Nursing Elites

1. The public health nurse is called to investigate a report of several cases of chickenpox at a daycare center. The daycare worker states that five children have been sent home over the past two weeks with fever and itchy blisters. Which intervention should the nurse implement first?

• A. Validate that the children sent home did develop chickenpox
• B. Report the presence of a viral endemic at the daycare center
• C. Confirm the number of children with symptoms
• D. Determine how many people have been exposed

Correct answer: A

Rationale: Validating that the children sent home did develop chickenpox is the most crucial initial step for the nurse. This intervention ensures that the appropriate public health measures are implemented for the containment of chickenpox. Reporting a viral endemic or confirming the number of children with symptoms may be important but are secondary to confirming the diagnosis. Determining the number of people exposed comes after confirming the diagnosis to assess the extent of the outbreak and implement necessary control measures.

2. The healthcare provider is developing a community outreach program to address childhood obesity. Which intervention should the healthcare provider implement first?

• A. conduct a survey to assess dietary habits and physical activity levels
• B. develop educational materials on healthy eating and exercise
• C. partner with local schools to promote physical activity programs
• D. organize community events that encourage healthy lifestyle choices

Correct answer: A

Rationale: Conducting a survey to assess dietary habits and physical activity levels should be the initial step in developing a community outreach program to address childhood obesity. By gathering data through a survey, the healthcare provider can identify specific needs, preferences, and challenges within the community. This information is crucial for designing tailored interventions that are more likely to be effective. Developing educational materials (Choice B) can come after understanding the community's needs through the survey. Partnering with local schools (Choice C) and organizing community events (Choice D) are important strategies but should be planned based on the data obtained from the survey to ensure relevance and impact.

3. 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.

4. After coronary artery bypass graft surgery, a male client is admitted to the coronary care unit. Which nursing diagnosis is of the highest priority?

• A. Ineffective breathing pattern.
• B. Impaired gas exchange.
• C. Acute pain.
• D. Risk for infection.

Correct answer: B

Rationale: Impaired gas exchange is the highest priority nursing diagnosis because it directly impacts the client's oxygenation. Following coronary artery bypass graft surgery, ensuring adequate oxygen exchange is crucial for the client's recovery. Ineffective breathing pattern, although important, may not be as critical as impaired gas exchange in the immediate postoperative period. Acute pain, while significant, can be managed effectively with appropriate interventions and is not as emergent as addressing impaired gas exchange. Risk for infection is also a valid concern post-surgery, but ensuring optimal gas exchange takes precedence to prevent complications associated with inadequate oxygenation.

5. During a follow-up visit, a client with diabetes reports difficulty maintaining a healthy diet. What should the nurse do first?

• A. Provide the client with meal planning resources
• B. Explore the client's dietary habits and challenges
• C. Refer the client to a nutritionist
• D. Educate the client on the importance of a healthy diet

Correct answer: B

Rationale: When a client with diabetes reports difficulty in maintaining a healthy diet, the initial action should be to explore the client's dietary habits and challenges. By doing so, the nurse can identify specific issues and barriers the client faces, which is crucial in developing a personalized and effective intervention plan. Providing meal planning resources (Choice A) can be beneficial later but should come after understanding the client's unique situation. Referring the client to a nutritionist (Choice C) may be necessary in some cases but should follow an assessment of the client's current challenges. Simply educating the client on the importance of a healthy diet (Choice D) does not address the specific difficulties the client is facing and may not lead to sustainable behavior change.

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