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 school nurse is organizing a vaccination clinic for middle school students. Which vaccine is most important for the nurse to include?

• A. hepatitis B
• B. tetanus, diphtheria, and pertussis (Tdap)
• C. varicella
• D. measles, mumps, and rubella (MMR)

Correct answer: B

Rationale: The most important vaccine for the school nurse to include in the vaccination clinic for middle school students is the tetanus, diphtheria, and pertussis (Tdap) vaccine. Tdap is recommended for preteens as part of the routine vaccination schedule to protect against these serious diseases. Hepatitis B, varicella, and MMR vaccines are also important but for this specific age group, Tdap takes precedence to ensure protection against tetanus, diphtheria, and pertussis.

3. A community health nurse is helping a group of nursing students plan a tertiary prevention program for a local community clinic that serves a majority Hispanic population. Which service project meets the requirement of a tertiary prevention program and would best serve this population?

• A. teaching clients about recommended immunizations for children
• B. demonstrating foot care to a group of clients who have diabetes
• C. taking blood pressures at a local shopping mall in the community
• D. instructing teens about prevention of sexually transmitted diseases

Correct answer: B

Rationale: The correct answer is B. Tertiary prevention focuses on managing and improving health outcomes for existing conditions, such as diabetes. Demonstrating foot care to clients with diabetes aligns with this level of prevention by helping to prevent complications and promote better health outcomes. Choices A, C, and D do not specifically target existing conditions or chronic diseases, which are the focus of tertiary prevention programs.

4. The nurse is planning a community health fair to promote mental health awareness. Which activity is most likely to engage participants?

• A. a lecture on the signs and symptoms of depression
• B. a workshop on stress management techniques
• C. a panel discussion with mental health experts
• D. a booth distributing brochures on mental health resources

Correct answer: B

Rationale: A workshop on stress management techniques is the most engaging activity as it allows participants to actively participate, learn practical skills, and interact with others. This hands-on approach fosters engagement and provides attendees with tools they can directly apply in their lives. Choice A, a lecture, may be informative but lacks the interactive element that promotes engagement. Choice C, a panel discussion, might be informative but could be passive for attendees. Choice D, distributing brochures, is informative but lacks the interactive and engaging nature of a workshop.

5. A client who has been receiving chemotherapy for cancer has a platelet count of 20,000/mm3. Which intervention should the nurse include in the plan of care?

• A. Apply ice packs to bruised areas.
• B. Encourage frequent oral hygiene.
• C. Avoid invasive procedures.
• D. Place the client in a private room.

Correct answer: C

Rationale: The correct intervention for a client with a platelet count of 20,000/mm3 due to chemotherapy is to avoid invasive procedures. Chemotherapy can cause a decrease in platelet count, leading to an increased risk of bleeding. By avoiding invasive procedures, the nurse helps reduce the risk of bleeding complications. Applying ice packs to bruised areas (Choice A) may further increase the risk of bleeding due to the pressure and potential trauma to the skin. Encouraging frequent oral hygiene (Choice B) is important for overall health but does not directly address the risk of bleeding associated with a low platelet count. Placing the client in a private room (Choice D) is not directly related to managing the platelet count and risk of bleeding; it is more about privacy and infection control, which are important but not the priority in this scenario.

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