Nursing Elites

1. During a home visit, the nurse observes that a client with limited mobility has difficulty accessing the bathroom. What should the nurse do first?

• A. suggest the client install a bedside commode
• B. assist the client in modifying the home environment
• C. refer the client to an occupational therapist
• D. educate the client on mobility aids

Correct answer: A

Rationale: The correct answer is to suggest that the client installs a bedside commode. This option provides an immediate solution to the client's difficulty accessing the bathroom. While modifying the home environment (Choice B) and referring the client to an occupational therapist (Choice C) are important steps, suggesting a bedside commode addresses the immediate need efficiently. Educating the client on mobility aids (Choice D) can be beneficial but may not be the most urgent action required in this scenario.

2. The nurse is assessing a client who complains of weight loss, racing heart rate, and difficulty sleeping. The nurse determines the client has moist skin with fine hair, prominent eyes, lid retraction, and a staring expression. These findings are consistent with which disorder?

• A. Graves' disease.
• B. Cushing's syndrome.
• C. Addison's disease.
• D. Hypothyroidism.

Correct answer: A

Rationale: The correct answer is A, Graves' disease. The symptoms described in the client are classic manifestations of hyperthyroidism, which is commonly caused by Graves' disease, an autoimmune condition affecting the thyroid. Weight loss, racing heart rate, difficulty sleeping, moist skin with fine hair, prominent eyes, lid retraction, and a staring expression are all indicative of hyperthyroidism. Choice B, Cushing's syndrome, is characterized by weight gain, hypertension, and a rounded face due to excess cortisol. Choice C, Addison's disease, presents with symptoms such as weight loss, fatigue, and hyperpigmentation due to adrenal insufficiency. Choice D, hypothyroidism, typically features symptoms opposite to those described in the client, such as weight gain, bradycardia, and dry skin.

3. Which intervention by the community health nurse is an example of a secondary level of prevention?

• A. providing a needle exchange program at a community mental health clinic
• B. developing an educational program for clients with diabetes mellitus
• C. administering influenza vaccines to residents of a nursing home
• D. initiating contact notifications for sexual partners of an HIV client

Correct answer: C

Rationale: Administering influenza vaccines to residents of a nursing home is an example of secondary prevention. Secondary prevention aims to detect and treat a disease or condition in its early stages to prevent complications. In this case, administering influenza vaccines helps prevent the spread of the flu among vulnerable individuals. Choices A, B, and D are not examples of secondary prevention. Providing a needle exchange program (Choice A) is a harm reduction strategy (tertiary prevention). Developing an educational program for clients with diabetes mellitus (Choice B) focuses on health promotion and primary prevention. Initiating contact notifications for sexual partners of an HIV client (Choice D) is a measure to prevent further transmission of the disease but is more aligned with tertiary prevention.

4. A school nurse is developing a program to address bullying among students. Which component is most important to include?

• A. education on the effects of bullying
• B. training for teachers on how to handle bullying incidents
• C. a peer mentoring program
• D. a zero-tolerance policy for bullying

Correct answer: B

Rationale: Training for teachers is the most important component to include in addressing bullying among students. Teachers play a crucial role in identifying, intervening, and preventing bullying incidents. By providing teachers with training on how to handle bullying, they can effectively address such situations, support victims, and educate students on appropriate behavior. While education on the effects of bullying (Choice A) is important, teachers need practical skills to intervene. Peer mentoring programs (Choice C) and zero-tolerance policies (Choice D) are valuable but may not be as effective without teachers being equipped to address bullying incidents directly.

5. A community health nurse is addressing the issue of domestic violence in the community. Which intervention should the nurse implement first?

• A. establishing a support group for survivors of domestic violence
• B. developing educational materials on recognizing signs of abuse
• C. partnering with local law enforcement to increase awareness
• D. conducting a community needs assessment to identify resources

Correct answer: D

Rationale: Conducting a community needs assessment is the most appropriate initial intervention when addressing domestic violence in the community. This step helps the nurse identify existing resources, gaps, and specific needs of the community related to domestic violence. By understanding the community's needs through a needs assessment, the nurse can tailor subsequent interventions effectively. Option A, establishing a support group, may be beneficial later but should not be the first step. Developing educational materials (Option B) and partnering with law enforcement (Option C) are important strategies; however, without understanding the community's specific needs through a needs assessment, the interventions may not be as targeted or effective.

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