Nursing Elites

1. 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.

2. When designing a home health care program for disabled children, which factor should be considered when assessing reimbursement for services from private insurance companies?

• A. greater access to any healthcare provider
• B. allowance for early discharge
• C. concern for the quality of care
• D. approval by the network healthcare provider

Correct answer: D

Rationale: When assessing reimbursement for services from private insurance companies, approval by the network healthcare provider is crucial. This approval ensures that the services provided are within the approved network, allowing for reimbursement. Choices A, B, and C are not directly related to the reimbursement process by private insurance companies. While greater access to any healthcare provider, allowance for early discharge, and concern for the quality of care are important considerations when designing a home health care program, they do not specifically impact the reimbursement process from private insurance companies.

3. An example of the continuum health model of health and wellness would be:

• A. a person is either well or not, and the emphasis is on continuously and aggressively treating people who are ill
• B. predicting that a person will most likely continue good health practices, based on his or her health practices in the past, such as getting flu shots
• C. using acupuncture and therapeutic touch to cure disease instead of traditional medical therapies
• D. none of the above

Correct answer: B

Rationale: The continuum health model emphasizes ongoing health practices based on past behaviors. Choice A is incorrect as it describes a more binary approach to health. Choice C is incorrect as it focuses on alternative therapies rather than the continuity of health practices.

4. What is the main focus of secondary prevention?

• A. Early detection and treatment
• B. Rehabilitation
• C. Health promotion
• D. Palliative care

Correct answer: A

Rationale: The main focus of secondary prevention is early detection and treatment of disease. This approach aims to identify health conditions in their early stages when they are easier to treat or manage effectively. Choice B, rehabilitation, is more aligned with restoring function after an illness or injury has occurred. Choice C, health promotion, concentrates on educating and empowering individuals to adopt healthy behaviors to prevent the onset of diseases. Choice D, palliative care, is focused on providing comfort and improving the quality of life for individuals with serious illnesses or at the end of life, rather than on early detection and treatment.

5. 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.

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