Nursing Elites

1. Community health nurses are particularly concerned with the source of communicable diseases such as hepatitis A. Which group of individuals have a higher risk of contracting that type of hepatitis?

• A. IV drug users who share needles
• B. low-income families living in cramped quarters
• C. those who have recently received a blood transfusion
• D. sexually active persons with multiple partners

Correct answer: B

Rationale: The correct answer is B. Hepatitis A is often spread through close personal contact and poor sanitary conditions, which are more common in low-income, cramped living situations. IV drug users sharing needles are at higher risk of hepatitis B and C due to bloodborne transmission. Those who have recently received a blood transfusion are at risk of hepatitis C or other bloodborne infections. Sexually active persons with multiple partners are at risk of hepatitis B, which can be transmitted through sexual contact.

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

• A. Providing education on the dangers of substance abuse
• B. Setting up a support group for individuals struggling with addiction
• C. Partnering with local law enforcement to reduce drug availability
• D. Creating a confidential hotline for reporting substance abuse

Correct answer: D

Rationale: Creating a confidential hotline for reporting substance abuse should be prioritized because it offers a safe and accessible way for individuals to seek help and support for their substance abuse issues. This intervention allows individuals to report their concerns anonymously and seek guidance without fear of judgment or repercussions. Providing education on the dangers of substance abuse (Choice A) is important but may not be as immediately impactful as offering a direct avenue for help. Setting up a support group (Choice B) is valuable but may not reach as many individuals or provide the same level of anonymity as a confidential hotline. Partnering with law enforcement (Choice C) is crucial for addressing substance abuse issues from a legal perspective but may not directly address the immediate needs of individuals seeking help.

3. The nurse obtains a pulse rate of 89 beats/min for an infant before administering digoxin (Lanoxin). What action should the nurse take?

• A. Administer the medication.
• B. Hold the medication and contact the healthcare provider.
• C. Double the dose.
• D. Increase fluid intake.

Correct answer: B

Rationale: The correct answer is to hold the medication and contact the healthcare provider. Bradycardia (pulse rate less than 100 beats/minute) is an early sign of digoxin toxicity. It is essential to withhold digoxin and notify the healthcare provider to prevent potential adverse effects. Administering the medication (Choice A) could exacerbate the toxicity. Doubling the dose (Choice C) is inappropriate and dangerous. Increasing fluid intake (Choice D) is not indicated in this situation and does not address the issue of digoxin toxicity.

4. A client is receiving atenolol (Tenormin) 25 mg PO after a myocardial infarction. The nurse determines the client's apical pulse is 65 beats per minute. What action should the nurse take next?

• A. Hold the medication.
• B. Call the healthcare provider.
• C. Administer the medication.
• D. Check the blood pressure.

Correct answer: C

Rationale: The correct action for the nurse to take next is to administer the medication. Atenolol is a beta-blocker commonly used post-myocardial infarction to reduce the workload of the heart. The client's apical pulse of 65 beats per minute is within the acceptable range after a myocardial infarction. Holding the medication or calling the healthcare provider is not necessary in this scenario as the pulse rate is appropriate for administering atenolol. Checking the blood pressure is not the priority in this situation, as the focus should be on the heart rate when administering atenolol.

5. The nurse is preparing a teaching plan for a client who is newly diagnosed with hypothyroidism. Which instruction should the nurse include?

• A. Take levothyroxine (Synthroid) at bedtime.
• B. Increase fiber intake to prevent constipation.
• C. Take the medication on an empty stomach.
• D. Take a double dose if a dose is missed.

Correct answer: C

Rationale: The correct instruction for a client newly diagnosed with hypothyroidism is to take the medication on an empty stomach. This is important because taking levothyroxine on an empty stomach ensures better absorption of the medication. Choice A, taking levothyroxine at bedtime, is incorrect as it does not promote optimal absorption. Choice B, increasing fiber intake to prevent constipation, is important but not the priority when it comes to medication administration. Choice D, taking a double dose if a dose is missed, is dangerous and should never be advised as it can lead to overdose and serious side effects.

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