Nursing Elites

1. A client with terminal cancer is experiencing severe pain. The nurse plans to implement which of the following pain management strategies?

• A. Administer analgesics on a fixed schedule
• B. Administer analgesics only when the client requests
• C. Use non-pharmacological methods only
• D. Increase the dose of analgesics when the client complains of pain

Correct answer: A

Rationale: Administering analgesics on a fixed schedule is the most appropriate pain management strategy for a client with terminal cancer experiencing severe pain. This approach ensures consistent pain control and helps prevent breakthrough pain. Administering analgesics only when the client requests (Choice B) may lead to uncontrolled pain as the client may delay requesting medication until the pain becomes unbearable. Using non-pharmacological methods only (Choice C) may not provide adequate pain relief for a client experiencing severe pain. Increasing the dose of analgesics when the client complains of pain (Choice D) may result in inconsistent pain control and could lead to potential overdose or adverse effects.

2. The family presents several problems. Which of the following criteria is considered in determining the priority health problem?

• A. expected consequence of the problem
• B. cooperation and support of the family
• C. involvement of the family members in the problem
• D. modifiability of the problem

Correct answer: D

Rationale: When determining the priority health problem within a family, one key criterion to consider is the modifiability of the problem. This means assessing whether the health issue can be changed or improved through interventions. Choices A, B, and C are not directly related to the priority of the health problem within the family. The expected consequence of the problem, cooperation and support of the family, and involvement of family members are important factors but do not specifically address the priority of the health issue based on modifiability.

3. A child is diagnosed with poison ivy. The mother tells the nurse that she does not know how her child contracted the rash since he had not been playing in wooded areas. As the nurse asks questions about possible contact, which of the following would the nurse recognize as highest risk for exposure?

• A. Playing with toys in a backyard flower garden
• B. Eating small amounts of grass while playing 'farm'
• C. Playing with cars on the pavement near burning leaves
• D. Throwing a ball to a neighborhood child who has poison ivy

Correct answer: C

Rationale: The correct answer is C. Poison ivy can be contracted through smoke from burning plants, which can carry the urushiol oil that causes the rash. Playing near burning leaves would be the highest risk for exposure in this scenario. Choices A, B, and D do not involve direct contact with burning plants or leaves, making them lower-risk activities for exposure to poison ivy.

4. A community health RN believes that immunization rates in a lower socioeconomic section of the city are probably below the target set by the state health department. What action should the RN take FIRST to intervene with this health problem?

• A. Take a health history of the members of the community
• B. Initiate an immunization program for the community
• C. Review current epidemiological population data that might document a low immunization rate
• D. Refer all clients to the local health department

Correct answer: C

Rationale: The correct first action for the community health RN to take in this situation is to review current epidemiological population data that might document a low immunization rate. By doing so, the RN can gather evidence to support further intervention strategies. Option A is incorrect because taking a health history would not provide immediate data on immunization rates in the community. Option B is incorrect as initiating an immunization program without confirming the actual immunization rates may not address the specific needs of the community. Option D is incorrect as a blanket referral without assessing the situation may not be the most effective first step.

5. 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.

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