Nursing Elites

1. When providing nursing care to a client receiving oxygen therapy via a nasal cannula, which of the following interventions would be appropriate?

• A. Ensure that adequate mist is supplied
• B. Inspect the nares and ears for skin breakdown
• C. Lubricate the tips of the cannula before insertion
• D. Maintain sterile technique when handling the cannula

Correct answer: B

Rationale: The correct answer is to inspect the nares and ears for skin breakdown. This is important because the nasal cannula can cause skin breakdown due to prolonged use and friction. Ensuring that the skin is intact helps prevent complications. Choice A is incorrect as oxygen therapy via a nasal cannula does not involve mist. Choice C is incorrect as lubricating the tips of the cannula is not a standard practice and may lead to complications. Choice D is incorrect because while cleanliness is important, maintaining sterile technique is not necessary for handling a nasal cannula in this context.

2. Which of the following is an example of a social determinant of health?

• A. Blood pressure
• B. Genetic mutations
• C. Housing conditions
• D. Age

Correct answer: C

Rationale: The correct answer is C: Housing conditions. Social determinants of health are the conditions in which people are born, grow, live, work, and age. Housing conditions directly impact health outcomes as they can affect exposure to toxins, safety, and overall well-being. Choice A, blood pressure, is a physiological measure and not a social determinant. Choice B, genetic mutations, relates to an individual's genetic makeup and is not influenced by social factors. Choice D, age, is a demographic factor and not a social determinant of health.

3. A pre-term baby develops nasal flaring, cyanosis, and diminished breath sounds on one side. The provider's diagnosis is spontaneous pneumothorax. Which procedure should the nurse prepare for first?

• A. Cardiopulmonary resuscitation
• B. Insertion of a chest tube
• C. Oxygen therapy
• D. Assisted ventilation

Correct answer: B

Rationale: The correct answer is B: Insertion of a chest tube. In a case of spontaneous pneumothorax, the primary intervention is to insert a chest tube. This procedure allows the trapped air to escape from the pleural space, relieving pressure and enabling the lung to re-expand. Choices A, C, and D are not the initial interventions for spontaneous pneumothorax. Cardiopulmonary resuscitation is indicated for cardiac arrest, oxygen therapy may provide supportive care but does not address the underlying issue of trapped air in the pleural space, and assisted ventilation may be needed later but is not the first-line treatment for a pneumothorax.

4. To individualize care for a client and ensure maximum participation in that care, what should the nurse consider as the most important factor in planning the said care?

• A. environment
• B. educational attainment
• C. health beliefs and practices
• D. health status

Correct answer: C

Rationale: The correct answer is C: health beliefs and practices. Health beliefs and practices directly influence a client's willingness and ability to participate in care. Understanding a client's health beliefs and practices helps the nurse tailor the care plan to align with the client's values and preferences. Choice A, environment, though important, may not be the most critical factor in individualizing care. Choice B, educational attainment, is relevant but not as significant as understanding the client's health beliefs and practices. Choice D, health status, is essential but does not address the individualization of care and maximizing participation as directly as health beliefs and practices.

5. A community hospital is an example of which level of health care?

• A. Secondary level health care
• B. Primary health care
• C. Tertiary level care
• D. Intermediate level care

Correct answer: A

Rationale: A community hospital is categorized under secondary level health care. Secondary level health care facilities, like community hospitals, provide specialized outpatient care, diagnostic services, and treatment that are more complex than what is offered in primary health care settings. Choice B, primary health care, refers to basic and routine health care services typically provided by family doctors or general practitioners, which is not the level of care provided by community hospitals. Tertiary level care (choice C) involves highly specialized and complex medical services such as neurosurgery or organ transplants, which are beyond the scope of services provided by community hospitals. Intermediate level care (choice D) is not a recognized category in the hierarchy of health care levels.

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