Nursing Elites

1. The public health nurse is preparing to administer flu vaccines at a community center. Which group should the nurse prioritize for vaccination?

• A. children under 5 years old
• B. adults aged 50-65
• C. pregnant women
• D. healthcare workers

Correct answer: C

Rationale: Pregnant women should be prioritized for flu vaccination as they are at higher risk for complications from the flu. During pregnancy, changes in the immune, heart, and lung functions make pregnant women more susceptible to severe illness from the flu. Vaccinating pregnant women not only protects them but also provides passive immunity to their newborns. Children under 5, adults aged 50-65, and healthcare workers are important groups for vaccination but do not have the same level of increased risk for flu complications as pregnant women.

2. When assessing the health of a community, what is the most important information for the nurse to obtain?

• A. life expectancy of community members
• B. mortality rates in the community
• C. description of health problems by community leaders
• D. expressed needs of community members

Correct answer: D

Rationale: The most important information for a nurse to obtain when assessing the health of a community is the expressed needs of community members. This information helps in tailoring health interventions to address specific concerns directly expressed by the community. Options A and B focus on statistical data rather than individual needs. Option C, while valuable, may not always capture the full spectrum of health issues faced by the community as perceived by the residents themselves.

3. During a home visit, a nurse observes an older client who is attempting to ambulate to the bathroom and notes that the client is unsteady and holds onto the furniture while refusing any assistance. Which action should the nurse implement?

• A. determine home navigational safety hazards
• B. maintain the client's privacy while in the bathroom
• C. recommend that the client obtain a walker
• D. encourage the client to obtain a medical alert device

Correct answer: A

Rationale: The correct action for the nurse to implement is to determine home navigational safety hazards. In this scenario, the client is unsteady and holds onto furniture while refusing assistance, indicating a risk of falls. By identifying and addressing home safety hazards, the nurse can help prevent potential accidents. Maintaining privacy in the bathroom (Choice B) is important but not the priority in this situation. Recommending a walker (Choice C) or a medical alert device (Choice D) may be appropriate interventions later but addressing home safety hazards is the immediate concern.

4. A client with a head injury is admitted to the hospital. Which finding indicates a need for immediate intervention?

• A. Glasgow Coma Scale (GCS) score of 15.
• B. Pupils are equal and reactive to light.
• C. Client is drowsy but arousable.
• D. Client does not remember the events leading to the injury.

Correct answer: C

Rationale: In a client with a head injury, being drowsy but still arousable can be a sign of increased intracranial pressure, which necessitates immediate intervention. This presentation may indicate a deterioration in neurological status, requiring prompt assessment and management to prevent further complications. Choices A, B, and D are not indicative of an immediate need for intervention in this scenario. A Glasgow Coma Scale (GCS) score of 15 indicates the highest level of consciousness; pupils being equal and reactive to light suggest intact cranial nerve function, and memory loss about the injury event is common in head injuries and does not necessarily warrant immediate intervention.

5. During a 2-week postoperative follow-up home visit, a female client who had gastric bypass surgery exhibits abdominal tenderness, shoulder pain, and describes feelings of malaise. Her vital signs are: T 101.8, BP 100/50, HR 104, and RR 18. Which action should the RN take?

• A. have the client transported via ambulance to the hospital
• B. recheck the client's vital signs in 30 minutes
• C. instruct the client to drive to the hospital for admission
• D. assess the client's current symptoms

Correct answer: A

Rationale: The client is presenting with signs of a potential postoperative complication, such as fever, low blood pressure, and tachycardia, which could indicate sepsis or another serious issue. These symptoms require immediate hospital evaluation and management. Option B of rechecking vital signs in 30 minutes could delay crucial intervention in a potentially life-threatening situation. Option C is unsafe as the client should not drive herself due to her condition. Option D is vague and does not address the urgency of the situation.

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