Nursing Elites

1. A public health nurse is developing a campaign to promote breast cancer screening. Which population should be the primary target of this campaign?

• A. women aged 20-30
• B. women aged 30-40
• C. women aged 40-50
• D. women aged 50-60

Correct answer: C

Rationale: The correct answer is women aged 40-50. This age group is at an increased risk for breast cancer and should be the primary target for screening campaigns. Women in this age range are more likely to benefit from regular screening as early detection can lead to better outcomes. Choices A, B, and D are incorrect because women aged 20-30 are generally not recommended for routine screening due to their lower risk, women aged 30-40 have a moderate risk but are not the primary target group, and women aged 50-60 should still be screened but targeting the 40-50 age group is more crucial for early detection and intervention.

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. A school nurse is organizing a vaccination clinic for middle school students. Which vaccine is most important for the nurse to include?

• A. hepatitis B
• B. tetanus, diphtheria, and pertussis (Tdap)
• C. varicella
• D. measles, mumps, and rubella (MMR)

Correct answer: B

Rationale: The most important vaccine for the school nurse to include in the vaccination clinic for middle school students is the tetanus, diphtheria, and pertussis (Tdap) vaccine. Tdap is recommended for preteens as part of the routine vaccination schedule to protect against these serious diseases. Hepatitis B, varicella, and MMR vaccines are also important but for this specific age group, Tdap takes precedence to ensure protection against tetanus, diphtheria, and pertussis.

4. The public health nurse is creating a plan to increase state funding for a local health clinic. Which strategy is likely to be most effective in obtaining funding for the clinic?

• A. Run the health clinic economically and promote the services the clinic provides.
• B. Organize concerned citizens to write letters and call state representatives.
• C. Highlight to the media the valuable services offered by the community clinic.
• D. Hire a professional lobbyist to convince Congress of the local clinic's value.

Correct answer: B

Rationale: Organizing concerned citizens to contact state representatives is likely the most effective strategy to secure state funding for the local health clinic. By mobilizing a group of citizens who are directly impacted by the clinic's services, the public health nurse can create a strong advocacy group that can influence decision-makers. Option A, running the health clinic economically and promoting its services, may be necessary but does not directly address the funding aspect. Option C, highlighting services to the media, may raise awareness but does not guarantee funding. Option D, hiring a professional lobbyist, may be costly and may not have the same grassroots impact as organizing citizens.

5. The nurse is documenting the medical history of a young adult who was recently diagnosed with type 1 diabetes mellitus. The client smokes 2 packs of cigarettes a day, and his father died of a heart attack at the age of 45. Which annual screening is most important for the nurse to include?

• A. peripheral neuropathy
• B. renal insufficiency
• C. retinopathy
• D. hyperlipidemia

Correct answer: D

Rationale: The most important annual screening for the nurse to include is hyperlipidemia. Given the client's smoking history, family history of premature heart disease, and the increased risk of cardiovascular complications associated with diabetes, screening for hyperlipidemia is crucial. This screening is essential in assessing the client's risk of developing cardiovascular disease, which is a significant concern in this case. Peripheral neuropathy (choice A) is a common long-term complication of diabetes but may not be the most immediate concern in this scenario. Renal insufficiency (choice B) is also a complication of diabetes, but given the client's high cardiovascular risk, hyperlipidemia screening takes priority. Retinopathy (choice C) is an important complication of diabetes affecting the eyes, but in this case, focusing on cardiovascular risk assessment through hyperlipidemia screening is more critical.

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