspnea. Which laboratory result requires immediate intervention?

• A. Blood glucose of 150 mg/dL.
• B. Serum potassium of 3.5 mEq/L.
• C. Serum creatinine of 1.0 mg/dL.
• D. Blood urea nitrogen (BUN) of 20 mg/dL.

Correct answer: C

Rationale: The correct answer is C. A serum creatinine level of 1.0 mg/dL is within the normal range. However, in a client with heart failure and severe dyspnea, fluid retention is a significant concern. An elevated serum creatinine level may indicate impaired kidney function, which can worsen fluid overload. Therefore, immediate intervention is required to prevent further complications. Choices A, B, and D are within normal ranges and not indicative of immediate intervention in this scenario.

4. The nurse is assisting with the triage of clients at a large community disaster and finds a man lying on the ground, who states that the blast threw him out of a second-story window. Which action should the nurse implement first?

• A. Logroll the client to his side and assess for back injuries
• B. Perform a complete neurological assessment
• C. Open the client's airway immediately
• D. Place the nurse's hands around the client's neck to stabilize

Correct answer: C

Rationale: Opening the client's airway immediately is the priority in this scenario. Ensuring the airway is clear takes precedence over other actions as it is crucial for the client's breathing and oxygenation. Logrolling the client to assess for back injuries may worsen the condition if there are spinal injuries, so this should not be done as the first step. Performing a complete neurological assessment is important but not the immediate priority over ensuring the airway is clear. Placing the nurse's hands around the client's neck to stabilize is incorrect and could potentially harm the client, as neck stabilization should only be done if there is a suspected neck injury, which is not indicated in this case.

5. A community health nurse is evaluating the effectiveness of a diabetes management program. Which outcome indicates that the program is successful?

• A. increased attendance at diabetes education sessions
• B. reduced incidence of diabetes-related hospitalizations
• C. higher rates of blood glucose monitoring among participants
• D. greater knowledge of diabetes management techniques

Correct answer: B

Rationale: The correct answer is B: reduced incidence of diabetes-related hospitalizations. This outcome is a strong indicator of successful diabetes management, as it suggests that participants are effectively controlling their condition and experiencing fewer severe complications that require hospitalization. Increased attendance at education sessions (choice A) may not directly correlate with improved health outcomes. While higher rates of blood glucose monitoring (choice C) are important, they alone may not reflect overall program success. Greater knowledge of diabetes management techniques (choice D) is valuable but does not directly measure the impact of the program on health outcomes like reduced hospitalizations.

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