Nursing Elites

1. A male client is brought to the emergency department as the result of a motorcycle accident. He was not wearing a helmet at the time of the accident and states that he has no intention of ever wearing one. Within the framework of the Transtheoretical Model (TTM), which response should the nurse provide?

• A. Wearing a helmet or not is certainly an individual decision.
• B. You should seriously consider wearing a helmet.
• C. Riding a motorcycle with a helmet increases your safety.
• D. I really think you don't have the facts about helmet use.

Correct answer: C

Rationale: Providing information on safety aligns with the TTM framework.

2. A 14-month-old had cleft palate surgical repair several days ago. The parents ask the nurse about feedings after discharge. Which lunch is the best example of an appropriate meal?

• A. Hot dog, carrot sticks, gelatin, milk
• B. Soup, blenderized soft foods, ice cream, milk
• C. Peanut butter and jelly sandwich, chips, pudding, milk
• D. Baked chicken, applesauce, cookie, milk

Correct answer: B

Rationale: Choice B, 'Soup, blenderized soft foods, ice cream, milk,' is the correct answer. After cleft palate repair, it is essential to provide soft and blenderized foods to prevent trauma to the surgical site and promote proper healing. Choices A, C, and D contain foods that may be difficult for the child to consume comfortably and safely after a cleft palate surgical repair. A hot dog, carrot sticks, chips, and hard cookies could potentially cause injury or discomfort to the surgical area. Peanut butter and jelly sandwich might be too difficult to swallow or may stick to the surgical site. Baked chicken could be too challenging to chew. Therefore, the best choice for an appropriate meal post cleft palate repair is soft, blenderized foods like soup, along with other soft options like ice cream and milk.

3. A client with cirrhosis of the liver is experiencing ascites. The nurse should implement which of the following interventions?

• A. Restrict fluid intake
• B. Increase sodium intake
• C. Encourage high-protein diet
• D. Administer diuretics

Correct answer: D

Rationale: Corrected Rationale: Ascites, the accumulation of fluid in the abdominal cavity, is a common complication of cirrhosis. Diuretics are the primary intervention to manage ascites by promoting the excretion of excess fluid from the body, thus reducing abdominal swelling. Restricting fluid intake (Choice A) would not be appropriate as it may lead to dehydration. Increasing sodium intake (Choice B) is contraindicated as it can worsen fluid retention. Encouraging a high-protein diet (Choice C) is not directly related to managing ascites.

4. When a nurse teaches a community about the importance of hand hygiene, the nurse is engaging in:

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

Correct answer: A

Rationale: The correct answer is A: Primary prevention. Primary prevention aims to prevent the occurrence of a disease or injury before it happens. Teaching about hand hygiene to the community helps in preventing infections from occurring in the first place. Choice B, Secondary prevention, involves early detection and treatment to halt or slow the progress of a condition. This would involve screening or early intervention after exposure. Choice C, Tertiary prevention, focuses on managing the disease to prevent complications, recurrence, or deterioration. This would include rehabilitation and monitoring to prevent further complications. Choice D, Quaternary prevention, relates to actions taken to avoid unnecessary interventions or over-medicalization. This usually involves questioning the necessity of certain medical procedures or treatments to prevent harm to patients.

5. Which intervention should the public health nurse implement to address one of the leading health indicators of Healthy People 2020?

• A. Lead a weekly water aerobics class for the elderly at a community center.
• B. Teach a class on cultural awareness to nursing students at the university.
• C. Design and implement a no smoking campaign at the local high school.
• D. Write a grant to help provide glucometers to individuals who cannot afford one.

Correct answer: C

Rationale: Designing and implementing a no smoking campaign aligns with the objective of reducing tobacco use, which is one of the leading health indicators of Healthy People 2020. This intervention directly targets a significant public health concern. Leading a water aerobics class, teaching cultural awareness, or providing glucometers, while beneficial in other contexts, do not specifically address the leading health indicators outlined by Healthy People 2020.

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