Nursing Elites

1. The school nurse is called to the playground for an episode of mouth trauma. The nurse finds that the front tooth of a 9-year-old child has been avulsed (knocked out). After recovering the tooth, the initial response should be to

• A. Rinse the tooth in water before placing it in the socket
• B. Place the tooth in a clean plastic bag for transport to the dentist
• C. Hold the tooth by the roots until reaching the emergency room
• D. Ask the child to replace the tooth even if the bleeding continues

Correct answer: A

Rationale: The correct immediate action after recovering an avulsed tooth is to rinse it with water and place it back in the socket. This helps preserve the tooth and increases the chances of successful re-implantation. Placing the tooth in a clean plastic bag for transport to the dentist (choice B) is not ideal as immediate re-implantation is preferred. Holding the tooth by the roots until reaching the emergency room (choice C) can further damage the tooth. Asking the child to replace the tooth even if bleeding continues (choice D) is incorrect and may lead to improper re-implantation.

2. A 16-month-old child has just been admitted to the hospital. As the nurse assigned to this child enters the hospital room for the first time, the toddler runs to the mother, clings to her, and begins to cry. What would be the initial action by the nurse?

• A. Arrange for a change in client care assignments
• B. Explain that this behavior is expected
• C. Discuss the appropriate use of 'time-out'
• D. Explain that the child is in need of extra attention

Correct answer: B

Rationale: The correct answer is to explain that this behavior is expected. At 16 months of age, children commonly experience separation anxiety, especially in unfamiliar environments like hospitals. It is important for the nurse to reassure the child and the parent that such behavior is normal. Option A is incorrect as there is no need to change client care assignments based on the child's behavior. Option C is not appropriate as discussing the use of 'time-out' is more relevant in behavior management for older children. Option D is incorrect as it does not address the underlying cause of the child's behavior related to separation anxiety.

3. The nurse is discussing dietary intake with an adolescent who has acne. The most appropriate statement for the nurse is:

• A. Eat a balanced diet for your age.
• B. Increase your intake of protein and Vitamin A.
• C. Decrease fatty foods from your diet.
• D. Do not use caffeine in any form, including chocolate.

Correct answer: A

Rationale: The most appropriate advice for an adolescent with acne is to eat a balanced diet for their age. A balanced diet that includes a variety of nutrients is essential for overall health, including skin health. While protein and Vitamin A are important for skin health, focusing solely on increasing these nutrients may not address the overall dietary needs. Similarly, solely decreasing fatty foods or avoiding caffeine may not be the most effective advice for managing acne. Therefore, the best advice is to promote a balanced diet tailored to the adolescent's age.

4. A client with chronic renal failure is receiving erythropoietin (Epogen). The nurse should monitor the client for which of the following side effects?

• A. Hypertension
• B. Hypoglycemia
• C. Hyperkalemia
• D. Hypocalcemia

Correct answer: A

Rationale: The correct answer is A: Hypertension. Erythropoietin can lead to hypertension as a side effect due to its stimulation of red blood cell production, which can increase blood viscosity. This can result in elevated blood pressure. Choices B, C, and D are incorrect. Hypoglycemia is not a common side effect of erythropoietin. Hyperkalemia is more commonly associated with renal failure rather than erythropoietin use. Hypocalcemia is not a typical side effect of erythropoietin administration.

5. For whom is the community health nurse primarily responsible?

• A. individuals
• B. populations
• C. families
• D. class E citizens

Correct answer: B

Rationale: Community health nurses are primarily responsible for populations. While they do provide care and support to individuals and families within the community, their focus is on the health and well-being of entire populations. Choice A is incorrect as the primary responsibility is broader than just individuals. Choice C is incorrect as families are part of the population but not the sole focus. Choice D, 'class E citizens', is too specific and not a standard term in public health, making it an incorrect choice.

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