Nursing Elites

1. The healthcare provider is caring for a client with a urinary tract infection. Which finding requires immediate intervention?

• A. Dysuria.
• B. Hematuria.
• C. Fever.
• D. Urinary frequency.

Correct answer: C

Rationale: Fever can indicate a severe infection, such as pyelonephritis, in a client with a urinary tract infection and requires immediate intervention. Hematuria and dysuria are common symptoms of a urinary tract infection but may not always require immediate intervention unless severe. Urinary frequency is also a common symptom and does not indicate the severity of the infection as fever does.

2. In a community clinic where a recent case of tuberculosis (TB) has been diagnosed, which client who attended the clinic is at the highest risk for presenting with TB?

• A. a young adult who works as a daycare worker
• B. an adult who works in a corporate office
• C. an adolescent who attends the community high school
• D. an adult with a history of alcoholism and homelessness

Correct answer: D

Rationale: Individuals who are homeless and have a history of alcoholism are at the highest risk for presenting with TB in this scenario. Homeless individuals often live in crowded conditions with poor ventilation, increasing the likelihood of TB transmission. Additionally, alcoholism can weaken the immune system, making individuals more susceptible to developing TB. The other options, such as a daycare worker, an office worker, or a high school student, do not inherently carry the same level of risk factors for TB transmission as being homeless with a history of alcoholism.

3. A public health nurse is implementing a program to improve vaccination rates among children in the community. Which intervention is most likely to be effective?

• A. Offering vaccinations at convenient locations and times
• B. Distributing educational materials about vaccines
• C. Providing incentives for getting vaccinated
• D. Hosting informational sessions for parents

Correct answer: A

Rationale: Offering vaccinations at convenient locations and times is the most effective intervention as it reduces barriers to access and makes it easier for parents to get their children vaccinated. This strategy directly addresses the issue of convenience and accessibility, which are common reasons for low vaccination rates. Distributing educational materials about vaccines (Choice B) can be helpful but may not directly address access issues. Providing incentives for getting vaccinated (Choice C) may be controversial and not sustainable in the long term. Hosting informational sessions for parents (Choice D) can be beneficial for education but may not directly improve vaccination rates as much as increasing access.

4. A client with a history of peptic ulcer disease is admitted with severe epigastric pain. Which finding requires immediate intervention?

• A. Nausea and vomiting.
• B. Hematemesis.
• C. Melena.
• D. Rebound tenderness.

Correct answer: D

Rationale: In a client with a history of peptic ulcer disease presenting with severe epigastric pain, the finding that requires immediate intervention is rebound tenderness. Rebound tenderness can indicate peritonitis, a serious condition that necessitates immediate medical attention. Nausea and vomiting, hematemesis, and melena are also concerning symptoms in a client with a history of peptic ulcer disease, but they do not signify the urgency of intervention as rebound tenderness does.

5. The community health nurse believes that immunization rates in a lower socioeconomic section of the city are probably below the target set by the state health department. What action should the nurse take first to intervene with this health problem?

• A. join a political action group that focuses attention on the issue in the local news media
• B. partner with a local children's hospital in setting up free 'shot' clinics in the neighborhood
• C. review current epidemiological population data that might document a low immunization rate
• D. call a meeting of citizens to inform them of the importance of having their children immunized

Correct answer: C

Rationale: The most appropriate initial action for the community health nurse to take when addressing low immunization rates in a lower socioeconomic area is to review current epidemiological data. By reviewing this data, the nurse can gather evidence that documents the low immunization rate in the community. This information is crucial to support the need for targeted interventions to increase immunization rates. Choices A, B, and D involve actions that may be important at later stages of intervention but are not the first step. Joining a political action group, partnering with a hospital for clinics, or holding a community meeting are all valuable strategies, but they should be based on evidence obtained from reviewing epidemiological data to ensure targeted and effective interventions.

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