Nursing Elites

1. Why is Kleinman's Explanatory Model of Health and Illness significant?

• A. it explains the health beliefs a family is likely to have.
• B. it emphasizes the role of culture in shaping health explanations.
• C. it discusses the significant role of popular and folk domains of influence.
• D. it is structured based on education.

Correct answer: B

Rationale: Kleinman's Explanatory Model of Health and Illness is significant because it emphasizes the crucial role that popular and folk domains of influence play in shaping individuals' understanding of health and illness. Kleinman distinguishes between disease, which is the biomedical understanding of health problems, and illness, which is the individual's personal interpretation of their health condition. By focusing on the cultural factors that influence these domains of influence, Kleinman's model underscores the impact of cultural beliefs and practices on health perceptions. Choice A is incorrect because the model goes beyond just family health beliefs. Choice B is more precise as it emphasizes the broader influence of culture. Choice C highlights the correct significance of popular and folk domains of influence, making it the correct choice. Choice D is incorrect as the model's significance lies in cultural domains, not educational structure.

2. The LPN is about to give 100 mg Lopressor (metoprolol) to a client. Before administering the drug, they take the patient's vitals, which are as follows: Pulse: 58 Blood Pressure: 90/62 Respirations: 18/minute What action should the LPN take?

• A. Give the client half the prescribed dose and report the findings to the RN on duty.
• B. Give the client double the dose and report the findings to the RN on duty.
• C. Administer the drug and report the findings to the RN on duty.
• D. Hold the drug and report the findings to the RN on duty.

Correct answer: D

Rationale: Lopressor is given to treat hypertension, and a pulse of 58 and a blood pressure of 90/62 are considered low. To prevent the client from bottoming out, the drug should be held, and the findings reported to the RN, who should consult with the attending physician. LPNs should never adjust client dosing, as that is outside of their scope of practice. It is crucial to follow facility guidelines, which often recommend holding blood pressure medication at 60 bpm and a systolic pressure of 90 or less. By holding the drug and notifying the RN, the LPN ensures the client's safety and allows for appropriate assessment and decision-making by the healthcare team. Giving half the dose or double the dose without proper authorization can lead to serious complications and is considered unsafe practice.

3. Nurses caring for clients who have cancer and are taking opioids need to assess for all of the following except:

• A. tolerance.
• B. constipation.
• C. sedation.
• D. addiction.

Correct answer: D

Rationale: The correct answer is 'addiction.' When caring for clients with cancer who are taking opioids, nurses need to assess for tolerance, constipation, and sedation as these are common side effects of opioid use. Addiction is not a primary concern when managing pain in terminally ill clients, as the goal is effective pain management rather than addiction prevention. Tolerance refers to the body's adaptation to the opioid over time, requiring higher doses for the same effect. Constipation and sedation are common side effects of opioids that nurses need to monitor and manage. Addiction is not a major concern in this population as the focus is on providing comfort and pain relief.

4. What is one of the main goals of Healthy People 2010?

• A. reduction of health care costs
• B. elimination of health disparities
• C. investigation of substance abuse
• D. determination of an acceptable morbidity rate

Correct answer: C

Rationale: The main goal of Healthy People 2010 is the elimination of health disparities among the U.S. population. This initiative outlines specific objectives to improve the overall health of Americans by addressing disparities in health outcomes. Choice A, reduction of health care costs, is not the primary goal of Healthy People 2010, although it may be a beneficial outcome. Choice C, investigation of substance abuse, is not a main goal of Healthy People 2010; while substance abuse may be a factor in health disparities, the primary focus is on broader disparities. Choice D, determination of an acceptable morbidity rate, is not the main focus of Healthy People 2010; instead, it aims to address health disparities in different population groups.

5. The mother of a newborn who was circumcised before discharge from the hospital calls the nurse at the pediatrician's office and tells the nurse that she is concerned because she has noticed a yellow crust over the circumcision site. The nurse provides which information to the mother?

• A. That it could indicate a sign of an infection and the infant's temperature should be checked every 2 hours
• B. That the crust is to be expected as a normal part of healing
• C. To bring the infant to the pediatrician's office to be checked
• D. To remove the crust, using a warm, wet face cloth and a mild soap

Correct answer: B

Rationale: After circumcision, a yellow crust may form over the circumcision site, which is a normal part of healing and should not be removed. The mother should be reassured that this crust is to be expected. Yellow crusting or discharge is not indicative of an infection, and there is no need to notify the pediatrician. Checking the infant's temperature every 2 hours is unnecessary and may cause unnecessary alarm to the mother.

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