Nursing Elites

1. The nurse is providing discharge teaching to a client with chronic obstructive pulmonary disease (COPD). Which statement by the client indicates a need for further teaching?

• A. I will use my albuterol inhaler before exercising.
• B. I will avoid secondhand smoke.
• C. I will get a flu shot every year.
• D. I will limit my fluid intake to 2 liters per day.

Correct answer: A

Rationale: Using an albuterol inhaler before exercising is appropriate for clients with COPD to prevent exercise-induced bronchospasm.

2. A public health nurse is working with a community to improve access to healthcare services. Which intervention is most likely to be effective?

• A. Setting up mobile clinics in underserved areas
• B. Distributing flyers with information about local clinics
• C. Offering transportation vouchers for medical appointments
• D. Partnering with local businesses to provide healthcare discounts

Correct answer: A

Rationale: Setting up mobile clinics in underserved areas is the most effective intervention to improve access to healthcare services. Mobile clinics directly bring healthcare services to the community, making it convenient for residents to access care without having to travel long distances. Distributing flyers may increase awareness but may not address the barriers to access. Offering transportation vouchers helps with one aspect of access but does not directly provide healthcare services. Partnering with local businesses for discounts may not address the primary issue of physical access to healthcare services in underserved areas.

3. The nurse is developing a series of childbirth preparation classes for primigravida women and their significant others. What is the priority expected outcome for these classes?

• A. Participants can identify at least three coping strategies to use during labor.
• B. Participants can list signs of labor and when to come to the hospital.
• C. Participants can describe three pain relief measures to use during labor.
• D. Participants can perform three relaxation techniques to use during labor.

Correct answer: A

Rationale: The priority expected outcome for childbirth preparation classes is for participants to be able to identify coping strategies to use during labor. This is crucial as coping strategies can help women manage pain, stress, and anxiety during childbirth. Choice B is important but does not focus on coping strategies needed during labor. Choice C is relevant but focuses solely on pain relief measures which are a part of coping strategies. Choice D is also relevant but does not encompass all aspects of coping with labor effectively.

4. During a community health fair, the nurse conducts a blood pressure screening for a 60-year-old woman who has a blood pressure of 160/100 mm Hg. What should the nurse do first?

• A. Instruct the client to monitor her blood pressure at home
• B. Refer the client to her healthcare provider for further evaluation
• C. Educate the client on lifestyle changes to reduce blood pressure
• D. Recheck the blood pressure in 15 minutes

Correct answer: B

Rationale: When encountering a high blood pressure reading at a community health fair, it is essential for the nurse to refer the client to her healthcare provider for further evaluation. This step ensures that the client receives a comprehensive assessment, diagnosis, and appropriate management plan. In this scenario, it is crucial to prioritize professional evaluation over self-monitoring, lifestyle education, or immediate rechecking of the blood pressure. Referral to a healthcare provider allows for timely intervention and ongoing monitoring of the client's blood pressure to prevent potential complications.

5. Which annual screening should the nurse include when planning eye health programs at a preschool?

• A. visual acuity
• B. red light reflex
• C. conjunctivitis
• D. glaucoma

Correct answer: A

Rationale: The correct answer is A: visual acuity. Screening for visual acuity is essential in preschoolers to identify any vision issues early on, such as nearsightedness or farsightedness, which may require corrective lenses or other interventions. Red light reflex (choice B) is a method used to assess the eyes for abnormalities, but it is not typically included in routine preschool eye health screenings. Conjunctivitis (choice C) is an eye infection and not a screening test. Glaucoma (choice D) is a condition more commonly associated with adults and the elderly, making it less relevant for preschool eye health programs.

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