Nursing Elites

1. A graduate nursing student requests information, including laboratory findings and chest x-ray results, about all clients with symptoms of H1N1 who have been seen during the last month in a community health clinic. Which action should the charge nurse take?

• A. Ask if permission has been obtained from the research committee.
• B. Ask the student to sign a standard waiver form.
• C. Obtain written authorization from clients to release the information.
• D. Provide the information for research purposes only.

Correct answer: C

Rationale: The correct action for the charge nurse to take is to obtain written authorization from clients to release the information. This step is crucial to ensure compliance with privacy laws and ethical standards. Asking for permission from the research committee (Choice A) may not address the individual clients' rights to privacy. Asking the student to sign a standard waiver form (Choice B) is not appropriate, as the authorization should come from the clients themselves. Providing the information for research purposes only (Choice D) without proper authorization violates client confidentiality and privacy.

2. Which bioterrorism agent is at high risk for use as a potential biological weapon that is readily transmitted by several portals of entry?

• A. anthrax
• B. smallpox
• C. botulism
• D. tularemia

Correct answer: A

Rationale: Anthrax is the correct answer. Anthrax spores can be transmitted through inhalation, ingestion, or skin contact, making it a high-risk agent for bioterrorism. Smallpox, botulism, and tularemia are also potential bioterrorism agents, but they do not have the same versatility in terms of multiple portals of entry, unlike anthrax.

3. During a follow-up home visit, the nurse observes that a client with chronic obstructive pulmonary disease (COPD) is using accessory muscles to breathe and has a pulse oximetry reading of 88%. What action should the nurse take first?

• A. Administer a prescribed bronchodilator
• B. Increase the oxygen flow rate
• C. Instruct the client to perform pursed-lip breathing
• D. Notify the healthcare provider immediately

Correct answer: C

Rationale: In this situation, the nurse should first instruct the client to perform pursed-lip breathing. Pursed-lip breathing helps improve oxygenation and decrease the work of breathing in clients with COPD. Administering a bronchodilator or increasing the oxygen flow rate may be necessary interventions but addressing the breathing technique through pursed-lip breathing is the initial action to optimize oxygenation. Notifying the healthcare provider immediately is not the first action indicated in this scenario; the nurse should intervene promptly to assist the client in improving breathing before escalating the situation.

4. Because this year's demographics reflect that a large percentage of the population is less than 19 years of age, a community group proposes building a new well-child clinic. Which question indicates that the nurse understands the potential gaps in this data?

• A. What percentage of the population was under 19 years of age in each of the previous 5 years?
• B. What is the distribution of males to females within this population?
• C. How can the income level of the families within the community be determined?
• D. How will the large percentage under 19 years affect the community dependency ratio?

Correct answer: A

Rationale: Option A is the correct answer because understanding the percentage of the population under 19 years of age in each of the previous five years helps to determine if the high percentage of youth is a consistent trend or a recent change. This information is crucial for assessing the need for a new well-child clinic. Choices B, C, and D are incorrect because they do not directly address the gaps in the data related to the age distribution trend over time, which is essential for making an informed decision about the necessity of the proposed clinic.

5. 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.

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