Nursing Elites

1. A client comes into the community health center upset and crying stating, “I will die of cancer now that I have this disease.” And then the client hands the nurse a paper with one word written on it: 'Pheochromocytoma.' Which response should the nurse state initially?

• A. 'Pheochromocytomas usually aren't cancerous (malignant). But they may be associated with cancerous tumors in other endocrine glands such as the thyroid (medullary carcinoma of the thyroid).'
• B. 'This problem is diagnosed by blood and urine tests that reveal elevated levels of adrenaline and noradrenaline.'
• C. 'Computerized tomography (CT) or magnetic resonance imaging (MRI) are used to detect an adrenal tumor.'
• D. 'You probably have had episodes of sweating, heart pounding, and headaches.'

Correct answer: A

Rationale: The correct initial response for the nurse to provide in this situation is to offer reassurance. Stating that 'Pheochromocytomas usually aren't cancerous (malignant)' helps to alleviate the client's anxiety and fear of having cancer. This response also establishes a foundation for further discussion about the condition, allowing the nurse to address the client's concerns and provide accurate information. Choice B is incorrect as it focuses solely on the diagnostic tests for pheochromocytoma but does not address the client's emotional distress. Choice C is incorrect as it discusses imaging modalities without directly addressing the client's concerns. Choice D is also incorrect as it assumes symptoms without first addressing the client's emotional state and fear of cancer.

2. A female adult walks into a local community health clinic and tells the nurse that she is homeless and cannot seem to find help. Which statement indicates to the nurse that a client is feeling separated from society and helpless?

• A. "I'm feeling really isolated from everyone and scared."
• B. "I feel like I cannot get enough food to live any longer."
• C. "I know that I will always be poor so what's the use of trying?"
• D. "People like me are never respected, no matter how well we do."

Correct answer: A

Rationale: The correct answer is A. The statement "I'm feeling really isolated from everyone and scared" indicates a sense of separation from society and helplessness. This choice reflects feelings of loneliness and fear, which are common among individuals who feel disconnected and helpless. Choices B, C, and D do not directly convey a sense of isolation and helplessness. Choice B focuses on food insecurity, choice C on a resigned attitude towards poverty, and choice D on lack of respect, none of which directly address the feelings of being separated from society and helpless as indicated in the scenario.

3. When a nurse teaches a community about the importance of hand hygiene, the nurse is engaging in:

• A. Primary prevention
• B. Secondary prevention
• C. Tertiary prevention
• D. Quaternary prevention

Correct answer: A

Rationale: The correct answer is A: Primary prevention. Primary prevention aims to prevent the occurrence of a disease or injury before it happens. Teaching about hand hygiene to the community helps in preventing infections from occurring in the first place. Choice B, Secondary prevention, involves early detection and treatment to halt or slow the progress of a condition. This would involve screening or early intervention after exposure. Choice C, Tertiary prevention, focuses on managing the disease to prevent complications, recurrence, or deterioration. This would include rehabilitation and monitoring to prevent further complications. Choice D, Quaternary prevention, relates to actions taken to avoid unnecessary interventions or over-medicalization. This usually involves questioning the necessity of certain medical procedures or treatments to prevent harm to patients.

4. What title should be given to this professional role in occupational health? A registered nurse who develops researchable questions, conducts research, and communicates the findings to occupational and environmental health professionals, other peers, and the public.

• A. manager
• B. researcher
• C. clinician/practitioner
• D. health promotion specialist

Correct answer: B

Rationale: The correct answer is 'B: researcher.' In this context, the individual is primarily involved in developing research questions, conducting research, and disseminating findings, which aligns with the responsibilities of a researcher. Choice 'A: manager' is incorrect because the role described does not primarily involve managerial duties. Choice 'C: clinician/practitioner' is also incorrect as the focus is on research activities rather than direct clinical practice. Choice 'D: health promotion specialist' does not encompass the full scope of responsibilities described in the scenario.

5. Certain health policies/strategies serve as guidelines in the delivery of services. Which of these is incorrect?

• A. A growth monitoring chart is a tool recommended for assessing and recording the child's health condition.
• B. Voluntary blood donation should be promoted through the organization of walking blood banks in rural areas.
• C. Public sectors should collaborate with the private sector for effective utilization of resources.
• D. Traditional birth attendants should be trained and allowed to provide prenatal care to mothers.

Correct answer: C

Rationale: Choice C is incorrect because public sectors are encouraged to collaborate with the private sector for effective utilization of resources, not work separately. Collaborating with the private sector can lead to improved resource allocation, better service delivery, and enhanced healthcare outcomes. Choices A, B, and D are correct as growth monitoring charts are indeed recommended for assessing child health, promoting voluntary blood donation through walking blood banks is beneficial, and training traditional birth attendants to provide prenatal care can improve maternal health.

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