Nursing Elites

1. The social ecological model considers the complex interplay between which levels of influence?

• A. Individual, interpersonal, organizational, community, and policy
• B. Genetic, biological, environmental, social, and economic
• C. Personal, family, community, national, and global
• D. Health, wealth, education, environment, and politics

Correct answer: A

Rationale: The correct answer is A: Individual, interpersonal, organizational, community, and policy. The social ecological model examines how individual, interpersonal, organizational, community, and policy factors interact to influence health and well-being. Choice B is incorrect because it includes genetic and biological factors that are not part of the social ecological model. Choice C is incorrect as it does not include organizational and policy levels of influence. Choice D is incorrect as it includes wealth and politics, which are not typically considered in the social ecological model.

2. Which of the following is the most effective way to prevent the spread of communicable diseases in a community?

• A. Regular health check-ups
• B. Isolation of infected individuals
• C. Immunization programs
• D. Public health education

Correct answer: C

Rationale: Immunization programs are the most effective way to prevent the spread of communicable diseases. Vaccinations help build immunity against specific diseases, reducing the likelihood of an outbreak. Regular health check-ups (Choice A) are important for individual health but do not directly prevent the spread of diseases on a community level. Isolation of infected individuals (Choice B) is a containment measure rather than prevention for the entire community. Public health education (Choice D) is valuable in raising awareness but may not be as effective as immunization programs in directly preventing the spread of communicable diseases.

3. 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.

4. Which of the following patients should the home care nurse assess first?

• A. A 65-year-old male with known COPD and difficulty breathing after climbing a flight of stairs.
• B. A 78-year-old with CHF who has gained 4 lbs according to her tele-monitoring.
• C. A 50-year-old with bilateral leg swelling and difficulty walking.
• D. A 60-year-old with lower back pain.

Correct answer: A

Rationale: The correct answer is A. A patient with known COPD and difficulty breathing after physical exertion like climbing stairs requires immediate assessment by the nurse. This could indicate a potential exacerbation of COPD, which needs prompt intervention to prevent respiratory distress. Choices B, C, and D describe important patient situations that also require attention, but the urgency is higher with a COPD patient experiencing difficulty breathing.

5. 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.

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