Nursing Elites

1. The occupational health nurse is completing a yearly self-evaluation. Which activity should the nurse document as an example of proficient performance criteria in professionalism?

• A. contributes money to a professional society or organization
• B. maintains chairmanship of the hospital nursing council
• C. documents the nursing process in care management
• D. develops policy initiatives that impact occupational health and safety

Correct answer: D

Rationale: The correct answer is D because developing policy initiatives that impact occupational health and safety demonstrates leadership and proficiency in contributing to the field. Choices A, B, and C do not directly relate to professionalism criteria in the context of occupational health nursing. Contributing money to a professional society, maintaining chairmanship of a nursing council, or documenting the nursing process, while important, do not specifically highlight the nurse's impact on occupational health and safety through policy development.

2. Community health nurses are particularly concerned with the source of communicable diseases such as hepatitis A. Which group of individuals have a higher risk of contracting that type of hepatitis?

• A. IV drug users who share needles
• B. low-income families living in cramped quarters
• C. those who have recently received a blood transfusion
• D. sexually active persons with multiple partners

Correct answer: B

Rationale: The correct answer is B. Hepatitis A is often spread through close personal contact and poor sanitary conditions, which are more common in low-income, cramped living situations. IV drug users sharing needles are at higher risk of hepatitis B and C due to bloodborne transmission. Those who have recently received a blood transfusion are at risk of hepatitis C or other bloodborne infections. Sexually active persons with multiple partners are at risk of hepatitis B, which can be transmitted through sexual contact.

3. During which home visit performed by a registered nurse or a practical nurse can the home healthcare agency expect Medicare reimbursement for documenting a skilled care service provided?

• A. 13-18 years of age
• B. 11-12 years of age
• C. 18-24 months of age
• D. 4-6 years of age

Correct answer: D

Rationale: The correct answer is D: 4-6 years of age. According to current CDC guidelines, a child receiving the measles, mumps, rubella (MMR) vaccine at 12 months of age should plan to receive the MMR booster between 4-6 years of age. Choices A, B, and C are incorrect as they do not align with the CDC's recommended age range for the MMR vaccine booster. It is crucial for healthcare providers to stay updated with current guidelines to ensure the timely administration of vaccines for optimal protection.

4. Because this year's demographics reflect that a large percentage of the population is less than 19 years of age, a community group proposes building a new well-child clinic. Which question indicates that the nurse understands the potential gaps in this data?

• A. What percentage of the population was under 19 years of age in each of the previous 5 years?
• B. What is the distribution of males to females within this population?
• C. How can the income level of the families within the community be determined?
• D. How will the large percentage under 19 years affect the community dependency ratio?

Correct answer: A

Rationale: Option A is the correct answer because understanding the percentage of the population under 19 years of age in each of the previous five years helps to determine if the high percentage of youth is a consistent trend or a recent change. This information is crucial for assessing the need for a new well-child clinic. Choices B, C, and D are incorrect because they do not directly address the gaps in the data related to the age distribution trend over time, which is essential for making an informed decision about the necessity of the proposed clinic.

5. A client who is receiving intravenous heparin therapy has an activated partial thromboplastin time (aPTT) of 90 seconds. Which action should the nurse take?

• A. Continue the heparin infusion as prescribed.
• B. Decrease the heparin infusion rate.
• C. Increase the heparin infusion rate.
• D. Stop the heparin infusion and notify the healthcare provider.

Correct answer: D

Rationale: An aPTT of 90 seconds is significantly elevated, indicating a high risk of bleeding due to excessive anticoagulation. In this case, the heparin infusion should be stopped immediately to prevent further anticoagulation and an increased bleeding risk. Notifying the healthcare provider is essential to discuss alternative anticoagulation strategies or interventions. Continuing heparin therapy without action could lead to severe bleeding complications. Decreasing or increasing the heparin infusion rate would exacerbate the risk of bleeding, making options A, B, and C incorrect.

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