Nursing Elites

1. The appropriate order of steps in active management of the third stage of labor include:

• A. Cord clamping and cutting, controlled cord traction, ergometrine administration, and inspection to be sure the placenta is intact.
• B. Intravenous oxytocin, cord clamping and cutting, and fundal massage
• C. Intramuscular injection oxytocin, controlled cord traction with counter traction to the uterus, uterine massage
• D. Controlled cord traction, fundal massage and oxytocin

Correct answer: C

Rationale: Intramuscular injection of oxytocin, controlled cord traction with counter traction to the uterus, and uterine massage are the appropriate steps in active management of the third stage of labor.

2. How should contaminated instruments used during delivery be handled?

• A. Wash with soap and water and soak in 0.5% chlorine solution for 10 minutes
• B. Soak in 0.5% chlorine solution for 30 minutes
• C. Wash with soap and water and boil for 2 hours
• D. Soak in 0.5% chlorine solution for 10 minutes

Correct answer: B

Rationale: When dealing with contaminated instruments used during delivery, it is crucial to soak them in a 0.5% chlorine solution for 30 minutes to ensure proper disinfection. This practice helps eliminate potential pathogens and ensures the safety of both the healthcare provider and the patient.

3. The public health RN is working with a client who desires to quit smoking. The client says to the RN, 'I want to quit but I just don't think I have it in me to really make it happen.' According to the Health Belief Model, this response relates to which factor:

• A. Susceptibility
• B. Self-efficacy
• C. Severity
• D. Cue to action

Correct answer: B

Rationale: The correct answer is B, 'Self-efficacy.' In the Health Belief Model, self-efficacy refers to a person's belief in their capacity to execute behaviors necessary to achieve specific goals or outcomes. In this scenario, the client's statement reflects a lack of confidence in their ability to successfully quit smoking, indicating low self-efficacy. By addressing and enhancing the client's self-efficacy, the public health RN can help empower the client to take steps towards successful smoking cessation.

4. The public health nurse partners with the American Heart Association to develop NYS public policy priority statements to promote the expansion of the Double Up Food Bucks program. Which area and intervention on the Minnesota Public Health Wheel do these actions most closely align?

• A. Counseling - Blue wedge
• B. Advocacy - Yellow wedge
• C. Outreach - Red wedge
• D. Screening - Red wedge

Correct answer: B

Rationale: In this scenario, the public health nurse is engaging in advocacy by partnering with an organization to influence public policy through the development of public policy priority statements. Advocacy, represented by the yellow wedge on the Minnesota Public Health Wheel, aligns most closely with these actions as it involves working to influence public policy.

5. Which action would engage the community in health promotion activities?

• A. Distributing health brochures
• B. Conducting health screenings
• C. Organizing community health fairs
• D. Hosting educational workshops

Correct answer: C

Rationale: Organizing community health fairs is an effective way to engage the community in health promotion activities. These fairs bring together community members, healthcare providers, and organizations to provide health education, screenings, resources, and promote healthy behaviors. They help raise awareness, encourage participation, and foster a sense of community well-being.

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