Nursing Elites

1. The nurse is teaching a community group about risks of cardiovascular disease. Several clients ask the nurse to determine their risk. Which client should the nurse identify as having the greatest risk for cardiovascular disease?

• A. A male with a serum cholesterol level of 199 mg/dl.
• B. A female with a serum cholesterol level of 201 mg/dl.
• C. A male with a low-density lipoprotein (LDL) level of 200 mg/dl.
• D. A female with a low-density lipoprotein (LDL) level of 160 mg/dl.

Correct answer: C

Rationale: The correct answer is C. A male with a high LDL level (200 mg/dl) has a significant risk for cardiovascular disease. High levels of LDL cholesterol are associated with an increased risk of atherosclerosis and heart disease. Choices A, B, and D have serum cholesterol levels that are slightly elevated but are not as specific or directly linked to cardiovascular risk as high LDL levels. Therefore, the client with the high LDL level is at the greatest risk for cardiovascular disease.

2. In terms of CHN practice, how is the nurse in the community trained?

• A. nurse-midwife
• B. practice nursing
• C. generalist in nursing
• D. midwife

Correct answer: C

Rationale: In community health nursing practice, nurses are trained as generalists in nursing. They receive education that equips them to address a wide range of health concerns in the community. Choice A, nurse-midwife, is incorrect as it refers to a specific role focusing on childbirth and maternal health. Choice B, practice nursing, is vague and does not specifically describe the training of community health nurses. Choice D, midwife, is also incorrect as it refers to a specialized role in maternal and newborn care, different from the generalist training of community health nurses.

3. A client with a history of hypertension is receiving enalapril (Vasotec). The nurse should monitor the client for which of the following side effects?

• A. Hyperkalemia
• B. Hypoglycemia
• C. Hypercalcemia
• D. Hypokalemia

Correct answer: A

Rationale: The correct answer is A: Hyperkalemia. Enalapril, an ACE inhibitor, can lead to hyperkalemia as a side effect. ACE inhibitors can cause potassium retention by inhibiting aldosterone secretion, which may result in elevated potassium levels. Hypoglycemia (choice B) is not typically associated with enalapril use. Hypercalcemia (choice C) is also not a common side effect of enalapril. Hypokalemia (choice D) is the opposite of what is expected with enalapril, as it tends to cause potassium retention.

4. In a well-child clinic, the nurse examines many children daily. Which of the following toddlers requires further follow-up?

• A. A 13-month-old who is unable to walk
• B. A 20-month-old who is only using 2 and 3 word sentences
• C. A 24-month-old who cries during examination
• D. A 30-month-old who is only drinking from a sip cup

Correct answer: D

Rationale: The correct answer is D because a 30-month-old should have developed the skill to drink from a regular cup by this age. Drinking from a sip cup at this stage may indicate a delay in development. Choices A, B, and C are not as concerning as they can be within the range of normal development. A 13-month-old not walking yet, a 20-month-old using 2 and 3 word sentences, and a 24-month-old crying during examination are all behaviors that can fall within the spectrum of typical development for their respective ages.

5. When designing a community health project based on a report provided by the World Health Organization that describes healthcare problems in the United States, which healthcare issue should the nurse prioritize the highest when planning the project?

• A. Overuse of diagnostic technology.
• B. Government-based health insurance.
• C. The neonatal and infant mortality rates.
• D. Number of people without access to health care.

Correct answer: C

Rationale: The neonatal and infant mortality rates should be given the highest priority when planning the project because they are critical indicators of the overall health and healthcare system's effectiveness. High neonatal and infant mortality rates signify underlying issues in prenatal care, access to healthcare services, and quality of care for newborns and infants. Choice A, overuse of diagnostic technology, though important, may not be as critical as addressing neonatal and infant mortality rates. Choice B, government-based health insurance, is significant but may not directly impact neonatal and infant mortality rates. Choice D, the number of people without access to healthcare, is a crucial issue, but addressing neonatal and infant mortality rates should take precedence due to their immediate impact on the health and well-being of the most vulnerable population.

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