Nursing Elites

1. A community health nurse is conducting a needs assessment in a rural area. Which data source is most likely to provide comprehensive information about the community's health status?

• A. Focus groups with community members
• B. Local hospital admission records
• C. State health department reports
• D. Surveys conducted by healthcare providers

Correct answer: C

Rationale: State health department reports are the most likely data source to provide comprehensive information about the community's health status. These reports offer a broad overview of health statistics and trends that can guide community health interventions. Focus groups with community members, although valuable for gathering qualitative insights, may not provide comprehensive health status data. Local hospital admission records are limited to specific healthcare utilization data and do not capture the overall health status of the entire community. Surveys conducted by healthcare providers may offer some insights but may not provide the breadth and depth of information available in state health department reports.

2. When assessing the health of a community, what is the most important information for the nurse to obtain?

• A. life expectancy of community members
• B. mortality rates in the community
• C. description of health problems by community leaders
• D. expressed needs of community members

Correct answer: D

Rationale: The most important information for a nurse to obtain when assessing the health of a community is the expressed needs of community members. This information helps in tailoring health interventions to address specific concerns directly expressed by the community. Options A and B focus on statistical data rather than individual needs. Option C, while valuable, may not always capture the full spectrum of health issues faced by the community as perceived by the residents themselves.

3. A client with a history of epilepsy is admitted with status epilepticus. Which medication should the nurse prepare to administer?

• A. Acetaminophen (Tylenol)
• B. Lorazepam (Ativan)
• C. Phenytoin (Dilantin)
• D. Carbamazepine (Tegretol)

Correct answer: B

Rationale: In the management of status epilepticus, the initial medication of choice is a benzodiazepine such as lorazepam (Ativan) to rapidly terminate the seizure activity. Lorazepam acts quickly and effectively in stopping seizures. Phenytoin (Dilantin) is often used as a second-line agent for status epilepticus, and carbamazepine (Tegretol) is not typically indicated for the acute treatment of status epilepticus. Acetaminophen (Tylenol) is a pain reliever and antipyretic but is not used in the treatment of status epilepticus.

4. The healthcare provider is assessing a client who is receiving total parenteral nutrition (TPN). Which finding requires immediate intervention?

• A. Blood glucose level of 150 mg/dL.
• B. Weight gain of 2 pounds in 24 hours.
• C. Decreased urine output.
• D. Temperature of 100.3°F (37.9°C).

Correct answer: C

Rationale: Decreased urine output in a client receiving total parenteral nutrition (TPN) requires immediate intervention because it can indicate potential complications such as fluid overload or kidney dysfunction. Monitoring urine output is crucial in assessing renal function and fluid balance in patients on TPN. A blood glucose level of 150 mg/dL is within a normal range and may not require immediate intervention. Weight gain of 2 pounds in 24 hours could be a concern but may not be as urgent as addressing decreased urine output. A temperature of 100.3°F (37.9°C) is slightly elevated but may not be directly related to TPN administration unless there are other symptoms of infection present.

5. The healthcare provider is assessing a client with a suspected myocardial infarction. Which finding requires immediate intervention?

• A. Chest pain radiating to the left arm.
• B. Shortness of breath.
• C. Nausea and vomiting.
• D. Diaphoresis.

Correct answer: B

Rationale: Shortness of breath is a critical sign that can indicate heart failure or pulmonary edema, conditions that require immediate intervention in a client with a suspected myocardial infarction. Chest pain radiating to the left arm is a classic symptom of a myocardial infarction but may not necessitate immediate intervention compared to severe shortness of breath. Nausea and vomiting can be present in myocardial infarction but are not as urgent as shortness of breath. Diaphoresis, or sweating, is a common symptom of a myocardial infarction but may not be as immediately concerning as significant shortness of breath.

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