Nursing Elites

1. A public health nurse is assessing a community's readiness for a new smoking cessation program. Which factor is most important to evaluate?

• A. the community's smoking rates
• B. the availability of smoking cessation resources
• C. the community's attitude towards smoking
• D. the local healthcare providers' support for the program

Correct answer: C

Rationale: The most critical factor to evaluate when assessing a community's readiness for a smoking cessation program is the community's attitude towards smoking. Understanding the community's perceptions, beliefs, and behaviors related to smoking is crucial as it helps determine the level of receptiveness and potential success of the program. Assessing smoking rates (Choice A) could provide valuable epidemiological data but may not reflect the community's readiness for change. While the availability of smoking cessation resources (Choice B) is important, without considering the community's attitude, the program's effectiveness may be limited. Local healthcare providers' support (Choice D) is valuable but secondary to the community's attitude, which directly influences the program's acceptance and impact.

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 nurse is preparing a teaching plan for a client who is newly diagnosed with hypothyroidism. Which instruction should the nurse include?

• A. Take levothyroxine (Synthroid) at bedtime.
• B. Increase fiber intake to prevent constipation.
• C. Take the medication on an empty stomach.
• D. Take a double dose if a dose is missed.

Correct answer: C

Rationale: The correct instruction for a client newly diagnosed with hypothyroidism is to take the medication on an empty stomach. This is important because taking levothyroxine on an empty stomach ensures better absorption of the medication. Choice A, taking levothyroxine at bedtime, is incorrect as it does not promote optimal absorption. Choice B, increasing fiber intake to prevent constipation, is important but not the priority when it comes to medication administration. Choice D, taking a double dose if a dose is missed, is dangerous and should never be advised as it can lead to overdose and serious side effects.

4. The nurse is preparing an orientation class for new employees at an inner-city clinic that serves a low-income population. Which information should the nurse include in the presentation to these new employees?

• A. A lack of transportation is the major impediment for the clinic's clients.
• B. Basic physiological needs are likely to be unmet in this clinic's client population.
• C. Printed material is less effective for this population that has limited reading skills.
• D. A group education class is often poorly attended by non-compliant clients.

Correct answer: A

Rationale: The correct answer is A. Addressing transportation issues is crucial when working with low-income populations as lack of transportation can be a significant barrier to accessing healthcare services. This information is important for new employees to understand the challenges faced by the clinic's clients and to strategize ways to overcome this barrier. Choices B, C, and D are incorrect because while they may be relevant considerations, addressing transportation barriers should be a priority given its impact on accessing care for this specific population.

5. The healthcare provider is caring for a client with a chest tube. Which observation indicates that the chest tube is functioning properly?

• A. Continuous bubbling in the water-seal chamber.
• B. No fluctuation (tidaling) in the water-seal chamber.
• C. Intermittent bubbling in the suction control chamber.
• D. Drainage of clear, pale yellow fluid from the chest tube.

Correct answer: D

Rationale: The drainage of clear, pale yellow fluid from the chest tube is an indication of proper chest tube functioning. Clear, pale yellow fluid signifies normal drainage from the pleural space without any signs of infection or complications. Choices A, B, and C are incorrect because continuous bubbling in the water-seal chamber, no fluctuation in the water-seal chamber, and intermittent bubbling in the suction control chamber are all indications of potential issues or malfunctioning of the chest tube system, which would require further assessment and intervention.

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