Nursing Elites

1. The healthcare provider is caring for a client with a chest tube. Which observation indicates that the chest tube is functioning effectively?

• A. Continuous bubbling in the water-seal chamber.
• B. Intermittent bubbling in the suction control chamber.
• C. No fluctuation (tidaling) in the water-seal chamber.
• D. Drainage of clear, pale yellow fluid from the chest tube.

Correct answer: B

Rationale: Intermittent bubbling in the suction control chamber is the correct observation indicating effective functioning of the chest tube. This bubbling signifies that the suction system is working correctly and maintaining the desired negative pressure in the pleural space. Continuous bubbling in the water-seal chamber suggests an air leak, which is not a normal finding. No fluctuation (tidaling) in the water-seal chamber may indicate a blockage or lack of communication between the pleural space and the water-seal, which is not ideal. Drainage of clear, pale yellow fluid from the chest tube is a normal finding, but it does not specifically indicate the effectiveness of the chest tube function.

2. A community health nurse is planning a program to address the rising rates of obesity in the community. Which intervention should the nurse prioritize?

• A. organizing community exercise programs
• B. distributing educational materials on healthy eating
• C. partnering with local grocery stores to provide discounts on healthy foods
• D. conducting health screenings for early detection of obesity-related conditions

Correct answer: A

Rationale: The correct answer is A: organizing community exercise programs. Physical activity plays a crucial role in weight management and reducing obesity rates. While educating about healthy eating (choice B) is important, focusing on exercise programs can have a more direct impact on addressing obesity. Partnering with local grocery stores for discounts on healthy foods (choice C) is beneficial but may not address the root cause of obesity. Conducting health screenings (choice D) is more reactive than proactive in addressing rising obesity rates.

3. 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.

4. A graduate nursing student requests information, including laboratory findings and chest x-ray results, about all clients with symptoms of H1N1 who have been seen during the last month in a community health clinic. Which action should the charge nurse take?

• A. Ask if permission has been obtained from the research committee.
• B. Ask the student to sign a standard waiver form.
• C. Obtain written authorization from clients to release the information.
• D. Provide the information for research purposes only.

Correct answer: C

Rationale: The correct action for the charge nurse to take is to obtain written authorization from clients to release the information. This step is crucial to ensure compliance with privacy laws and ethical standards. Asking for permission from the research committee (Choice A) may not address the individual clients' rights to privacy. Asking the student to sign a standard waiver form (Choice B) is not appropriate, as the authorization should come from the clients themselves. Providing the information for research purposes only (Choice D) without proper authorization violates client confidentiality and privacy.

5. A community health nurse is developing a program to increase physical activity among adults in the community. Which intervention is most likely to be successful?

• A. distributing flyers about the benefits of exercise
• B. organizing free community exercise classes
• C. partnering with local gyms to offer discounts
• D. hosting a health fair with information booths

Correct answer: B

Rationale: Organizing free community exercise classes is the most likely successful intervention as it provides a structured and accessible opportunity for adults to engage in physical activity. This choice directly offers a practical solution by providing a regular and organized setting for individuals to participate in physical activity. Distributing flyers about the benefits of exercise, while informative, may not lead to actual participation. Partnering with local gyms to offer discounts relies on individuals taking the initiative to sign up for gym memberships, which may not be feasible for everyone. Hosting a health fair with information booths is informative but may not directly address the need for increased physical activity among adults in the community.

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