Nursing Elites

1. All of the following factors, when identified in the history of a family, are correlated with poverty except:

• A. high infant mortality rate
• B. frequent use of Emergency Departments
• C. consultation with folk healers
• D. low incidence of dental problems

Correct answer: D

Rationale: Factors correlated with poverty often include a high infant mortality rate, frequent use of Emergency Departments, and consultation with folk healers, as these indicate limited access to healthcare. Dental problems are prevalent in poverty due to a lack of preventive care and access to treatments. High infant mortality is a significant issue linked with poverty as it reflects poor healthcare access. Families in poverty might resort to Emergency Departments for healthcare due to financial barriers. Consulting folk healers is common in communities with limited access to formal healthcare. However, a low incidence of dental problems is less likely in impoverished families due to the lack of preventive services and the presence of other health issues.

2. When a nurse-midwife, performing a vaginal examination of a client who suspects that she is pregnant, documents the presence of the Chadwick sign, what does this indicate?

• A. That the cervix appears violet
• B. That cervical softening is present
• C. A positive sign of pregnancy
• D. A thinning of the cervix

Correct answer: A

Rationale: The correct interpretation of the Chadwick sign is that the cervix appears violet in color. This sign is a probable sign of pregnancy, characterized by the violet coloration of the cervix due to increased vascularity of the pelvic organs. It is not a definitive positive sign of pregnancy but rather a probable one. Choices B and D are incorrect as cervical softening is known as the Goodell sign, and thinning of the cervix is referred to as the Hegar sign. These signs are also probable signs of pregnancy, but they do not specifically indicate the Chadwick sign.

3. A 17-year-old female was raped by a young man in her neighborhood. She is in the Emergency Department for evaluation and tests. After the procedure is completed, a rape crisis counselor (nurse specialist) talks to the client in a conference room regarding the rape. Implementing counseling by the nurse specialist for the raped victim represents:

• A. assessment.
• B. crisis intervention.
• C. empathetic concern.
• D. unwarranted intrusion

Correct answer: B

Rationale: Crisis intervention is the correct choice. Counseling by a nurse specialist after a traumatic event like rape falls under the Crisis Intervention Model. This approach aims to provide immediate support to individuals facing a crisis to enhance coping mechanisms. In this scenario, the nurse specialist is offering specialized care tailored to rape victims, helping the client navigate through the emotional aftermath of the traumatic experience. Choices A, C, and D are incorrect: A is not the correct answer as the nurse specialist is providing emotional support rather than conducting an assessment; C, while important, does not fully capture the specialized intervention being provided; and D is inaccurate as the nurse specialist's intervention is warranted and essential for the victim's well-being.

4. While assisting with data collection, the client informs the nurse that he is having difficulty swallowing medications and food. The nurse gathers additional subjective data and documents that the client is experiencing which disorder?

• A. Pyrosis
• B. Anorexia
• C. Eructation
• D. Dysphagia

Correct answer: D

Rationale: The correct answer is 'Dysphagia.' Dysphagia is the term used to indicate difficulty swallowing, which can occur in disorders of the throat or esophagus. Anorexia refers to a loss of appetite, not difficulty swallowing. Eructation is the medical term for belching, not difficulty swallowing. Pyrosis is heartburn, a burning sensation in the esophagus and stomach caused by the reflux of gastric acid, not difficulty swallowing.

5. Before administering the hepatitis B vaccine to a newborn infant, what should the nurse do?

• A. Request parental consent to administer the vaccine.
• B. Check the infant for jaundice.
• C. Check the infant's temperature.
• D. Obtain parental consent to administer the vaccine.

Correct answer: D

Rationale: Before administering the hepatitis B vaccine to a newborn infant, the nurse must obtain parental consent. Hepatitis B vaccine is typically given at birth, 1 month, and 6 months of age. Checking the infant for jaundice, checking the temperature, and requesting a hepatitis blood screen are unnecessary in this context. Parental consent is crucial for any medical intervention involving minors.

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