Nursing Elites

1. 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.

2. A client with a history of chronic kidney disease is receiving erythropoietin therapy. Which finding indicates that the therapy is effective?

• A. Hemoglobin of 12 g/dL.
• B. Reticulocyte count of 1%.
• C. Blood pressure of 130/80 mm Hg.
• D. Serum ferritin level of 100 ng/mL.

Correct answer: A

Rationale: The correct answer is A. A hemoglobin level of 12 g/dL is an indicator of effective erythropoietin therapy as it shows an increase in red blood cell production. Reticulocyte count (choice B) reflects the bone marrow's response to anemia but does not directly confirm the effectiveness of erythropoietin therapy. Blood pressure (choice C) and serum ferritin level (choice D) are not specific indicators of the effectiveness of erythropoietin therapy for chronic kidney disease.

3. While screening all children in the third grade for head lice, the school nurse observes that one girl has a brownish thickening on her neck. Which action should the nurse take in response to this finding?

• A. review the child's medical folder for a list of allergies
• B. instruct the child's parents to begin treatment
• C. advise the child's parents to obtain a medical evaluation of the child
• D. none of the above

Correct answer: C

Rationale: The correct action for the nurse to take is to advise the child's parents to obtain a medical evaluation of the child. This is important because a medical professional needs to properly diagnose and treat the brownish thickening observed on the child's neck. Reviewing the child's medical folder for allergies (Choice A) is not appropriate in this situation as it does not address the specific concern. Instructing the child's parents to begin treatment (Choice B) without a proper diagnosis can be harmful and ineffective. Choosing 'none of the above' (Choice D) is not the best option when a potential health issue is identified; seeking a medical evaluation is the most appropriate course of action.

4. A 56-year-old female client is receiving intracavitary radiation via a radium implant. Which nurse should be assigned to care for this client?

• A. A nurse who is pregnant.
• B. A nurse with Marfan syndrome who is postmenopausal.
• C. A nurse with a cold.
• D. A nurse who is lactating.

Correct answer: B

Rationale: A nurse with Marfan syndrome who is postmenopausal can safely care for the client because Marfan syndrome does not affect the ability to care for this client, and postmenopausal status minimizes the risk of radiation exposure affecting reproductive health. Choice A is incorrect because pregnancy increases the risk of radiation exposure to the fetus. Choice C is incorrect because a nurse with a cold may have a compromised immune system and should not be exposed to radiation therapy. Choice D is incorrect because lactation can increase the risk of radiation exposure to breast tissue.

5. The nurse is assessing an older adult client and determines that the client's left upper eyelid droops, covering more of the iris than the right eyelid. Which description should the nurse use to document this finding?

• A. Ptosis on the left eyelid.
• B. Nystagmus.
• C. Astigmatism.
• D. Exophthalmos.

Correct answer: A

Rationale: The correct answer is A: 'Ptosis on the left eyelid.' Ptosis is the term used to describe an eyelid droop that covers a large portion of the iris, which may be caused by issues with the oculomotor nerve or eyelid muscles. Choice B, 'Nystagmus,' refers to involuntary eye movements and is not related to eyelid drooping. Choice C, 'Astigmatism,' is a refractive error affecting vision due to an irregularly shaped cornea or lens, not an eyelid condition. Choice D, 'Exophthalmos,' is a protrusion of the eyeball associated with conditions like hyperthyroidism, not eyelid drooping.

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