Nursing Elites

1. A female adult walks into a local community health clinic and tells the nurse that she is homeless and cannot seem to find help. Which statement indicates to the nurse that a client is feeling separated from society and helpless?

• A. "I'm feeling really isolated from everyone and scared."
• B. "I feel like I cannot get enough food to live any longer."
• C. "I know that I will always be poor so what's the use of trying?"
• D. "People like me are never respected, no matter how well we do."

Correct answer: A

Rationale: Choice A is the correct answer because the statement reflects a sense of isolation and helplessness, indicating a profound emotional and social disconnect. The client expresses feeling separated from others and scared, highlighting a deep emotional distress. Choices B, C, and D touch on different issues such as food insecurity, hopelessness about poverty, and lack of respect, but they do not specifically address the feelings of isolation and helplessness mentioned in the client's statement.

2. A client with type 2 diabetes mellitus is admitted with hyperosmolar hyperglycemic state (HHS). Which laboratory result requires immediate intervention?

• A. Serum osmolality of 320 mOsm/kg.
• B. Serum glucose of 600 mg/dL.
• C. Serum potassium of 4.5 mEq/L.
• D. Serum sodium of 140 mEq/L.

Correct answer: B

Rationale: A serum glucose level of 600 mg/dL is extremely high in a client with hyperosmolar hyperglycemic state (HHS) and poses a significant risk of serious complications such as dehydration, coma, and electrolyte imbalances. Rapid intervention is crucial to normalize the glucose level and prevent further deterioration. Serum osmolality of 320 mOsm/kg, serum potassium of 4.5 mEq/L, and serum sodium of 140 mEq/L, while important to monitor in HHS, do not represent an immediate life-threatening condition that requires urgent intervention compared to the critically high glucose level.

3. The school nurse is preparing a presentation on the importance of physical activity for elementary school students. Which benefit should the nurse emphasize?

• A. Improved academic performance
• B. Increased social interactions
• C. Enhanced physical strength
• D. Better sleep patterns

Correct answer: A

Rationale: The correct answer is A: Improved academic performance. Physical activity has been shown to improve academic performance by enhancing concentration and cognitive function. This benefit is particularly important for elementary school students who are developing foundational skills. Choice B, increased social interactions, while important for overall development, may not directly relate to the academic aspect that the nurse is focusing on. Choice C, enhanced physical strength, is a valid benefit of physical activity but may not be as relevant to academic performance as the ability to concentrate and learn. Choice D, better sleep patterns, is also a valuable outcome of physical activity but is not as directly linked to academic performance as improved cognitive function.

4. The nurse is assessing a client with pneumonia who is receiving oxygen therapy. Which finding indicates that the therapy is effective?

• A. The client's respiratory rate is 20 breaths per minute.
• B. The client's arterial blood gases show a pH of 7.35.
• C. The client's oxygen saturation is 92%.
• D. The client's breath sounds are clear.

Correct answer: A

Rationale: A respiratory rate of 20 breaths per minute indicates effective oxygen therapy. In pneumonia, the respiratory rate typically increases due to the body's effort to improve oxygenation. Option B (pH of 7.35) is related to acid-base balance, not specifically indicating oxygen therapy effectiveness. Option C (oxygen saturation of 92%) is below the normal range (95-100%), suggesting the need for oxygen therapy. Option D (clear breath sounds) is a positive finding but not a direct indicator of oxygen therapy effectiveness.

5. A public health nurse is addressing the issue of childhood lead poisoning in a low-income community. Which intervention should be prioritized?

• A. Providing free blood lead level testing for children
• B. Distributing pamphlets on the dangers of lead exposure
• C. Conducting home inspections for lead-based paint
• D. Educating parents about lead poisoning prevention

Correct answer: A

Rationale: Providing free blood lead level testing for children should be prioritized as it directly identifies children who are at risk and in need of intervention. This intervention allows for early detection and timely implementation of necessary measures to prevent further lead exposure or address existing poisoning. Distributing pamphlets (choice B) may raise awareness but does not directly identify at-risk children. Conducting home inspections (choice C) is important but may not be as immediate and targeted as blood lead level testing. Educating parents (choice D) is essential but may not directly identify and address individual cases of lead poisoning as testing does.

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