Nursing Elites

1. On admission to the psychiatric unit, the client is trembling and appears fearful. The nurse’s initial response should be to

• A. Give the client orientation materials and review the unit rules and regulations
• B. Introduce oneself and accompany the client to their room
• C. Take the client to the day room and introduce them to the other clients
• D. Ask the nursing assistant to get the client’s vital signs and complete the admission search

Correct answer: B

Rationale: In situations where a client is trembling and fearful upon admission to a psychiatric unit, it is essential to prioritize building trust and reducing anxiety. By introducing oneself and accompanying the client to their room, the nurse can establish a therapeutic relationship, provide a sense of security, and address the client's immediate emotional needs. Choices A, C, and D are not the most appropriate initial responses as they do not directly address the client's emotional state or focus on establishing a supportive relationship.

2. A nurse working in a community health setting is performing primary health screenings. Which individual is at highest risk for contracting an HIV infection?

• A. A 17-year-old who is sexually active with numerous partners.
• B. A 45-year-old lesbian who has been sexually active with two partners in the past year.
• C. A 30-year-old cocaine user who inhales the drug and works in a topless bar.
• D. A 34-year-old male homosexual who is in a monogamous relationship.

Correct answer: A

Rationale: The correct answer is A. A 17-year-old who is sexually active with numerous partners is at the highest risk for contracting an HIV infection due to engaging in risky sexual behavior with multiple partners, increasing the likelihood of exposure to the virus. Choice B is less risky as the individual has had a relatively lower number of sexual partners in the past year. Choice C, although involving drug use, does not directly correlate with a higher risk of contracting HIV unless needles are shared. Choice D, a 34-year-old male homosexual in a monogamous relationship, has a lower risk compared to choice A as long as the relationship remains monogamous.

3. When the Public Health Nurse assesses needs and plans health interventions for a group of people in coordination with other health professionals, they are demonstrating which of the following features of community health nursing:

• A. CHN involves interdisciplinary collaboration
• B. The use of an epidemiologic approach is an essential part of nursing practice
• C. CHN is oriented towards populations
• D. CHN encourages the client's participation in determining their own health

Correct answer: A

Rationale: The correct answer is A. Interdisciplinary collaboration is a fundamental feature of community health nursing. In this scenario, the nurse works with other health professionals to assess needs and plan interventions for a group of people, emphasizing the importance of teamwork and cooperation. Choice B is incorrect because while epidemiology plays a role in community health nursing, it is not the primary focus of this particular situation. Choice C is incorrect as it describes the population-focused nature of community health nursing, which is related but not directly demonstrated in the given scenario. Choice D is incorrect because while client participation is essential in community health nursing, it is not the primary feature demonstrated in the scenario provided.

4. What title should be given to this occupational health nurse job description? A registered nurse who functions in a comprehensive executive role to set goals, formulate policy, and direct and evaluate the health service.

• A. manager
• B. researcher
• C. health educator
• D. health promotion specialist

Correct answer: A

Rationale: The correct answer is 'manager.' In the job description provided, the role involves setting goals, formulating policy, and directing and evaluating health services, which aligns with the responsibilities of a manager. A 'researcher' primarily focuses on conducting research, a 'health educator' specializes in educating individuals about health-related topics, and a 'health promotion specialist' concentrates on promoting health and wellness initiatives. Therefore, 'manager' is the most suitable title for the described role.

5. The school RN is assessing a group of middle school students for signs of scoliosis and discovers a female student with noticeable unequal symmetry of the upper and lower back. Which intervention is most important for the RN to implement?

• A. Send the student home
• B. Make a referral to have the scoliosis further evaluated.
• C. Withdraw the student from all physical activities
• D. Tell the student not to carry her backpack on her back

Correct answer: B

Rationale: Referring the student for further evaluation of scoliosis is crucial to confirm the diagnosis and determine the appropriate management plan. Sending the student home (choice A) without proper assessment and intervention is not the best course of action. Withdrawing the student from all physical activities (choice C) is not necessary and may cause unnecessary distress. Instructing the student not to carry her backpack on her back (choice D) does not address the underlying issue of scoliosis and is not the most important intervention at this point.

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