Nursing Elites

1. What is the term for creating a surgical airway in the front of the neck (cervical region) to remove copious secretions?

• A. Bronchoscopy
• B. Tracheostomy
• C. Thoracentesis
• D. Underwater seal drainage

Correct answer: B

Rationale: Tracheostomy is the process of surgically creating an airway in the front of the neck to aid in breathing or remove secretions from the airway. Bronchoscopy involves visualizing the airways using a scope, not creating an airway. Thoracentesis is the procedure to remove fluid or air from the pleural space around the lungs, not related to creating an airway. Underwater seal drainage is a method used in chest drainage systems to remove air or fluid from the pleural space, not the creation of an airway.

2. The client diagnosed with a mild concussion is being discharged from the emergency department. Which discharge instruction should the nurse teach the client's significant other?

• A. Awaken the client every two (2) hours.
• B. Monitor for increased intracranial pressure.
• C. Observe frequently for hypervigilance.
• D. Offer the client food every three (3) to four (4) hours.

Correct answer: A

Rationale: In a client with a mild concussion, it is important to monitor for signs of deterioration, which includes changes in the client's level of consciousness. Waking the client every two hours helps in assessing their neurological status, ensuring they can awaken and respond appropriately. This intervention aids in detecting any worsening symptoms promptly and seeking medical assistance if needed.

3. The appropriate order of steps in active management of the third stage of labor include:

• A. Cord clamping and cutting, controlled cord traction, ergometrine administration, and inspection to be sure the placenta is intact.
• B. Intravenous oxytocin, cord clamping and cutting, and fundal massage
• C. Intramuscular injection oxytocin, controlled cord traction with counter traction to the uterus, uterine massage
• D. Controlled cord traction, fundal massage and oxytocin

Correct answer: C

Rationale: Intramuscular injection of oxytocin, controlled cord traction with counter traction to the uterus, and uterine massage are the appropriate steps in active management of the third stage of labor.

4. The public health RN is engaging with a teen in his community who is concerned about how he will be able to stay part of his friend group when they are all vaping and your client does not want to take part but does not want to feel awkward. Using motivational interviewing techniques, the RN says to the client, 'I understand this concern. Please tell me more about this and how it feels awkward for you.' The RN's question is an example of:

• A. Moving the teen to find a new friend group.
• B. Addressing the problem of teen awkwardness.
• C. Agreeing that awkwardness is hard.
• D. Using open-ended questioning.

Correct answer: D

Rationale: The RN's question, 'Please tell me more about this and how it feels awkward for you,' is an example of using open-ended questioning. Open-ended questions encourage clients to share more about their feelings and thoughts, allowing for a deeper exploration of their concerns and experiences. It helps in building rapport, understanding the client's perspective, and facilitating a client-centered conversation.

5. Which is an essential aspect of developing a community health intervention?

• A. Assessing the availability of local health resources
• B. Engaging policymakers in the planning process
• C. Developing culturally appropriate health materials
• D. Allocating funding for health services

Correct answer: A

Rationale: Assessing the availability of local health resources is a crucial step in the development of a community health intervention. By understanding the resources already present in the community, intervention strategies can be tailored to effectively address the specific health needs of the population. This assessment helps in identifying gaps, strengths, and areas for improvement, ensuring that the intervention is well-informed and targeted towards improving community health outcomes.

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