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 tells the nurse he is fearful of planned surgery because of evil thoughts about a family member. What is the best initial response by the nurse?

• A. Call a chaplain
• B. Deny the feelings
• C. Cite recovery statistics
• D. Listen to the client

Correct answer: D

Rationale: The correct answer is to listen to the client. Listening allows the nurse to establish therapeutic communication, understand the client's fears and concerns, provide emotional support, and help alleviate anxiety. Calling a chaplain (Choice A) may be appropriate if the client requests spiritual support but should not be the initial response. Denying the feelings (Choice B) is dismissive and can hinder trust and communication. Citing recovery statistics (Choice C) is irrelevant and does not address the client's immediate emotional needs.

3. You are teaching a client about the patient-controlled analgesia (PCA) planned for post-operative care. Which statement indicates further teaching may be needed by the client?

• A. ''I will be receiving continuous doses of medication.''
• B. ''I should call the nurse before I take additional doses.''
• C. ''I will call for assistance if my pain is not relieved.''
• D. ''The machine will prevent an overdose.''

Correct answer: B

Rationale: PCA allows patients to self-administer pain medication within prescribed limits, without the need to call the nurse before taking an additional dose. Choice B suggests a misunderstanding of how PCA works, as the patient should be educated that they can self-administer doses within the safety parameters set by the healthcare provider. Choices A, C, and D demonstrate proper understanding of PCA, hence are not indicative of needing further teaching.

4. To individualize care for a client and ensure maximum participation in that care, what should the nurse consider as the most important factor in planning the said care?

• A. environment
• B. educational attainment
• C. health beliefs and practices
• D. health status

Correct answer: C

Rationale: The correct answer is C: health beliefs and practices. Health beliefs and practices directly influence a client's willingness and ability to participate in care. Understanding a client's health beliefs and practices helps the nurse tailor the care plan to align with the client's values and preferences. Choice A, environment, though important, may not be the most critical factor in individualizing care. Choice B, educational attainment, is relevant but not as significant as understanding the client's health beliefs and practices. Choice D, health status, is essential but does not address the individualization of care and maximizing participation as directly as health beliefs and practices.

5. Prior to initiating a community health program targeting teenage smoking, what information is most important for the nurse to obtain?

• A. The incidence of smoking among the teenage population in this community.
• B. The amount of available funding for tobacco prevention education programs.
• C. The target objectives for teenage smoking described by Healthy People 2020.
• D. Satisfaction data from programs that targeted the teenage population in this community.

Correct answer: A

Rationale: The most important information for the nurse to obtain before initiating a community health program targeting teenage smoking is the incidence of smoking among the teenage population in the community. Understanding the prevalence of smoking will help in designing effective intervention strategies. Choice B about funding, while important, is secondary to understanding the scope of the issue. Choice C, the target objectives from Healthy People 2020, may provide guidance but are not as crucial as knowing the local prevalence. Choice D, satisfaction data from previous programs, does not provide essential information for planning a new program.

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