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. 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.

3. Several employees who have a 10-year or longer smoking history ask for assistance with smoking cessation. A nurse develops a 2-month program that includes weekly group sessions on lifestyle changes and use of over-the-counter nicotine substitute products. Which measurement provides the best indication of the program's effectiveness?

• A. survey employees to determine how many are smoking 2 months after the end of the program
• B. test the employees' knowledge of OTC nicotine substitute products at the end of the program
• C. ask employees to inform the group if they stop smoking and if they start smoking again
• D. design a questionnaire that identifies lifestyle changes contributing to smoking cessation

Correct answer: A

Rationale: Surveying employees to determine how many are smoking 2 months after the end of the program provides a direct assessment of the program's effectiveness. This measurement evaluates the actual behavior change related to smoking cessation. Choice B, testing knowledge of OTC nicotine substitute products, does not directly measure smoking cessation outcomes. Choice C relies on self-reporting, which may not be accurate or reliable. Choice D focuses on identifying lifestyle changes but does not directly assess the program's impact on smoking cessation.

4. During a home visit, the nurse observes that a client with limited mobility has difficulty accessing the bathroom. What should the nurse do first?

• A. suggest the client install a bedside commode
• B. assist the client in modifying the home environment
• C. refer the client to an occupational therapist
• D. educate the client on mobility aids

Correct answer: A

Rationale: The correct answer is to suggest that the client installs a bedside commode. This option provides an immediate solution to the client's difficulty accessing the bathroom. While modifying the home environment (Choice B) and referring the client to an occupational therapist (Choice C) are important steps, suggesting a bedside commode addresses the immediate need efficiently. Educating the client on mobility aids (Choice D) can be beneficial but may not be the most urgent action required in this scenario.

5. The nurse is designing a community health project based on a report provided by the World Health Organization that describes healthcare problems in the United States. Which healthcare issue should the nurse give the highest priority when planning the project?

• A. overuse of diagnostic technology
• B. government-based health insurance
• C. the neonatal and infant mortality rates
• D. number of people without access to healthcare

Correct answer: D

Rationale: The correct answer is D: number of people without access to healthcare. Ensuring access to healthcare is fundamental to addressing a wide range of health issues and is a priority for improving overall community health. Option A, overuse of diagnostic technology, though important, is not the highest priority when considering basic access to healthcare. Option B, government-based health insurance, is relevant but may not directly address the issue of lack of access for all individuals. Option C, neonatal and infant mortality rates, is crucial but addressing access to healthcare for all individuals is a more immediate and foundational concern for the community health project.

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