Nursing Elites

1. As a community Health Nurse, you are a change agent. Which of the following roles must you play to succeed as a change agent?

• A. information provider
• B. information seeker
• C. motivator
• D. leader

Correct answer: B

Rationale: To succeed as a change agent, being an information seeker is crucial. While being an information provider, motivator, and leader are important roles, actively seeking information is fundamental to understanding the community's needs, concerns, and challenges before implementing effective changes. This active information seeking helps in making informed decisions and developing strategies that address the specific issues faced by the community. Therefore, the correct choice is B. Choices A, C, and D are also important roles but may not be as fundamental as actively seeking information.

2. The nurse at a health fair has taken a client's blood pressure twice, 10 minutes apart, in the same arm while the client is seated. The nurse records the two blood pressures of 172/104 mm Hg and 164/98 mm Hg. What is the appropriate nursing action in response to these readings?

• A. Refer the client to a nutritionist after providing health teaching about a low-sodium diet.
• B. Place the client in a recumbent position and call the paramedics for transport to the hospital.
• C. Talk with the client to assess whether there is stress in the client's life and refer to a counseling service.
• D. Take the client's blood pressure in the other arm and then schedule a healthcare practitioner's appointment for as soon as possible.

Correct answer: D

Rationale: The appropriate nursing action in response to significantly high blood pressure readings like 172/104 mm Hg and 164/98 mm Hg is to confirm the readings by taking the blood pressure in the other arm. This can help rule out any error or issue specific to that arm. The nurse should then schedule a healthcare practitioner's appointment for as soon as possible to further assess the client's condition and determine the appropriate intervention. Choice A is incorrect because solely referring the client to a nutritionist for a low-sodium diet without further assessment or confirmation of the blood pressure readings is premature. Choice B is incorrect as the client is already seated, and calling paramedics for immediate transport to the hospital is not warranted based solely on the blood pressure readings provided. Choice C is incorrect as stress may not be the sole reason for the high blood pressure readings, and further assessment is required before referring the client to counseling services.

3. What is the most common cause of vaginal bleeding immediately after birth?

• A. Uterine atony
• B. Genital lacerations
• C. Abnormal clotting mechanism
• D. Endometritis

Correct answer: A

Rationale: Vaginal bleeding immediately after birth is most often due to uterine atony, which is the failure of the uterus to contract following delivery. This results in inadequate compression of blood vessels at the placental site, leading to hemorrhage. Genital lacerations and abnormal clotting mechanisms can also cause bleeding but are less common immediately after birth compared to uterine atony. Endometritis, inflammation of the lining of the uterus, usually presents with symptoms like fever and pelvic pain rather than immediate postpartum bleeding.

4. Which presentation of an infectious disease is acquired through an indirect transmission?

• A. Syphilis contracted from a sexual partner.
• B. Measles resulting from a daycare center outbreak.
• C. Malaria following exposure in a mosquito-infested area.
• D. Nosocomial influenza spreading rapidly in a long-term care center.

Correct answer: C

Rationale: The correct answer is C. Malaria is transmitted indirectly through mosquito bites. Choice A is incorrect as syphilis is acquired through direct contact with an infected sexual partner. Choice B is incorrect as measles can be transmitted through respiratory droplets in close contact settings like daycare centers. Choice D is incorrect as nosocomial influenza spreads within healthcare facilities through direct contact or droplets.

5. What components should a nurse include when conducting a community health assessment?

• A. Personal health history of community members
• B. Number of hospitals in the community
• C. Demographic data, health status indicators, and community resources
• D. Results of laboratory tests

Correct answer: C

Rationale: When conducting a community health assessment, it is essential to gather demographic data (such as age, gender, ethnicity), health status indicators (like prevalence of diseases, mortality rates), and information on community resources (such as healthcare facilities, social services). These components help in understanding the health needs of the community and planning appropriate interventions. Choices A, B, and D are not typically part of a community health assessment as they focus on individual health data or specific medical information rather than the broader population health perspective required for community assessments.

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