Nursing Elites

1. A Hispanic client confides in the nurse that she is concerned that staff may give her newborn the 'evil eye.' The nurse should communicate to other personnel that the appropriate approach is to

• A. Touch the baby after looking at him
• B. Talk very slowly while speaking to him
• C. Avoid touching the child
• D. Look only at the parents

Correct answer: A

Rationale: In some Hispanic cultures, touching the baby after looking at them is believed to prevent the 'evil eye.' Respecting this cultural belief can help build trust and comfort with the client. Choices B, C, and D are incorrect as they do not address the specific cultural concern raised by the client. Talking slowly or avoiding touching the child does not relate to the belief in the 'evil eye.' Similarly, focusing only on the parents does not address the client's worry about the newborn receiving the 'evil eye.'

2. The public health RN is called to investigate a report of several cases of varicella at a daycare center. The daycare workers state that 5 children have been sent home over the past 2 weeks with fever and itchy blisters. Which intervention should the RN implement first?

• A. Validate that the children who were sent home had chickenpox.
• B. Ask the parents to take the child to see their pediatrician.
• C. Ask the parents to not send the child back to daycare until after 6 weeks.
• D. Tell the parents to send the child back to daycare; it was a mistake they were sent home.

Correct answer: A

Rationale: The correct answer is to validate that the children who were sent home had chickenpox. This is crucial in confirming the presence of varicella, which is necessary for appropriate management and control of the outbreak. Option B is not the first intervention because the focus initially is on verifying the cases within the daycare center. Option C is incorrect as it suggests a prolonged exclusion period without confirming the diagnosis. Option D is inappropriate and potentially harmful, as sending a child back without proper assessment can lead to further spread of the infection.

3. When a nurse teaches a community about the importance of regular health screenings, this activity falls under which level of prevention?

• A. Primary prevention
• B. Secondary prevention
• C. Tertiary prevention
• D. Quaternary prevention

Correct answer: B

Rationale: The correct answer is B: Secondary prevention. Secondary prevention aims to detect and treat disease early to prevent complications. Teaching about the importance of regular health screenings helps in early detection and intervention, which aligns with the goals of secondary prevention. Choice A, Primary prevention, involves actions to prevent the onset of a health condition. Choice C, Tertiary prevention, focuses on managing and treating existing conditions to prevent further complications. Choice D, Quaternary prevention, relates to actions taken to mitigate or avoid unnecessary interventions, over-medicalization, and the consequences of unnecessary treatment.

4. What is the most common cause of vaginal bleeding immediately after birth?

• A. Uterine atony
• B. Genital lacerations
• C. Abnormal clotting mechanism
• D. Endometritis

Correct answer: A

Rationale: Vaginal bleeding immediately after birth is most often due to uterine atony, which is the failure of the uterus to contract following delivery. This results in inadequate compression of blood vessels at the placental site, leading to hemorrhage. Genital lacerations and abnormal clotting mechanisms can also cause bleeding but are less common immediately after birth compared to uterine atony. Endometritis, inflammation of the lining of the uterus, usually presents with symptoms like fever and pelvic pain rather than immediate postpartum bleeding.

5. Which of the following measures the risk of dying from causes related to pregnancy, childbirth, and puerperium?

• A. maternal mortality
• B. neonatal death rate
• C. fetal death rate
• D. infant mortality rate

Correct answer: A

Rationale: The correct answer is A, maternal mortality. Maternal mortality specifically measures the risk of dying from pregnancy-related causes. Neonatal death rate, fetal death rate, and infant mortality rate focus on different populations and timeframes. Neonatal death rate refers to deaths within the first 28 days of life, fetal death rate measures stillbirths, and infant mortality rate includes deaths of infants under one year of age. Therefore, A is the most appropriate measure for assessing the risk of dying from causes related to pregnancy, childbirth, and puerperium.

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