Nursing Elites

1. The school nurse who is reviewing immunization records of students who will start kindergarten within the next month notes that most of the students have only received one dose of the measles, mumps, rubella (MMR) vaccine. Which intervention should the nurse implement?

• A. Note in the student records that the second dose of the MMR vaccine should be administered prior to entering first grade
• B. Send notices home with the children on the first day of class advising that MMR vaccine series must be completed
• C. Contact kindergarten parents to remind them that the second dose of MMR is due at the start of the school year
• D. Speak at the next parent-teacher association meeting to teach parents the benefits of immunizing their children

Correct answer: C

Rationale: The correct intervention for the school nurse is to contact kindergarten parents to remind them that the second dose of the MMR vaccine is due at the start of the school year. This approach directly addresses the issue of incomplete vaccination coverage and ensures that children receive the complete vaccination on time. Choice A is incorrect as it only notes the need for the second dose without actively engaging parents. Choice B is not as effective as directly contacting parents and may lead to delays in completing the vaccination series. Choice D, while promoting immunization, does not directly address the current situation of incomplete MMR vaccination among the kindergarten students.

2. Which bioterrorism agent is at high risk for use as a potential biological weapon that is readily transmitted by several portals of entry?

• A. anthrax
• B. smallpox
• C. botulism
• D. tularemia

Correct answer: A

Rationale: Anthrax is the correct answer. Anthrax spores can be transmitted through inhalation, ingestion, or skin contact, making it a high-risk agent for bioterrorism. Smallpox, botulism, and tularemia are also potential bioterrorism agents, but they do not have the same versatility in terms of multiple portals of entry, unlike anthrax.

3. A client with a history of alcohol abuse is admitted with cirrhosis. Which finding requires immediate intervention?

• A. Jaundice.
• B. Ascites.
• C. Peripheral edema.
• D. Spider angiomas.

Correct answer: C

Rationale: Peripheral edema in a client with cirrhosis can indicate fluid overload and worsening liver function, necessitating immediate intervention to prevent further complications such as respiratory distress, cardiac issues, or renal impairment. Jaundice (choice A) is a common manifestation of cirrhosis but may not require immediate intervention unless severe. Ascites (choice B) is also a common complication of cirrhosis that may require intervention but is not as urgent as addressing peripheral edema. Spider angiomas (choice D) are typically benign skin lesions associated with cirrhosis but do not require immediate intervention unless bleeding or rupture occurs.

4. The healthcare provider is caring for a client with a chest tube following thoracic surgery. Which intervention should the healthcare provider include in the plan of care?

• A. Clamp the chest tube for 30 minutes every 2 hours.
• B. Milk the chest tube to ensure patency.
• C. Keep the drainage system at the level of the chest.
• D. Ensure that the chest tube is not clamped or kinked.

Correct answer: D

Rationale: Ensuring that the chest tube is not clamped or kinked is essential to maintain proper drainage and prevent complications. Clamping the chest tube can lead to a buildup of pressure in the pleural space, causing potential harm to the client. Milking the chest tube is not recommended as it can cause damage to the delicate tubing. Keeping the drainage system at the level of the chest ensures proper drainage by gravity, preventing backflow of fluids, but ensuring the tube is not clamped or kinked takes precedence in this scenario.

5. The healthcare professional is developing a community health program to address the high rates of childhood asthma in a neighborhood. Which intervention should the healthcare professional prioritize?

• A. conducting home visits to identify asthma triggers
• B. distributing asthma education materials at schools
• C. holding workshops on asthma management for parents
• D. partnering with local healthcare providers to offer free asthma screenings

Correct answer: A

Rationale: The healthcare professional should prioritize conducting home visits to identify asthma triggers as it is crucial for reducing asthma attacks in children. By identifying triggers in the home environment, interventions can be implemented to create a safer living space for children with asthma. This approach directly addresses the root cause of asthma exacerbations. Distributing asthma education materials at schools is beneficial for raising awareness but may not address individual triggers. Holding workshops on asthma management for parents is valuable for education but does not directly tackle trigger identification. Partnering with local healthcare providers to offer free asthma screenings focuses on detection rather than prevention through trigger identification.

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