Nursing Elites

1. The nurse is assessing a client with a suspected deep vein thrombosis (DVT). Which finding supports this diagnosis?

• A. Positive Homan's sign.
• B. Unilateral leg swelling.
• C. Bilateral calf pain.
• D. Redness and warmth in the affected leg.

Correct answer: D

Rationale: The correct answer is D: Redness and warmth in the affected leg. These are classic signs of deep vein thrombosis (DVT) and support the diagnosis. Choice A, Positive Homan's sign, is an outdated and unreliable test for DVT, so it is not the best choice. Choice B, Unilateral leg swelling, can be seen in DVT but is less specific compared to redness and warmth. Choice C, Bilateral calf pain, is not a typical finding in DVT, as the pain in DVT is usually unilateral.

2. A client with a history of hypertension is admitted with a blood pressure of 200/120 mm Hg. Which medication should the nurse prepare to administer?

• A. Metoprolol (Lopressor).
• B. Furosemide (Lasix).
• C. Lisinopril (Zestril).
• D. Nitroprusside (Nipride).

Correct answer: D

Rationale: The correct answer is D, Nitroprusside (Nipride). In this scenario of severe hypertension (200/120 mm Hg), a hypertensive emergency is present, requiring rapid reduction of blood pressure. Nitroprusside is a vasodilator that acts quickly to lower blood pressure in such emergencies. Options A, B, and C are incorrect: A) Metoprolol is a beta-blocker that lowers blood pressure but is not indicated for hypertensive emergencies requiring rapid reduction. B) Furosemide is a diuretic that helps with fluid retention but does not rapidly lower blood pressure. C) Lisinopril is an ACE inhibitor used for long-term management of hypertension, not for immediate reduction in hypertensive emergencies.

3. On a day when the temperature is expected to drop below freezing during the night, the nurse is asked to determine which homeless adults are most in need of the limited spaces available in a shelter. It is most important for which person to be admitted at night?

• A. an adult who was hit by a car 3 weeks ago
• B. a young person with diabetes mellitus
• C. a middle-aged person who has hypertension
• D. an older person who is malnourished

Correct answer: D

Rationale: Malnourished individuals are at higher risk of severe complications from cold exposure due to their weakened immune system and decreased ability to regulate body temperature. This places them at a greater risk of hypothermia and other cold-related conditions, making them the most vulnerable group in need of shelter. Choice A is not the most critical as the injury is from 3 weeks ago and should have received appropriate medical care by now. Choice B, a young person with diabetes mellitus, while vulnerable, can manage their condition with proper medication and care. Choice C, a middle-aged person with hypertension, may need monitoring but is less susceptible to immediate harm from cold exposure compared to a malnourished individual.

4. The healthcare provider is developing a community outreach program to address childhood obesity. Which intervention should the healthcare provider implement first?

• A. conduct a survey to assess dietary habits and physical activity levels
• B. develop educational materials on healthy eating and exercise
• C. partner with local schools to promote physical activity programs
• D. organize community events that encourage healthy lifestyle choices

Correct answer: A

Rationale: Conducting a survey to assess dietary habits and physical activity levels should be the initial step in developing a community outreach program to address childhood obesity. By gathering data through a survey, the healthcare provider can identify specific needs, preferences, and challenges within the community. This information is crucial for designing tailored interventions that are more likely to be effective. Developing educational materials (Choice B) can come after understanding the community's needs through the survey. Partnering with local schools (Choice C) and organizing community events (Choice D) are important strategies but should be planned based on the data obtained from the survey to ensure relevance and impact.

5. When examining sources for funding, which criteria should the nurse clarify about the program for the community group?

• A. a prescription from the healthcare provider for each visit made
• B. documentation of a skilled care service provided during the visit
• C. a copy of the client's health history and social security card
• D. a record of the preventive healthcare services provided during the visit

Correct answer: C

Rationale: The correct answer is C because when seeking funding sources for a community outreach program, it is essential to clarify aspects related to the client's personal information, such as health history and identification details. This information helps in demonstrating the need for the program and understanding the target population. Choices A, B, and D are incorrect because they focus on clinical documentation, services provided during visits, and preventive healthcare services, which are not directly related to clarifying funding criteria about the program.

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