Nursing Elites

1. A community health RN believes that immunization rates in a lower socioeconomic section of the city are probably below the target set by the state health department. What action should the RN take FIRST to intervene with this health problem?

• A. Take a health history of the members of the community
• B. Initiate an immunization program for the community
• C. Review current epidemiological population data that might document a low immunization rate
• D. Refer all clients to the local health department

Correct answer: C

Rationale: The correct first action for the community health RN to take in this situation is to review current epidemiological population data that might document a low immunization rate. By doing so, the RN can gather evidence to support further intervention strategies. Option A is incorrect because taking a health history would not provide immediate data on immunization rates in the community. Option B is incorrect as initiating an immunization program without confirming the actual immunization rates may not address the specific needs of the community. Option D is incorrect as a blanket referral without assessing the situation may not be the most effective first step.

2. The nurse is planning a nutrition class for a group of high school students emphasizing the goals for nutrition from Healthy People 2020. Which meal selection provides the best choices in meeting these goals?

• A. pasta with cheese sauce, garlic butter bread, and vegetable juice drink
• B. a 6-oz pork chop, creamed peas, cheese sauce on potatoes, coffee
• C. vegetable lasagna, lettuce salad, a whole wheat roll, 8 oz of 2% milk
• D. bacon, lettuce, tomato sandwich, whole grain chips, 8 oz. of whole milk

Correct answer: C

Rationale: The correct answer is C because vegetable lasagna, lettuce salad, and a whole wheat roll with 2% milk align with the nutrition goals of Healthy People 2020. These choices provide a balanced meal with vegetables, whole grains, and dairy, promoting a healthier dietary pattern. Choices A, B, and D do not offer as comprehensive a selection of food groups or as healthy options as choice C, making them less aligned with the nutrition goals of Healthy People 2020.

3. An example of secondary prevention strategy would be:

• A. Screening for breast cancer in women who have no symptoms
• B. Using pain control medications for terminal cancer patients
• C. Educating teenagers about using condoms to prevent STDs
• D. None of the above

Correct answer: A

Rationale: The correct answer is A. Screening for breast cancer is a secondary prevention strategy aimed at early detection, which falls under secondary prevention as it focuses on early identification and intervention before the disease progresses. Choice B is incorrect as it refers to palliative care for symptom management in terminal cancer patients, which is not a secondary prevention strategy. Choice C is incorrect as educating teenagers about condom use is a primary prevention strategy to prevent the initial occurrence of STDs rather than intervening after exposure, making it a primary, not a secondary prevention strategy. Choice D is incorrect as there is a valid example of a secondary prevention strategy provided in choice A.

4. Which of the following is an example of a positive outcome for one of the Leading Health Indicators of Healthy People 2020?

• A. A community has adopted a no smoking policy.
• B. A rural community has a public transportation system.
• C. The high school dropout rate has decreased by 15%.
• D. A county has decreased its divorce rate by 10%.

Correct answer: A

Rationale: The correct answer is A. A community adopting a no smoking policy is a positive outcome for the Leading Health Indicators of Healthy People 2020 as it promotes a healthier environment by reducing exposure to secondhand smoke and decreasing smoking-related illnesses. Choices B, C, and D do not directly align with the goals of the Leading Health Indicators. While public transportation and reduced dropout rates are beneficial for community well-being, they are not specific examples of Leading Health Indicators. Decreasing divorce rates, while potentially beneficial for family stability, is not a focus area of the Leading Health Indicators.

5. The nurse is teaching a group of adults about modifiable cardiac risk factors. Which of the following should the nurse focus on first?

• A. Weight reduction
• B. Stress management
• C. Physical exercise
• D. Smoking cessation

Correct answer: D

Rationale: The correct answer is D, smoking cessation. Smoking is a major and modifiable risk factor for cardiovascular disease. It is often the highest priority in cardiac risk reduction because stopping smoking has immediate and long-term benefits for heart health. Choices A, B, and C are also important in reducing cardiac risk factors, but smoking cessation takes precedence due to its significant impact on cardiovascular health.

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