Nursing Elites

1. The parish nurse notes that an elderly male client has had a 5 lbs weight loss since his check-up one month ago. The client has good hygiene, still drives a car, and lives alone. To which agency should the nurse refer this client?

• A. the adult day care center
• B. the social security administration office
• C. the women, infants, and children office
• D. the senior citizen center

Correct answer: D

Rationale: The correct answer is 'D: the senior citizen center.' In this scenario, the elderly male client is experiencing unexplained weight loss, which could be indicative of underlying health issues or social isolation. Referring him to the senior citizen center is appropriate as it can provide social support, resources, and programs tailored to address the client's weight loss and overall well-being. Choice A, the adult day care center, is not the most suitable option as the client is still independent and living alone. Choice B, the social security administration office, and Choice C, the women, infants, and children office, are not relevant in this context and do not address the client's specific needs related to weight loss and social support.

2. A female client reports to the nurse that her sleep was interrupted by 'thoughts of anger towards my husband.' What type of thoughts is the client having?

• A. Obsessive.
• B. Phobic.
• C. Delusional.
• D. Paranoid.

Correct answer: A

Rationale: The correct answer is A: Obsessive. Obsessive thoughts are recurring, unwanted, and intrusive thoughts that cause distress or anxiety. In this scenario, the client is experiencing repetitive thoughts of anger towards her husband, indicating an inability to control these thoughts. Choice B, Phobic, is incorrect as phobic thoughts are related to irrational fears. Choice C, Delusional, is incorrect as delusional thoughts involve fixed false beliefs. Choice D, Paranoid, is incorrect as paranoid thoughts involve irrational suspicions and mistrust.

3. A nurse is developing a community health education program focused on preventing childhood obesity. Which intervention should be prioritized?

• A. Creating a school-based exercise program
• B. Distributing educational pamphlets on healthy eating
• C. Organizing a community health fair
• D. Partnering with local restaurants to offer healthy meal options

Correct answer: A

Rationale: The correct answer is A: Creating a school-based exercise program. This intervention directly addresses the need to increase physical activity among children, a crucial aspect in preventing childhood obesity. While distributing educational pamphlets on healthy eating (choice B) can be beneficial, promoting physical activity through a structured program is more effective in combating obesity. Organizing a community health fair (choice C) may raise awareness but may not lead to sustained behavior change like a structured exercise program. Partnering with local restaurants to offer healthy meal options (choice D) addresses nutrition but does not directly impact physical activity levels, which are essential in obesity prevention.

4. During a home visit, the nurse observes that a client with limited mobility has difficulty accessing the bathroom. What should the nurse do first?

• A. suggest the client install a bedside commode
• B. assist the client in modifying the home environment
• C. refer the client to an occupational therapist
• D. educate the client on mobility aids

Correct answer: A

Rationale: The correct answer is to suggest that the client installs a bedside commode. This option provides an immediate solution to the client's difficulty accessing the bathroom. While modifying the home environment (Choice B) and referring the client to an occupational therapist (Choice C) are important steps, suggesting a bedside commode addresses the immediate need efficiently. Educating the client on mobility aids (Choice D) can be beneficial but may not be the most urgent action required in this scenario.

5. The client is unable to void, and the plan of care sets an objective for the client to ingest at least 1000 mL of fluid between 7:00 am and 3:30 pm. Which client response should the nurse document to indicate a successful outcome?

• A. Drinks adequate fluids.
• B. Void without difficulty.
• C. Feels less thirsty.
• D. Drinks 240 mL of fluid five times during the shift.

Correct answer: D

Rationale: The correct answer is D. Drinking 240 mL of fluid five times during the shift indicates a fluid intake of 1200 mL, which exceeds the minimum objective of at least 1000 mL. The client meeting or exceeding the fluid intake goal is a clear indicator of a successful outcome. Choices A, B, and C are incorrect because simply drinking adequate fluids, voiding without difficulty, or feeling less thirsty do not directly demonstrate meeting the specific objective of fluid intake set in the care plan.

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