Nursing Elites

1. A public health nurse is managing several projects for the community. Which of the following interventions should the nurse identify as a primary prevention strategy?

• A. Teaching parenting skills to expectant mothers and their partners.
• B. Conducting mental health screenings at the local community center
• C. Referring clients with obesity to community exercise programs
• D. Providing crisis intervention through a mobile counseling unit

Correct answer: A

Rationale: The correct answer is teaching parenting skills to expectant mothers and their partners. This intervention is a primary prevention strategy aimed at educating individuals before a problem or condition develops. By teaching parenting skills, the nurse is promoting healthy behaviors and relationships, which can prevent future issues. The other options involve secondary or tertiary prevention strategies by identifying and treating existing conditions or providing interventions after a problem has occurred.

2. A client has unilateral paralysis and dysphagia following a right hemispheric stroke. Which of the following interventions should the nurse include in the plan?

• A. Place the client's left arm on a pillow while he is sitting.
• B. Provide total care in assisting with the client's ADLs.
• C. Encourage mobility and avoid bed rest.
• D. Facilitate feeding by placing food on the left side of the client's mouth when ready to eat.

Correct answer: A

Rationale: Placing the client's left arm on a pillow while sitting helps prevent shoulder displacement and assists in maintaining proper positioning and alignment. This intervention is crucial to prevent complications associated with immobility. Providing total care in ADLs may hinder the client's independence and recovery. Encouraging mobility is essential in preventing complications of immobility. Facilitating feeding by placing food on the unaffected side of the mouth helps reduce the risk of aspiration in clients with dysphagia.

3. During an assessment, a healthcare provider observes a client with a chest tube and drainage system. What is an expected finding?

• A. Continuous bubbling in the water seal chamber
• B. Gentle constant bubbling in the suction control chamber
• C. Drainage system positioned upright at chest level
• D. Exposed sutures without dressing

Correct answer: B

Rationale: When assessing a client with a chest tube and drainage system, gentle constant bubbling in the suction control chamber is an expected finding. This indicates that the system is functioning properly. Continuous bubbling in the water seal chamber would suggest an air leak, the drainage system should be positioned upright at chest level to promote proper drainage, and exposed sutures without dressing would be an incorrect finding as they should be covered to prevent infection.

4. Which term is best described as a systematic, rational method of planning and providing nursing care for individuals, families, groups, and communities?

• A. Assessment
• B. Nursing Process
• C. Diagnosis
• D. Implementation

Correct answer: B

Rationale: The correct answer is B: Nursing Process. The nursing process is a systematic, rational method that guides nurses in planning and delivering patient care. It involves a series of steps including assessment, diagnosis, planning, implementation, and evaluation. By utilizing the nursing process, nurses can provide individualized care tailored to the specific needs of patients, families, groups, and communities. Choice A, Assessment, is a step within the nursing process but does not encompass the entire process itself. Choice C, Diagnosis, is another step within the nursing process and focuses on identifying the patient's health problems. Choice D, Implementation, is also a step in the nursing process where the care plan is put into action, but it does not solely describe the entire systematic and rational method of planning and providing nursing care.

5. A client in the emergency department is experiencing an acute asthma attack. Which assessment indicates an improvement in respiratory status?

• A. SaO2 95%
• B. Wheezing
• C. Retraction of sternal muscles
• D. Premature ventricular complexes (PVC's)

Correct answer: A

Rationale: An SaO2 of 95% indicates an improvement in the client's oxygen saturation, suggesting better respiratory status. In asthma exacerbation, a decrease in SaO2 levels would signal worsening respiratory distress. Wheezing, retraction of sternal muscles, and premature ventricular complexes are indicators of respiratory compromise and worsening respiratory status in acute asthma attacks. Monitoring SaO2 levels is crucial in assessing the effectiveness of interventions and guiding treatment decisions.

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