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 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. 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.

4. An elderly client with limited mobility reports feeling isolated and lonely. Which intervention should the nurse prioritize?

• A. Arrange for regular visits from a home health aide
• B. Suggest the client join a local senior center
• C. Refer the client to a support group for seniors
• D. Recommend that the client engage in a new hobby

Correct answer: B

Rationale: The correct answer is to suggest the client join a local senior center. Joining a local senior center provides the elderly client with opportunities for social interaction, engagement in activities, and access to support systems, which can significantly help alleviate feelings of isolation and loneliness. Regular visits from a home health aide (Choice A) may provide physical assistance but may not address the client's need for social connection. Referring the client to a support group for seniors (Choice C) is beneficial, but joining a senior center offers a wider range of activities and social opportunities. Recommending a new hobby (Choice D) may be helpful, but the priority should be addressing the client's immediate need for social interaction and support.

5. A female client makes routine visits to a neighborhood community health center. The nurse notes that this client often presents with facial bruising, particularly around the eyes. The nurse discusses prevention of domestic violence with the client even though the client does not admit to it. What level of prevention has the nurse applied in this situation?

• A. primary prevention
• B. secondary prevention
• C. tertiary prevention
• D. health promotion

Correct answer: A

Rationale: The nurse has applied primary prevention in this situation. Primary prevention involves efforts to prevent the occurrence of domestic violence before it starts, even if the client does not admit to the abuse. Secondary prevention focuses on early detection and intervention to reduce the harm caused by violence that is already occurring. Tertiary prevention involves actions taken to rehabilitate and support individuals who have experienced domestic violence. Health promotion encompasses a broader approach aimed at improving overall health and well-being, which may include education on domestic violence prevention but is not specific to this scenario.

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