Nursing Elites

1. A public health nurse is working with a community to improve access to healthcare services. Which intervention is most likely to be effective?

• A. Setting up mobile clinics in underserved areas
• B. Distributing flyers with information about local clinics
• C. Offering transportation vouchers for medical appointments
• D. Partnering with local businesses to provide healthcare discounts

Correct answer: A

Rationale: Setting up mobile clinics in underserved areas is the most effective intervention to improve access to healthcare services. Mobile clinics directly bring healthcare services to the community, making it convenient for residents to access care without having to travel long distances. Distributing flyers may increase awareness but may not address the barriers to access. Offering transportation vouchers helps with one aspect of access but does not directly provide healthcare services. Partnering with local businesses for discounts may not address the primary issue of physical access to healthcare services in underserved areas.

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

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

Correct answer: B

Rationale: Intermittent bubbling in the suction control chamber is the correct observation indicating effective functioning of the chest tube. This bubbling signifies that the suction system is working correctly and maintaining the desired negative pressure in the pleural space. Continuous bubbling in the water-seal chamber suggests an air leak, which is not a normal finding. No fluctuation (tidaling) in the water-seal chamber may indicate a blockage or lack of communication between the pleural space and the water-seal, which is not ideal. Drainage of clear, pale yellow fluid from the chest tube is a normal finding, but it does not specifically indicate the effectiveness of the chest tube function.

3. A client with a history of coronary artery disease is admitted with chest pain. Which assessment finding requires immediate intervention?

• A. Heart rate of 90 beats per minute.
• B. Respiratory rate of 20 breaths per minute.
• C. Blood pressure of 130/80 mm Hg.
• D. Chest pain radiating to the left arm.

Correct answer: D

Rationale: Chest pain radiating to the left arm is a classic symptom of a myocardial infarction (heart attack) in individuals with coronary artery disease. This finding indicates that the heart muscle may not be receiving adequate oxygen, which requires immediate intervention to prevent further damage or complications. The other assessment findings (heart rate of 90 beats per minute, respiratory rate of 20 breaths per minute, blood pressure of 130/80 mm Hg) are within normal limits and do not suggest an acute, life-threatening condition like myocardial infarction.

4. Because this year's demographics reflect that a large percentage of the population is less than 19 years of age, a community group proposes building a new well-child clinic. Which question indicates that the nurse understands the potential gaps in this data?

• A. What percentage of the population was under 19 years of age in each of the previous 5 years?
• B. What is the distribution of males to females within this population?
• C. How can the income level of the families within the community be determined?
• D. How will the large percentage under 19 years affect the community dependency ratio?

Correct answer: A

Rationale: Option A is the correct answer because understanding the percentage of the population under 19 years of age in each of the previous five years helps to determine if the high percentage of youth is a consistent trend or a recent change. This information is crucial for assessing the need for a new well-child clinic. Choices B, C, and D are incorrect because they do not directly address the gaps in the data related to the age distribution trend over time, which is essential for making an informed decision about the necessity of the proposed clinic.

5. A client with a history of heart failure is admitted with pulmonary edema. Which finding requires immediate intervention?

• A. Peripheral edema.
• B. Oxygen saturation of 88%.
• C. Jugular vein distention.
• D. Productive cough with pink, frothy sputum.

Correct answer: D

Rationale: A productive cough with pink, frothy sputum is a classic sign of pulmonary edema, indicating fluid in the lungs. This finding requires immediate intervention to prevent respiratory compromise and worsening of the condition. Peripheral edema (Choice A) is a manifestation of heart failure but is not as urgent as addressing pulmonary edema. Oxygen saturation of 88% (Choice B) is low and requires attention, but the pink, frothy sputum signifies acute respiratory distress. Jugular vein distention (Choice C) can be seen in heart failure, but the immediate concern in this scenario is addressing the pulmonary edema to ensure adequate gas exchange and oxygenation.

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