Nursing Elites

1. A public health nurse is evaluating a program designed to reduce childhood obesity. Which outcome indicates that the program is successful?

• A. increased participation in physical activities
• B. higher attendance at nutrition education sessions
• C. reduced rates of childhood obesity
• D. greater knowledge of healthy eating habits

Correct answer: C

Rationale: The correct answer is C: reduced rates of childhood obesity. A reduction in childhood obesity rates is a direct indicator that the program is successful in achieving its goal. Increased participation in physical activities (choice A) and higher attendance at nutrition education sessions (choice B) are positive outcomes, but they do not directly measure the program's effectiveness in reducing obesity. Greater knowledge of healthy eating habits (choice D) is important but does not guarantee a decrease in obesity rates. Therefore, the most significant outcome to determine the success of a childhood obesity reduction program is a reduction in obesity rates.

2. A community health nurse is addressing the issue of domestic violence in the community. Which intervention should be prioritized?

• A. Providing education on the signs of domestic violence
• B. Setting up a support group for survivors
• C. Partnering with local law enforcement to increase patrols
• D. Creating a confidential hotline for reporting abuse

Correct answer: D

Rationale: Creating a confidential hotline for reporting abuse is the most critical intervention when addressing domestic violence. A hotline offers a safe and confidential way for individuals experiencing abuse to report incidents, seek help, and access support services. This intervention prioritizes immediate safety and support for victims. Providing education on the signs of domestic violence (Choice A) is important for prevention but may not address the urgent needs of individuals currently experiencing abuse. Setting up a support group for survivors (Choice B) is valuable for emotional support but may not reach those who are not yet identified as survivors. Partnering with local law enforcement to increase patrols (Choice C) focuses more on the law enforcement response rather than providing a direct avenue for victims to seek help and support.

3. The school nurse is developing an individualized healthcare plan for a student with type 1 diabetes. Which component is most important to include in the plan?

• A. a schedule for blood glucose monitoring
• B. a list of low-carbohydrate snacks
• C. a contact list of healthcare providers
• D. a log for recording insulin administration

Correct answer: A

Rationale: The correct answer is A: a schedule for blood glucose monitoring. Regular blood glucose monitoring is essential in managing type 1 diabetes as it helps in monitoring blood sugar levels, adjusting treatment plans, and preventing complications such as hypoglycemia or hyperglycemia. Choice B, a list of low-carbohydrate snacks, while important for managing blood sugar levels, is not as critical as consistent blood glucose monitoring. Choice C, a contact list of healthcare providers, though important for emergency situations, is not the most crucial component in managing daily care. Choice D, a log for recording insulin administration, is valuable for tracking insulin doses but does not directly address the immediate need for monitoring blood glucose levels.

4. 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.

5. A client with chronic renal failure is scheduled for hemodialysis in the morning. Which pre-dialysis medication should the nurse withhold until after the dialysis treatment is completed?

• A. Calcium carbonate (Os-Cal)
• B. Furosemide (Lasix)
• C. Spironolactone (Aldactone)
• D. Multivitamins

Correct answer: B

Rationale: The correct answer is B: Furosemide (Lasix). Furosemide is a diuretic that promotes fluid loss, and giving it before hemodialysis can lead to excessive fluid loss during the treatment, potentially causing hypovolemia. Withholding furosemide until after the dialysis session helps in preventing this complication. Choices A, C, and D are incorrect because calcium carbonate, spironolactone, and multivitamins are not typically contraindicated before hemodialysis in clients with chronic renal failure.

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