Nursing Elites

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

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

Correct answer: D

Rationale: The drainage of clear, pale yellow fluid from the chest tube is an indication of proper chest tube functioning. Clear, pale yellow fluid signifies normal drainage from the pleural space without any signs of infection or complications. Choices A, B, and C are incorrect because continuous bubbling in the water-seal chamber, no fluctuation in the water-seal chamber, and intermittent bubbling in the suction control chamber are all indications of potential issues or malfunctioning of the chest tube system, which would require further assessment and intervention.

2. 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.

3. The client with liver cirrhosis needs immediate intervention for which abnormal laboratory result?

• A. Prothrombin time (PT) of 14 seconds.
• B. Bilirubin of 1.2 mg/dL.
• C. Albumin of 4 g/dL.
• D. Ammonia level of 80 mcg/dL.

Correct answer: D

Rationale: An elevated ammonia level of 80 mcg/dL indicates hepatic encephalopathy, a serious complication of liver cirrhosis that requires immediate intervention. Ammonia is a neurotoxin that accumulates in the blood due to impaired liver function, leading to cognitive impairment and altered mental status. Monitoring and lowering ammonia levels are crucial in managing hepatic encephalopathy to prevent further neurological deterioration. Prothrombin time, bilirubin, and albumin levels are important parameters in assessing liver function and overall health status in clients with liver cirrhosis, but an elevated ammonia level poses an immediate threat to neurological function and warrants prompt attention.

4. When planning a community health fair to promote mental health awareness, which activity should be included to best engage participants?

• A. free mental health screenings
• B. lectures on mental health topics
• C. distribution of mental health resources
• D. interactive workshops on stress management

Correct answer: A

Rationale: The best activity to engage participants in a community health fair promoting mental health awareness is to offer free mental health screenings. This activity not only attracts participants but also provides them with immediate, valuable information about their mental health status. Free screenings can help raise awareness, encourage early detection of mental health issues, and prompt participants to seek further assistance if needed. Lectures, while informative, may not be as engaging or impactful as the personalized feedback individuals receive from screenings. Distributing resources is helpful, but active engagement through screenings is more effective in promoting awareness and encouraging action. Interactive workshops on stress management are beneficial but might not provide the same level of individualized insight into mental health as screenings do.

5. A community health nurse is evaluating the effectiveness of a recent smoking cessation program. Which outcome indicates success?

• A. increased attendance at support group meetings
• B. reduced number of cigarettes smoked per day
• C. higher sales of nicotine replacement products
• D. lower relapse rate among participants

Correct answer: D

Rationale: The correct answer is D: lower relapse rate among participants. A lower relapse rate indicates that participants are successfully quitting smoking and maintaining their cessation, which is the ultimate goal of a smoking cessation program. Increased attendance at support group meetings (choice A) may demonstrate engagement but does not necessarily indicate successful smoking cessation. Similarly, higher sales of nicotine replacement products (choice C) may reflect increased product usage but not necessarily successful smoking cessation. While reducing the number of cigarettes smoked per day (choice B) is a positive change, it does not guarantee successful smoking cessation or long-term abstinence.

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