Nursing Elites

1. The healthcare provider is planning a health education session for new parents on infant care. Which topic should be prioritized?

• A. signs of infant dehydration
• B. proper diaper changing techniques
• C. immunization schedule
• D. breastfeeding positions

Correct answer: A

Rationale: Recognizing signs of infant dehydration is crucial for ensuring the health and well-being of infants. Dehydration can be life-threatening for infants if not addressed promptly. Proper diaper changing techniques, while important for hygiene, can be learned incrementally. The immunization schedule and breastfeeding positions are also essential topics, but identifying signs of dehydration takes precedence as it requires immediate attention to prevent serious complications.

2. A school nurse is planning a program to address bullying among students. Which strategy is most likely to be effective?

• A. Implementing a zero-tolerance policy for bullying
• B. Conducting peer mediation sessions
• C. Providing workshops on conflict resolution
• D. Promoting bystander intervention

Correct answer: D

Rationale: Promoting bystander intervention is the most effective strategy as it empowers students to take action and prevent bullying incidents. By encouraging bystanders to intervene when they witness bullying, the behavior is less likely to continue. Zero-tolerance policies may have limited effectiveness as they often focus on punishment rather than prevention. Peer mediation and conflict resolution workshops are valuable but may not directly address the immediate need for bystander intervention in bullying situations.

3. The healthcare provider is preparing to administer digoxin (Lanoxin) to a client. Which assessment finding should the healthcare provider report before administering the medication?

• A. Apical pulse of 58 beats per minute.
• B. Serum potassium level of 3.0 mEq/L.
• C. Blood pressure of 140/90 mm Hg.
• D. Client reports seeing halos around lights.

Correct answer: D

Rationale: Seeing halos around lights is a classic symptom of digoxin toxicity, known as visual disturbances. This finding indicates an adverse effect of digoxin and should be reported immediately to the healthcare provider. Monitoring for visual changes is crucial as it can progress to more severe toxicity, leading to life-threatening dysrhythmias or other complications. Apical pulse, serum potassium level, and blood pressure are important assessments when administering digoxin, but the presence of visual disturbances, such as seeing halos around lights, takes precedence due to its direct association with digoxin toxicity. Changes in these other parameters should also be noted and addressed, but they are not the priority when compared to a symptom directly linked to potential toxicity.

4. A community health nurse is helping a group of nursing students plan a tertiary prevention program for a local community clinic that serves a majority Hispanic population. Which service project meets the requirement of a tertiary prevention program and would best serve this population?

• A. teaching clients about recommended immunizations for children
• B. demonstrating foot care to a group of clients who have diabetes
• C. taking blood pressures at a local shopping mall in the community
• D. instructing teens about prevention of sexually transmitted diseases

Correct answer: B

Rationale: The correct answer is B. Tertiary prevention focuses on managing and improving health outcomes for existing conditions, such as diabetes. Demonstrating foot care to clients with diabetes aligns with this level of prevention by helping to prevent complications and promote better health outcomes. Choices A, C, and D do not specifically target existing conditions or chronic diseases, which are the focus of tertiary prevention programs.

5. A client is receiving atenolol (Tenormin) 25 mg PO after a myocardial infarction. The nurse determines the client's apical pulse is 65 beats per minute. What action should the nurse take next?

• A. Hold the medication.
• B. Call the healthcare provider.
• C. Administer the medication.
• D. Check the blood pressure.

Correct answer: C

Rationale: The correct action for the nurse to take next is to administer the medication. Atenolol is a beta-blocker commonly used post-myocardial infarction to reduce the workload of the heart. The client's apical pulse of 65 beats per minute is within the acceptable range after a myocardial infarction. Holding the medication or calling the healthcare provider is not necessary in this scenario as the pulse rate is appropriate for administering atenolol. Checking the blood pressure is not the priority in this situation, as the focus should be on the heart rate when administering atenolol.

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