Nursing Elites

1. The nurse is caring for a 4-year-old child with a greenstick fracture. In explaining this type of fracture to the parents, the best response by the nurse should be that

• A. A child's bone is more flexible and can be bent 45 degrees before breaking
• B. Bones of children are more porous than adults and often have incomplete breaks
• C. Compression of porous bones produces a buckle or torus type break
• D. Bone fragments often remain attached by a periosteal hinge

Correct answer: B

Rationale: The correct answer is B. Greenstick fractures are common in children because their bones are softer and more porous than adult bones, leading to incomplete breaks when force is applied. Choice A is incorrect as greenstick fractures are not due to bone flexibility but rather the porous nature of children's bones. Choice C is incorrect as it describes a buckle or torus type break, which is not characteristic of a greenstick fracture. Choice D is incorrect as greenstick fractures do not involve bone fragments remaining attached by a periosteal hinge.

2. A client with acute pancreatitis is receiving total parenteral nutrition (TPN). The nurse should monitor the client for which of the following complications?

• A. Hypoglycemia
• B. Hyperkalemia
• C. Hyperglycemia
• D. Hyponatremia

Correct answer: C

Rationale: The correct answer is C: Hyperglycemia. Total parenteral nutrition (TPN) contains a high glucose content, which can lead to elevated blood sugar levels, resulting in hyperglycemia. Monitoring for hyperglycemia is crucial in clients receiving TPN to prevent complications such as osmotic diuresis, dehydration, and electrolyte imbalances. Choices A, B, and D are incorrect because TPN is more likely to cause hyperglycemia rather than hypoglycemia, hyperkalemia, or hyponatremia.

3. What is a key component of a successful smoking cessation program?

• A. Providing nicotine replacement therapy
• B. Offering surgical interventions
• C. Conducting regular health screenings
• D. Promoting alcohol consumption

Correct answer: A

Rationale: The correct answer is A. Providing nicotine replacement therapy is a key component of smoking cessation programs as it helps individuals manage nicotine withdrawal symptoms. Nicotine replacement therapy includes options like nicotine gum, patches, lozenges, or inhalers. Choice B, offering surgical interventions, is incorrect as smoking cessation programs primarily focus on behavioral and pharmacological interventions rather than surgical procedures. Choice C, conducting regular health screenings, is also incorrect as it is not a direct key component of smoking cessation programs. Choice D, promoting alcohol consumption, is not only incorrect but counterproductive, as it can be detrimental to overall health and hinder smoking cessation efforts.

4. A female client makes routine visits to a neighborhood community health center. The nurse notes that this client often presents with facial bruising, particularly around the eyes. The nurse discusses prevention of domestic violence with the client even though the client does not admit to being battered. What level of prevention has the nurse applied in this situation?

• A. primary prevention
• B. secondary prevention
• C. tertiary prevention
• D. health promotion

Correct answer: B

Rationale: The correct answer is B: secondary prevention. Secondary prevention involves identifying and addressing issues early to prevent further harm. In this scenario, the nurse is intervening by discussing domestic violence prevention with the client who is showing signs of facial bruising, aiming to prevent further harm even though the client has not disclosed being battered. Choice A (primary prevention) focuses on preventing the onset of a problem before it occurs, like educating about healthy relationships before violence happens. Choice C (tertiary prevention) involves managing and treating the effects of a problem that has already occurred, such as providing counseling to a domestic violence survivor. Choice D (health promotion) aims to enhance well-being and prevent health problems through educational and environmental interventions, which may include aspects of preventing domestic violence, but in this case, the nurse's direct intervention is more about early identification and prevention of harm, aligning it with secondary prevention.

5. In the provision of preventive care to workers, the nurse must be aware of biological hazards that are harmful to workers and their families, such as:

• A. bacteria, fungi, and insects
• B. noise
• C. toxic metals, poisonous gas fumes, and dust
• D. stress

Correct answer: A

Rationale: The correct answer is A: bacteria, fungi, and insects. Biological hazards in the workplace can include microorganisms like bacteria and fungi that can cause infections, as well as insects that may carry diseases. Noise (choice B) is considered a physical hazard, not a biological one. Toxic metals, poisonous gas fumes, and dust (choice C) are examples of chemical hazards, not biological hazards. While stress (choice D) can be a health concern in the workplace, it is not classified as a biological hazard.

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