Nursing Elites

1. 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.

2. A graduate nursing student requests information, including laboratory findings and chest x-ray results, about all clients with symptoms of H1N1 who have been seen during the last month in a community health clinic. Which action should the charge nurse take?

• A. Ask if permission has been obtained from the research committee.
• B. Ask the student to sign a standard waiver form.
• C. Obtain written authorization from clients to release the information.
• D. Provide the information for research purposes only.

Correct answer: C

Rationale: The correct action for the charge nurse to take is to obtain written authorization from clients to release the information. This step is crucial to ensure compliance with privacy laws and ethical standards. Asking for permission from the research committee (Choice A) may not address the individual clients' rights to privacy. Asking the student to sign a standard waiver form (Choice B) is not appropriate, as the authorization should come from the clients themselves. Providing the information for research purposes only (Choice D) without proper authorization violates client confidentiality and privacy.

3. A client who has active tuberculosis (TB) is admitted to the medical unit. What action is most important for the nurse to implement?

• A. Wear a gown and gloves.
• B. Have the client wear a mask.
• C. Perform hand hygiene.
• D. Assign the client to a negative air-flow room.

Correct answer: D

Rationale: The correct answer is to assign the client to a negative air-flow room (Choice D). Active tuberculosis requires implementation of airborne precautions, including isolating the client in a negative pressure air-flow room to prevent the spread of the infection to others. Choice A (Wear a gown and gloves) is important for standard precautions but does not address the specific airborne precautions needed for tuberculosis. Choice B (Have the client wear a mask) may help reduce the spread of respiratory droplets but does not provide adequate protection for healthcare workers or other patients. Choice C (Perform hand hygiene) is essential for infection control but is not the most critical action when dealing with an airborne infection like tuberculosis.

4. The school nurse is coaching a group of high school students on ways to deal with the stress of final exams. Today the class is focusing on healthy food choices for lunch in the school cafeteria. Which option should the nurse recommend?

• A. cheeseburger on a whole wheat bun, French fries, and a large cola beverage
• B. tuna casserole with peas and corn, a fresh apple, crackers, and orange juice
• C. fruit salad with fresh berries and oranges, chicken vegetable soup, and tea
• D. chef salad with turkey, ham, and ranch dressing, apple juice, and milk

Correct answer: C

Rationale: The recommended option for managing stress during final exams is a balanced and nutritious meal. Fruit salad with fresh berries and oranges, chicken vegetable soup, and tea offer a variety of nutrients and antioxidants that can help combat stress. Option A is not ideal as it includes high-fat and high-calorie foods. Option B is a good choice, but Option C provides a wider range of nutrients and hydration. Option D is a healthy choice with a variety of proteins and vitamins, but Option C offers lighter options that may be easier to digest during stressful times.

5. During a home visit, the nurse observes an elderly client with disabilities slip and fall. What action should the nurse take first?

• A. provide the client with 4 ounces of orange juice
• B. call 911 to summon emergency assistance
• C. check the client for lacerations or fractures
• D. assess the client's blood sugar level

Correct answer: C

Rationale: The correct action for the nurse to take first after an elderly client with disabilities slips and falls is to check the client for lacerations or fractures. This is crucial to assess the extent of injuries and provide appropriate medical attention promptly. Option A, providing orange juice, is not a priority in this situation and does not address the potential injuries. While calling 911 (Option B) may be necessary, assessing for immediate injuries takes precedence. Assessing the client's blood sugar level (Option D) is not the immediate priority after a fall unless there is a specific indication or suspicion of hypoglycemia.

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