Nursing Elites

1. The nurse is conducting a process evaluation of a prevention education program for older adults who are at risk for substance abuse. Which data source provides the information the nurse needs to conduct this process evaluation?

• A. client's score on an alcohol screening instrument
• B. results of a urine drug and alcohol screen
• C. most recent community census data
• D. documentation of client education in the nursing record

Correct answer: D

Rationale: Correct! Documentation of client education in the nursing record is the most appropriate data source for conducting a process evaluation of a prevention education program. This documentation provides insight into the educational process, its implementation, and the quality of education delivered. Choices A and B focus on assessing the clients directly for substance abuse, which is different from evaluating the educational process. Choice C, the most recent community census data, is not directly related to evaluating the specific prevention education program for older adults at risk for substance abuse.

2. A community health nurse is conducting a home visit to assess a family's health needs. What is the first step in this process?

• A. Develop a care plan
• B. Conduct a physical examination
• C. Establish rapport with the family
• D. Provide health education

Correct answer: C

Rationale: Establishing rapport with the family is crucial in the initial stages of a home visit. It helps build trust, open communication channels, and allows the nurse to gain insight into the family's health needs and concerns. Developing a care plan (Choice A) comes after the assessment phase, where information is gathered. Conducting a physical examination (Choice B) is a part of the assessment but typically follows establishing rapport. Providing health education (Choice D) is important but usually occurs after the assessment and care planning stages.

3. During an initial clinic visit, the nurse is taking the history for a client who wants to confirm her pregnancy. The client's last child has a history of low-birth-weight (LBW). Which additional finding is most important for the nurse to consider?

• A. Cigarette smoking.
• B. African American ethnicity.
• C. Poor nutritional status.
• D. Limited maternal education.

Correct answer: A

Rationale: The correct answer is A: Cigarette smoking. Cigarette smoking is a significant risk factor for low birth weight. Smoking during pregnancy reduces the amount of oxygen available to the baby, leading to LBW. Choice B, African American ethnicity, while it may be a risk factor, is not as directly linked to LBW as cigarette smoking. Choice C, poor nutritional status, can contribute to LBW but is not as significant as cigarette smoking in this case. Choice D, limited maternal education, is an important social determinant of health but is not as directly related to LBW as cigarette smoking.

4. Which facilities are capable of performing minor surgeries and some simple laboratory examinations?

• A. Secondary level health care
• B. Intermediate level care
• C. Tertiary level care
• D. Primary health care

Correct answer: A

Rationale: Secondary level health care facilities are equipped to perform minor surgeries and simple laboratory examinations. Intermediate level care (choice B) refers to a level of care between primary and secondary care, focusing on more complex procedures than minor surgeries. Tertiary level care (choice C) is specialized care that includes services like cardiac surgery and neurosurgery. Primary health care (choice D) is the first point of contact for individuals and is not typically equipped for minor surgeries or complex laboratory tests.

5. Which bioterrorism agent poses a high risk for use as a potential biological weapon due to its ability to be readily transmitted through several portals of entry?

• A. Anthrax.
• B. Smallpox.
• C. Botulism.
• D. Tularemia.

Correct answer: A

Rationale: The correct answer is Anthrax. Anthrax is a high-risk bioterrorism agent because it can be readily transmitted through multiple portals of entry such as inhalation, ingestion, or skin contact. This makes it a significant concern for use as a biological weapon. Smallpox, though highly contagious, is not known for multiple portals of entry like Anthrax. Botulism is a potent toxin but is not as easily transmissible through various routes as Anthrax. Tularemia, while a serious bacterial infection, does not have the same ease of transmission through multiple portals of entry as Anthrax.

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