Nursing Elites

1. When asked to help develop interventions to combat obesity among children, the community health nurse should stress the importance of implementing which activity?

• A. Set goals that are focused on developing healthier lifestyles.
• B. Develop strict diet plans for school-aged children.
• C. Provide diet classes for obese children during school hours.
• D. Require all children to participate in organized team sports.

Correct answer: A

Rationale: The correct answer is A: Setting goals that are focused on developing healthier lifestyles. This approach is essential in combating childhood obesity as it promotes sustainable habits and behaviors. Option B, developing strict diet plans, may not be effective in the long term and could lead to unhealthy relationships with food. Option C, providing diet classes during school hours, may not address the root causes of obesity and could potentially stigmatize the children. Option D, requiring all children to participate in organized team sports, may not be feasible for all children and might not address dietary habits and sedentary behaviors.

2. A client with chronic congestive heart failure should be instructed to contact the home health nurse if which finding occurs?

• A. Weight gain of 2 pounds or more in a 48-hour period
• B. Urinating 4 to 5 times a day
• C. A significant decrease in appetite
• D. Appearance of non-pitting ankle edema

Correct answer: A

Rationale: A rapid weight gain of 2 pounds or more in a 48-hour period may indicate fluid retention and worsening heart failure, requiring prompt medical evaluation and intervention. This finding is crucial in managing chronic congestive heart failure as it signifies a potential exacerbation of the condition. Choices B, C, and D are less concerning in this context. Urinating 4 to 5 times a day is within the normal range for most individuals and may not be directly related to heart failure. A significant decrease in appetite may be due to various factors and might not be an immediate cause for concern in heart failure patients. The appearance of non-pitting ankle edema, although related to heart failure, is a more chronic and less urgent symptom when compared to a rapid weight gain, which requires immediate attention.

3. Which of the following measures the proportion of the population that exhibits a particular disease at a particular time and includes both new and old cases?

• A. proportionate morbidity rate
• B. case fatality rate
• C. incidence ratio
• D. prevalence ratio

Correct answer: D

Rationale: The correct answer is D, prevalence ratio. Prevalence ratio measures the proportion of the population with a particular disease at a specific time, including both new and existing cases. Choice A, proportionate morbidity rate, is not a standard term and might confuse students. Choice B, case fatality rate, measures the proportion of deaths from a specific disease compared to the total number of cases but does not include both new and old cases. Choice C, incidence ratio, measures the rate of new cases of a disease in a specific population over a defined period, not considering existing cases.

4. The multidisciplinary home health care team is discussing a female client diagnosed with Parkinson's disease. The home health care nurse reports the client is getting worse, and her husband is no longer able to care for her in the home. Which action should the home health nurse implement first?

• A. Request a chaplain to counsel the couple.
• B. Assign a home health care aide to provide daily care.
• C. Discuss placing the wife in a nursing home with the husband.
• D. Contact the client's children to discuss the situation.

Correct answer: B

Rationale: In situations where a client's condition worsens and the caregiver is no longer able to provide sufficient care, the first action to implement is to assign a home health care aide to provide daily care. This ensures that the client's immediate needs are met and that they receive proper care and support. Requesting a chaplain for counseling (Choice A) may be beneficial but is not the most urgent action. Discussing placing the wife in a nursing home (Choice C) should only be considered after assessing the client's needs and exploring all other options. Contacting the client's children (Choice D) can be helpful but does not address the immediate need for daily care that the client requires.

5. A client with heart failure is receiving digoxin (Lanoxin). The nurse should monitor the client for which of the following signs of digoxin toxicity?

• A. Tachycardia
• B. Hypotension
• C. Bradycardia
• D. Hyperglycemia

Correct answer: C

Rationale: The correct answer is C: Bradycardia. Digoxin toxicity often presents with bradycardia, which is a common sign of toxicity associated with this medication. Tachycardia (Choice A) is not typically seen with digoxin toxicity. Hypotension (Choice B) can occur but is less specific to digoxin toxicity. Hyperglycemia (Choice D) is not a typical sign of digoxin toxicity. Therefore, monitoring for bradycardia is crucial in clients receiving digoxin to detect toxicity early.

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