Nursing Elites

1. 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.

2. After assessing the health care needs of an elementary school, the nurse determines that an increased prevalence of pediculosis capitis is a priority problem. The nurse develops a 2-month program with the goal to eradicate the condition in the school. The program includes educational pamphlets sent home to parents and regular assessment of children by the school nurse. What action should the nurse implement to evaluate the effectiveness of the program?

• A. evaluate the teachers' ability to identify pediculosis capitis 2 months after initiation of the program
• B. conduct an initial examination of each child in the school to obtain baseline data
• C. survey parents 3 weeks after pamphlets are sent home to assess their understanding of the condition
• D. measure the prevalence of pediculosis capitis among the children after four months

Correct answer: D

Rationale: Measuring the prevalence of pediculosis capitis among the children after four months is the most appropriate action to evaluate the program's effectiveness. This approach provides data on the program's long-term impact and effectiveness in eradicating the condition. Option A focuses on the teachers' ability, which is not directly related to the program's effectiveness in eradicating the condition. Option B suggests conducting an initial examination, which does not provide information on the program's impact. Option C involves assessing parents' understanding, which is important but does not directly evaluate the program's effectiveness in eradicating pediculosis capitis.

3. The healthcare professional is developing a health education program for adolescents on the dangers of smoking. Which strategy is most likely to be effective?

• A. showing graphic images of the effects of smoking
• B. inviting former smokers to share their experiences
• C. providing statistical data on smoking-related illnesses
• D. distributing pamphlets on smoking cessation resources

Correct answer: B

Rationale: Inviting former smokers to share their experiences is the most effective strategy because personal stories can have a powerful impact on adolescents and motivate them to avoid smoking. This approach makes the consequences of smoking more relatable and real, potentially influencing behavior change. Showing graphic images may be too harsh and could lead to desensitization or avoidance of the issue. Providing statistical data may not resonate as strongly with adolescents as personal stories. Distributing pamphlets, while informative, may not have the same emotional impact as hearing real-life experiences.

4. The healthcare provider is developing a community outreach program to address childhood obesity. Which intervention should the healthcare provider implement first?

• A. conduct a survey to assess dietary habits and physical activity levels
• B. develop educational materials on healthy eating and exercise
• C. partner with local schools to promote physical activity programs
• D. organize community events that encourage healthy lifestyle choices

Correct answer: A

Rationale: Conducting a survey to assess dietary habits and physical activity levels should be the initial step in developing a community outreach program to address childhood obesity. By gathering data through a survey, the healthcare provider can identify specific needs, preferences, and challenges within the community. This information is crucial for designing tailored interventions that are more likely to be effective. Developing educational materials (Choice B) can come after understanding the community's needs through the survey. Partnering with local schools (Choice C) and organizing community events (Choice D) are important strategies but should be planned based on the data obtained from the survey to ensure relevance and impact.

5. In conducting a health assessment for a family with a history of cardiovascular disease, which family member should be prioritized for further evaluation and intervention?

• A. a 45-year-old father who smokes and has high cholesterol
• B. a 17-year-old daughter who is overweight and inactive
• C. a 50-year-old mother with a history of hypertension
• D. a 12-year-old son who has a normal weight and is active

Correct answer: A

Rationale: The 45-year-old father who smokes and has high cholesterol is at a higher risk for cardiovascular disease due to multiple risk factors. Smoking and high cholesterol are significant contributors to the development of cardiovascular issues. Prioritizing his evaluation and intervention is crucial to address these modifiable risk factors. The other family members, though they may have risk factors as well, do not present with the same level of immediate risk based on the information provided.

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