Nursing Elites

1. A female client makes routine visits to a neighborhood community health center. The nurse notes that this client often presents with facial bruising, particularly around the eyes. The nurse discusses prevention of domestic violence with the client even though the client does not admit to it. What level of prevention has the nurse applied in this situation?

• A. primary prevention
• B. secondary prevention
• C. tertiary prevention
• D. health promotion

Correct answer: A

Rationale: The nurse has applied primary prevention in this situation. Primary prevention involves efforts to prevent the occurrence of domestic violence before it starts, even if the client does not admit to the abuse. Secondary prevention focuses on early detection and intervention to reduce the harm caused by violence that is already occurring. Tertiary prevention involves actions taken to rehabilitate and support individuals who have experienced domestic violence. Health promotion encompasses a broader approach aimed at improving overall health and well-being, which may include education on domestic violence prevention but is not specific to this scenario.

2. A male client who has been taking propranolol (Inderal) for 18 months tells the nurse the healthcare provider discontinued the medication because his blood pressure has been normal for the past three months. Which instruction should the nurse provide?

• A. Abruptly stop the medication.
• B. Continue the medication at the same dose.
• C. Ask the healthcare provider about tapering the drug dose over the next week.
• D. Increase the dose of the medication.

Correct answer: C

Rationale: Gradually tapering the dose over one to two weeks should be recommended to prevent rebound tachycardia, hypertension, and ventricular dysrhythmias.

3. A public health nurse is implementing a program to improve vaccination rates among children in the community. Which intervention is most likely to be effective?

• A. Offering vaccinations at convenient locations and times
• B. Distributing educational materials about vaccines
• C. Providing incentives for getting vaccinated
• D. Hosting informational sessions for parents

Correct answer: A

Rationale: Offering vaccinations at convenient locations and times is the most effective intervention as it reduces barriers to access and makes it easier for parents to get their children vaccinated. This strategy directly addresses the issue of convenience and accessibility, which are common reasons for low vaccination rates. Distributing educational materials about vaccines (Choice B) can be helpful but may not directly address access issues. Providing incentives for getting vaccinated (Choice C) may be controversial and not sustainable in the long term. Hosting informational sessions for parents (Choice D) can be beneficial for education but may not directly improve vaccination rates as much as increasing access.

4. A community health nurse is evaluating the effectiveness of a recent smoking cessation program. Which outcome indicates success?

• A. increased attendance at support group meetings
• B. reduced number of cigarettes smoked per day
• C. higher sales of nicotine replacement products
• D. lower relapse rate among participants

Correct answer: D

Rationale: The correct answer is D: lower relapse rate among participants. A lower relapse rate indicates that participants are successfully quitting smoking and maintaining their cessation, which is the ultimate goal of a smoking cessation program. Increased attendance at support group meetings (choice A) may demonstrate engagement but does not necessarily indicate successful smoking cessation. Similarly, higher sales of nicotine replacement products (choice C) may reflect increased product usage but not necessarily successful smoking cessation. While reducing the number of cigarettes smoked per day (choice B) is a positive change, it does not guarantee successful smoking cessation or long-term abstinence.

5. A nurse has started a group for senior citizens in a church setting. The group decides that their first project will be to begin a program for home-bound members. Which program outcome is the best measure of the project's effectiveness?

• A. number of home-bound seniors who are visited
• B. number of church members who are over 65
• C. average annual income for the homebound members
• D. calls received showing interest in the program

Correct answer: A

Rationale: The number of home-bound seniors visited is the best measure of the project's effectiveness as it directly reflects the reach and impact of the program. Choice B is incorrect as it does not directly relate to the effectiveness of the program for home-bound seniors. Choice C is irrelevant as the average annual income of home-bound members is not a direct measure of the program's effectiveness. Choice D, calls showing interest, is not as direct a measure as the actual visits to the home-bound seniors.

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