Nursing Elites

1. A 15-year-old client with a lengthy confining illness is at risk for altered growth and development of which task?

• A. Loss of control
• B. Insecurity
• C. Dependence
• D. Lack of trust

Correct answer: C

Rationale: A 15-year-old client with a lengthy confining illness is at risk for altered growth and development of the task of dependence. Prolonged illness and confinement can lead to the development of dependence as the individual may become reliant on others for their care and needs. Choices A, B, and D are incorrect in this context. Loss of control, insecurity, and lack of trust are important factors to consider but are not directly related to the altered growth and development task of dependence due to illness and confinement.

2. In a well-child clinic, the nurse examines many children daily. Which of the following toddlers requires further follow-up?

• A. A 13-month-old who is unable to walk
• B. A 20-month-old who is only using 2 and 3 word sentences
• C. A 24-month-old who cries during examination
• D. A 30-month-old who is only drinking from a sip cup

Correct answer: D

Rationale: The correct answer is D because a 30-month-old should have developed the skill to drink from a regular cup by this age. Drinking from a sip cup at this stage may indicate a delay in development. Choices A, B, and C are not as concerning as they can be within the range of normal development. A 13-month-old not walking yet, a 20-month-old using 2 and 3 word sentences, and a 24-month-old crying during examination are all behaviors that can fall within the spectrum of typical development for their respective ages.

3. The major target of the Philippine Family Program are women belonging to the high-risk group which includes:

• A. Women under 20 or over 35 years old
• B. Women suffering from certain medical conditions that contradict pregnancy
• C. All these groups
• D. Women who have had at least 4 deliveries

Correct answer: C

Rationale: The correct answer is C, 'All these groups.' The Philippine Family Program targets women under 20 years old, over 35 years old, those with certain medical conditions that contradict pregnancy, and women who have had at least 4 deliveries. Therefore, choice C is the correct answer because it encompasses all the high-risk groups identified by the program. Choices A, B, and D are incorrect because they do not cover all the specified high-risk groups targeted by the program.

4. A female client makes routine visits to a neighborhood community health center. The nurse notes that this client often presents with facial bruising, particularly around the eyes. The nurse discusses prevention of domestic violence with the client even though the client does not admit to being battered. What level of prevention has the nurse applied in this situation?

• A. primary prevention
• B. secondary prevention
• C. tertiary prevention
• D. health promotion

Correct answer: B

Rationale: The correct answer is B: secondary prevention. Secondary prevention involves identifying and addressing issues early to prevent further harm. In this scenario, the nurse is intervening by discussing domestic violence prevention with the client who is showing signs of facial bruising, aiming to prevent further harm even though the client has not disclosed being battered. Choice A (primary prevention) focuses on preventing the onset of a problem before it occurs, like educating about healthy relationships before violence happens. Choice C (tertiary prevention) involves managing and treating the effects of a problem that has already occurred, such as providing counseling to a domestic violence survivor. Choice D (health promotion) aims to enhance well-being and prevent health problems through educational and environmental interventions, which may include aspects of preventing domestic violence, but in this case, the nurse's direct intervention is more about early identification and prevention of harm, aligning it with secondary prevention.

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

• A. Encourage the employees to disclose if they have joined another smoking cessation group.
• B. Ask the employees to inform the group if they stop smoking and if they start back up again.
• C. Survey the employees about their smoking habits.
• D. Observe if the employees are smoking in the designated smoking areas.

Correct answer: C

Rationale: Surveying the employees about their smoking habits provides measurable data on program effectiveness. By collecting data directly from the employees through surveys, the occupational nurse can track changes in smoking habits, frequency, and quantity of cigarettes smoked. This direct feedback allows for a more accurate assessment of the program's impact on smoking cessation. Choices A and B rely on self-disclosure and may not provide reliable or objective data. Choice D does not directly measure changes in smoking habits but rather observes behavior in designated areas, which may not reflect overall smoking cessation progress.

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