Nursing Elites

1. The nurse working in a community health clinic that serves recent Somali immigrants notes that most mothers refuse to give permission for routine immunizations of their preschoolers. Which individual is likely to have the most influence on these women's perceptions about their children's healthcare needs?

• A. husbands
• B. clinic healthcare providers
• C. older females
• D. tribal chief

Correct answer: D

Rationale: In many Somali communities, the tribal chief holds significant influence over health decisions. The tribal chief often plays a crucial role in shaping community beliefs and practices, including healthcare decisions. While husbands may have some influence, the tribal chief typically holds more authority in community matters. Clinic healthcare providers have a role in educating and advising, but the tribal chief's influence is often more profound in this cultural context. Older females may have some influence, especially in familial matters, but the tribal chief is usually the key decision-maker in community health issues.

2. Which one of the following statements, if made by the client, indicates teaching about Inderal (propranolol) has been effective?

• A. ''I may experience seizures if I stop the medication abruptly.''
• B. ''I may experience an increase in my heart rate for a few weeks.''
• C. ''I can expect to feel nervousness the first few weeks.''
• D. ''I can have a heart attack if I stop this medication suddenly.''

Correct answer: D

Rationale: The correct answer is D. Stopping Inderal (propranolol) abruptly can cause rebound hypertension, angina, and even a myocardial infarction (heart attack), so it is crucial to taper off the medication under medical supervision. Choices A, B, and C are incorrect because they do not reflect the serious consequences associated with abrupt discontinuation of propranolol.

3. When the nurse identifies what appears to be ventricular tachycardia on the cardiac monitor of a client being evaluated for possible myocardial infarction, the first action the nurse should perform is to

• A. Begin cardiopulmonary resuscitation
• B. Prepare for immediate defibrillation
• C. Notify the 'Code' team and healthcare provider
• D. Assess airway, breathing, and circulation

Correct answer: D

Rationale: The correct first action for the nurse to take when identifying what appears to be ventricular tachycardia in a client being evaluated for possible myocardial infarction is to assess the client's airway, breathing, and circulation. This step is crucial to determine the client's stability and the need for immediate intervention. Beginning cardiopulmonary resuscitation or preparing for immediate defibrillation without first assessing the airway, breathing, and circulation could delay potentially life-saving interventions. Notifying the 'Code' team and healthcare provider should come after ensuring the client's immediate needs are addressed.

4. A school nurse is assessing a child who has frequent absences from school due to asthma. Which of the following is the priority nursing action?

• A. Teaching the child how to use an inhaler
• B. Assessing the child's asthma management plan
• C. Discussing the importance of school attendance with the parents
• D. Referring the child to a pulmonologist

Correct answer: B

Rationale: The correct answer is to assess the child's asthma management plan. This is the priority action as it allows the nurse to evaluate the current treatment regimen, identify any gaps or areas for improvement, and ensure that the plan is being effectively implemented. Teaching the child how to use an inhaler (Choice A) may be important but should come after assessing the management plan. Discussing the importance of school attendance with the parents (Choice C) is secondary to ensuring proper asthma management. Referring the child to a pulmonologist (Choice D) may be necessary but is not the priority at this stage; first, the nurse needs to evaluate the current plan in place.

5. The nurse-manager is planning to transform safety ideas into prevention and protection strategies in the workplace. What committee should review and plan policies and education about safety in the workplace?

• A. policy and procedures committee
• B. quality assurance committee
• C. education committee
• D. ethics committee

Correct answer: B

Rationale: The quality assurance committee is responsible for reviewing and planning policies and education related to workplace safety. This committee focuses on ensuring the quality of care and services provided, which includes implementing safety measures. The policy and procedures committee primarily deals with developing and maintaining organizational policies and procedures. The education committee focuses on educational programs and initiatives, not specifically on safety policies. The ethics committee is concerned with ethical issues and dilemmas, not safety policies and education.

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