Nursing Elites

1. A nurse is developing a community health education program focused on preventing childhood obesity. Which intervention should be prioritized?

• A. Creating a school-based exercise program
• B. Distributing educational pamphlets on healthy eating
• C. Organizing a community health fair
• D. Partnering with local restaurants to offer healthy meal options

Correct answer: A

Rationale: The correct answer is A: Creating a school-based exercise program. This intervention directly addresses the need to increase physical activity among children, a crucial aspect in preventing childhood obesity. While distributing educational pamphlets on healthy eating (choice B) can be beneficial, promoting physical activity through a structured program is more effective in combating obesity. Organizing a community health fair (choice C) may raise awareness but may not lead to sustained behavior change like a structured exercise program. Partnering with local restaurants to offer healthy meal options (choice D) addresses nutrition but does not directly impact physical activity levels, which are essential in obesity prevention.

2. A 6-year-old child is alert but quiet when brought to the emergency center with periorbital ecchymosis and ecchymosis behind the ears. The nurse suspects potential child abuse and continues to assess the child for additional manifestations of a basilar skull fracture. What assessment finding would be consistent with the basilar skull fracture?

• A. Blurred vision.
• B. Shoulder pain.
• C. Abdominal pain.
• D. Rhinorrhea or otorrhea with halo sign.

Correct answer: D

Rationale: The correct answer is D: Rhinorrhea or otorrhea with halo sign. Raccoon eyes (periorbital ecchymosis) and Battle's sign (ecchymosis behind the ear) are signs of a basilar skull fracture, indicating the need to assess for possible meningeal tears that manifest as a halo sign with cerebrospinal fluid (CSF) leakage from the ears or nose. Choices A, B, and C are incorrect because blurred vision, shoulder pain, and abdominal pain are not typically associated with a basilar skull fracture.

3. The client with the sexually transmitted disease HPV reports having had prior sexually transmitted infections. Which response should the nurse provide?

• A. Emphasize that using safe sex practices removes the risk of transmission.
• B. Instruct the client of the importance of notifying sexual partners.
• C. Reassure that complications will not occur if infection is treated.
• D. Provide counseling that most contraceptives prevent against infection.

Correct answer: B

Rationale: Instructing the client about the importance of notifying sexual partners is crucial when dealing with sexually transmitted infections like HPV. This helps prevent the spread of the infection to others and promotes responsible sexual behavior. Choices A, C, and D are incorrect because while using safe sex practices is important, notifying sexual partners is more immediate and directly related to preventing the spread of the infection. Reassuring about complications and discussing contraceptives do not address the immediate need to notify partners.

4. 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.

5. A client with a history of hypertension is admitted with acute renal failure. Which assessment finding requires immediate intervention?

• A. Blood pressure of 180/100 mm Hg.
• B. Urine output of 50 mL in 4 hours.
• C. Heart rate of 100 beats per minute.
• D. Nausea and vomiting.

Correct answer: B

Rationale: Urine output of 50 mL in 4 hours indicates oliguria, which can be a sign of worsening renal function and requires immediate intervention. In acute renal failure, maintaining adequate urine output is crucial to prevent further kidney damage and manage fluid balance. A high blood pressure reading (Option A) is concerning but may not require immediate intervention in this scenario as it could be due to the history of hypertension. A heart rate of 100 beats per minute (Option C) is slightly elevated but may not be the most critical finding at this moment. Nausea and vomiting (Option D) are important to assess but are not as urgent as addressing oliguria in a client with acute renal failure.

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