Nursing Elites

1. Which sign or reflex is used to diagnose meningitis?

• A. Homan's sign
• B. Brudzinski
• C. Startle
• D. Anterior drawer

Correct answer: B

Rationale: Brudzinski sign is a physical exam finding used to diagnose meningitis. It is elicited by flexing the patient's neck, resulting in involuntary flexion of the hips and knees. This maneuver indicates meningeal irritation, a common feature in meningitis. Homan's sign is used to assess for deep vein thrombosis, Startle is a reflex response to sudden stimuli, and the Anterior drawer test is used to diagnose ligamentous instability in the knee.

2. One of the first steps in community assessment may involve the community health nurse driving or walking through an area and making observations about such things as environmental layout and location of agencies, hospitals, industries, and so forth. This is called a(n):

• A. Census survey.
• B. Needs survey.
• C. Informant survey.
• D. Windshield survey.

Correct answer: D

Rationale: A windshield survey involves observations made from a moving vehicle, allowing the community health nurse to gather information about the community's physical and social environment without direct interaction. This method helps in understanding the community's resources, potential hazards, and overall characteristics, which are essential for planning and implementing effective community health interventions.

3. Which of the following is an example of tertiary prevention?

• A. Vaccination
• B. Screening for cancer
• C. Physical therapy
• D. Health education

Correct answer: C

Rationale: Tertiary prevention aims to manage and improve the quality of life of individuals already diagnosed with a disease. Physical therapy, which focuses on rehabilitation and restoring function after an injury or illness, is a prime example of tertiary prevention. It helps individuals regain mobility and independence, thereby reducing the impact of the disease and preventing further complications.

4. A patient who has multiple health issues is discharged after a recent hospitalization. Which of the following comprehensive programs would a community health nurse refer the patient to if the patient is not under medical supervision but does have insurance?

• A. private health care practitioner
• B. a patient-centered medical home
• C. hospital clinic
• D. subacute facility

Correct answer: B

Rationale: A patient-centered medical home is a comprehensive care model that provides coordinated healthcare services across various settings. It is an ideal referral for a patient with multiple health issues who is not under medical supervision but has insurance, as it offers a patient-focused approach to managing the patient's overall health needs.

5. The public health RN is working with a client who desires to quit smoking. The client says to the RN, 'I want to quit but I just don't think I have it in me to really make it happen.' According to the Health Belief Model, this response relates to which factor:

• A. Susceptibility
• B. Self-efficacy
• C. Severity
• D. Cue to action

Correct answer: B

Rationale: The correct answer is B, 'Self-efficacy.' In the Health Belief Model, self-efficacy refers to a person's belief in their capacity to execute behaviors necessary to achieve specific goals or outcomes. In this scenario, the client's statement reflects a lack of confidence in their ability to successfully quit smoking, indicating low self-efficacy. By addressing and enhancing the client's self-efficacy, the public health RN can help empower the client to take steps towards successful smoking cessation.

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