Nursing Elites

1. The nurse is assessing a client with pneumonia who is receiving oxygen therapy. Which finding indicates that the therapy is effective?

• A. The client's respiratory rate is 20 breaths per minute.
• B. The client's arterial blood gases show a pH of 7.35.
• C. The client's oxygen saturation is 92%.
• D. The client's breath sounds are clear.

Correct answer: A

Rationale: A respiratory rate of 20 breaths per minute indicates effective oxygen therapy. In pneumonia, the respiratory rate typically increases due to the body's effort to improve oxygenation. Option B (pH of 7.35) is related to acid-base balance, not specifically indicating oxygen therapy effectiveness. Option C (oxygen saturation of 92%) is below the normal range (95-100%), suggesting the need for oxygen therapy. Option D (clear breath sounds) is a positive finding but not a direct indicator of oxygen therapy effectiveness.

2. A public health nurse is planning a smoking cessation program for a local community. Which component is most important to include in the program?

• A. information on the health risks of smoking
• B. strategies for coping with withdrawal symptoms
• C. testimonials from former smokers
• D. distribution of nicotine replacement therapy

Correct answer: B

Rationale: The most important component to include in a smoking cessation program is strategies for coping with withdrawal symptoms. Withdrawal symptoms are a significant barrier to quitting smoking, and providing effective coping strategies can greatly increase the program's success. Choice A, providing information on the health risks of smoking, may be important but addressing withdrawal symptoms is more crucial. Testimonials from former smokers (Choice C) and distribution of nicotine replacement therapy (Choice D) are helpful but not as essential as addressing withdrawal symptoms directly.

3. During a follow-up visit, a client with diabetes reports difficulty maintaining a healthy diet. What should the nurse do first?

• A. Provide the client with meal planning resources
• B. Explore the client's dietary habits and challenges
• C. Refer the client to a nutritionist
• D. Educate the client on the importance of a healthy diet

Correct answer: B

Rationale: When a client with diabetes reports difficulty in maintaining a healthy diet, the initial action should be to explore the client's dietary habits and challenges. By doing so, the nurse can identify specific issues and barriers the client faces, which is crucial in developing a personalized and effective intervention plan. Providing meal planning resources (Choice A) can be beneficial later but should come after understanding the client's unique situation. Referring the client to a nutritionist (Choice C) may be necessary in some cases but should follow an assessment of the client's current challenges. Simply educating the client on the importance of a healthy diet (Choice D) does not address the specific difficulties the client is facing and may not lead to sustainable behavior change.

4. The public health nurse is creating a plan to increase state funding for a local health clinic. Which strategy is likely to be most effective in obtaining funding for the clinic?

• A. Run the health clinic economically and promote the services the clinic provides.
• B. Organize concerned citizens to write letters and call state representatives.
• C. Highlight to the media the valuable services offered by the community clinic.
• D. Hire a professional lobbyist to convince Congress of the local clinic's value.

Correct answer: B

Rationale: Organizing concerned citizens to contact state representatives is likely the most effective strategy to secure state funding for the local health clinic. By mobilizing a group of citizens who are directly impacted by the clinic's services, the public health nurse can create a strong advocacy group that can influence decision-makers. Option A, running the health clinic economically and promoting its services, may be necessary but does not directly address the funding aspect. Option C, highlighting services to the media, may raise awareness but does not guarantee funding. Option D, hiring a professional lobbyist, may be costly and may not have the same grassroots impact as organizing citizens.

5. The school nurse is conducting an audit of incident reports for adolescent students. Which finding is the best indication that the Healthy People 2020 objectives are being addressed?

• A. the absenteeism rate has increased greatly over the past two years
• B. during the last year fewer firearms were retrieved on school property
• C. the number of requests for pregnancy testing is higher than last year
• D. decline in the number of students enrolled in school during the year

Correct answer: B

Rationale: The correct answer is B. A decrease in firearms retrieved on school property is a positive indication that the Healthy People 2020 objectives are being addressed. This finding suggests progress in reducing violence and improving safety in schools, which aligns with the goals of promoting overall health and safety among adolescents. Choices A, C, and D do not directly relate to the Healthy People 2020 objectives. Increased absenteeism, higher requests for pregnancy testing, and a decline in student enrollment do not necessarily reflect the specific health and safety goals outlined in Healthy People 2020.

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