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. A home health nurse is reviewing the laboratory results for several clients with heart failure. Which client finding would the nurse report to the health care provider immediately?

• A. Total cholesterol 190
• B. Glycosylated hemoglobin of 7%
• C. B-type natriuretic peptide 550 pg/ml (more than 100 is concerning)
• D. Potassium 3.7

Correct answer: C

Rationale: An elevated B-type natriuretic peptide level indicates worsening heart failure, requiring immediate attention. This biomarker reflects the severity of heart failure and helps guide treatment decisions. Total cholesterol and glycosylated hemoglobin are important for assessing cardiovascular risk and diabetes management but are not indicative of acute heart failure exacerbation. A potassium level of 3.7 falls within the normal range and does not suggest an immediate concern in the context of heart failure.

3. A school nurse is providing education on the importance of physical activity to elementary school students. Which activity is most appropriate for this age group?

• A. a lecture on the benefits of exercise
• B. an interactive game that involves physical movement
• C. a worksheet about different types of physical activities
• D. a video presentation on famous athletes

Correct answer: B

Rationale: An interactive game that involves physical movement is the most appropriate activity for elementary school students when educating them on the importance of physical activity. This choice is preferred because it engages children directly in physical activity, making the learning experience fun, interactive, and memorable. Children at this age group learn best through hands-on experiences and active participation, which can be effectively facilitated through interactive games. Choices A, C, and D are less suitable for this age group as they do not actively involve children in physical movement or interactive learning experiences. A lecture may not be engaging enough for young children, a worksheet may not provide the required level of activity, and a video presentation may not offer the same level of direct engagement and participation as an interactive game.

4. A nurse is planning a community health fair to promote cardiovascular health. Which activity should be included to best engage participants?

• A. free blood pressure screenings
• B. lectures on heart-healthy diets
• C. distribution of pamphlets on heart disease
• D. cooking demonstrations of healthy recipes

Correct answer: A

Rationale: Offering free blood pressure screenings should be included in the community health fair to best engage participants. This activity provides immediate, valuable information about participants' cardiovascular health. Blood pressure screenings are interactive, engaging, and offer personalized insights that can motivate individuals to take action towards improving their heart health. Lectures on heart-healthy diets, distribution of pamphlets, and cooking demonstrations, although beneficial, may not have the same level of immediate impact and engagement as the hands-on experience of getting one's blood pressure checked.

5. When caring for a client with a chest tube, which intervention is most important to include in the plan of care?

• A. Maintain continuous suction on the chest tube.
• B. Clamp the chest tube during client movement.
• C. Ensure that the chest tube is clamped for at least 8 hours each day.
• D. Keep the collection chamber below the level of the chest.

Correct answer: D

Rationale: Keeping the collection chamber below the level of the chest is crucial in caring for a client with a chest tube. This positioning helps ensure proper drainage of fluids and prevents complications such as backflow of drainage into the chest cavity. Option A is incorrect as continuous suction can lead to excessive drainage and tissue damage. Option B is incorrect as clamping the chest tube during client movement can cause a buildup of pressure and compromise proper drainage. Option C is incorrect because clamping the chest tube for extended periods can impede the drainage process, leading to potential complications.

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