Nursing Elites

1. The nurse administers a booster dose of DTaP (diphtheria, tetanus, and pertussis) vaccine to an infant. Which level of prevention is the nurse implementing?

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

Correct answer: A

Rationale: The correct answer is A: Primary prevention. Administering a booster dose of DTaP vaccine to an infant is an example of primary prevention. Primary prevention aims to prevent disease or injury before it occurs by preventing exposure to risk factors. Tertiary prevention focuses on reducing the impact of a disease or injury that has already occurred, while secondary prevention involves early detection and treatment to prevent the progression of disease. Choice B, tertiary prevention, is incorrect as it deals with managing the consequences of a disease rather than preventing it. Choice C, secondary prevention, is also incorrect as it focuses on early detection and treatment rather than vaccination to prevent the disease. Choice D, primary nursing, is unrelated to the level of prevention being implemented in this scenario.

2. A client with terminal cancer is experiencing severe pain. The nurse plans to implement which of the following pain management strategies?

• A. Administer analgesics on a fixed schedule
• B. Administer analgesics only when the client requests
• C. Use non-pharmacological methods only
• D. Increase the dose of analgesics when the client complains of pain

Correct answer: A

Rationale: Administering analgesics on a fixed schedule is the most appropriate pain management strategy for a client with terminal cancer experiencing severe pain. This approach ensures consistent pain control and helps prevent breakthrough pain. Administering analgesics only when the client requests (Choice B) may lead to uncontrolled pain as the client may delay requesting medication until the pain becomes unbearable. Using non-pharmacological methods only (Choice C) may not provide adequate pain relief for a client experiencing severe pain. Increasing the dose of analgesics when the client complains of pain (Choice D) may result in inconsistent pain control and could lead to potential overdose or adverse effects.

3. In providing comprehensive family health care, the nurse utilizes four (4) basic processes. These are listed in the order in which they are carried out as follows:

• A. assessment, planning, intervention, and evaluation
• B. assessment, intervention, planning, and evaluation
• C. planning, assessment, intervention, and evaluation
• D. planning, intervention, evaluation, and assessment

Correct answer: A

Rationale: The correct order for the basic processes in providing comprehensive family health care is assessment, planning, intervention, and evaluation. Assessment is the first step to gather information, followed by planning to set goals and strategies, then intervention to implement the plan, and finally evaluation to assess the outcomes. Choice A is correct as it follows this logical sequence. Choices B, C, and D are incorrect because they do not follow the correct order of these essential processes in nursing care.

4. What is the term for a learning process whereby knowledge, attitudes, and practice of people are changed to improve the health status of individuals, families, or communities?

• A. Motivating
• B. Counseling
• C. Disease prevention
• D. Health education

Correct answer: D

Rationale: Health education is the correct term for the learning process that involves changing knowledge, attitudes, and practices to enhance health status. Choice A, 'Motivating,' is incorrect as it refers to inspiring action rather than the educational aspect. Choice B, 'Counseling,' focuses on providing guidance and support rather than specifically targeting knowledge and practice changes. Choice C, 'Disease prevention,' is related to strategies aimed at avoiding the occurrence of illnesses rather than the broader concept of educating for overall health improvement.

5. After 3 days, the nurse notes that James has chest indrawing and stridor. His mother returned him to the health center immediately. The nurse should:

• A. Change the antibiotic to second-line antibiotics
• B. Advise the mother to observe the child and continue giving the antibiotics
• C. Give the first dose of antibiotics and refer urgently
• D. Observe the child at the center

Correct answer: C

Rationale: Chest indrawing and stridor are signs of severe respiratory distress. In this situation, immediate referral is essential. Giving the first dose of antibiotics before referral can help initiate treatment, but urgent referral for further evaluation and management is crucial. Choice A is incorrect because simply changing the antibiotic without assessing the severity of the symptoms and providing urgent care is not appropriate. Choice B is incorrect as advising the mother to observe the child and continue antibiotics delays necessary intervention for a potentially life-threatening condition. Choice D is incorrect as observing the child at the center is not sufficient when signs of severe illness are present.

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