Nursing Elites

1. A school nurse is planning a program to address bullying among students. Which strategy is most likely to be effective?

• A. Implementing a zero-tolerance policy for bullying
• B. Conducting peer mediation sessions
• C. Providing workshops on conflict resolution
• D. Promoting bystander intervention

Correct answer: D

Rationale: Promoting bystander intervention is the most effective strategy as it empowers students to take action and prevent bullying incidents. By encouraging bystanders to intervene when they witness bullying, the behavior is less likely to continue. Zero-tolerance policies may have limited effectiveness as they often focus on punishment rather than prevention. Peer mediation and conflict resolution workshops are valuable but may not directly address the immediate need for bystander intervention in bullying situations.

2. 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.

3. A public health nurse is planning a vaccination clinic for a rural community. Which vaccine should the nurse prioritize for adults in this area?

• A. hepatitis A
• B. influenza
• C. varicella
• D. measles, mumps, rubella (MMR)

Correct answer: B

Rationale: The correct answer is 'B: influenza.' Influenza vaccination is crucial for adults, particularly in rural areas where access to healthcare may be limited. Influenza can cause serious illness and complications, and vaccination helps protect individuals and prevent the spread of the virus. While vaccines for hepatitis A, varicella, and measles, mumps, rubella (MMR) are important, prioritizing influenza vaccination in this scenario is essential due to its seasonal prevalence and potential impact on public health. Hepatitis A and varicella vaccines are also important but may not be as immediately critical for this population. MMR vaccine is typically administered in childhood, so it is not the priority for adults in this scenario.

4. The nurse obtains a heart rate of 92 and a blood pressure of 110/76 before administering a scheduled dose of verapamil (Calan) for a client with atrial flutter. Which action should the nurse implement?

• A. Administer the dose as prescribed.
• B. Hold the medication.
• C. Call the healthcare provider.
• D. Repeat the vital signs in 30 minutes.

Correct answer: A

Rationale: The correct action is to administer the dose as prescribed. Verapamil slows sinoatrial nodal automaticity and delays atrioventricular nodal conduction, which helps in slowing the ventricular rate. The heart rate of 92 and blood pressure of 110/76 are within an acceptable range for administering verapamil in a client with atrial flutter. Holding the medication, calling the healthcare provider, or repeating the vital signs in 30 minutes are not necessary based on the vital signs obtained and the action of verapamil in this scenario.

5. When planning a community health fair to promote mental health awareness, which activity should be included to best engage participants?

• A. free mental health screenings
• B. lectures on mental health topics
• C. distribution of mental health resources
• D. interactive workshops on stress management

Correct answer: A

Rationale: The best activity to engage participants in a community health fair promoting mental health awareness is to offer free mental health screenings. This activity not only attracts participants but also provides them with immediate, valuable information about their mental health status. Free screenings can help raise awareness, encourage early detection of mental health issues, and prompt participants to seek further assistance if needed. Lectures, while informative, may not be as engaging or impactful as the personalized feedback individuals receive from screenings. Distributing resources is helpful, but active engagement through screenings is more effective in promoting awareness and encouraging action. Interactive workshops on stress management are beneficial but might not provide the same level of individualized insight into mental health as screenings do.

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