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. At a routine health assessment, a client tells the nurse that she is planning a pregnancy in the near future. She asks about preconception diet changes. Which of the statements made by the nurse is best?

• A. Include fibers in your daily diet.
• B. Increase green leafy vegetable intake.
• C. Drink a glass of milk with each meal.
• D. Eat at least 1 serving of fish weekly.

Correct answer: B

Rationale: The correct answer is B: "Increase green leafy vegetable intake." This is the best advice because green leafy vegetables are rich in folic acid, which is essential for fetal development and helps prevent neural tube defects. Choice A is not specific enough and does not address the importance of folic acid. Choice C, drinking milk with each meal, does not provide the necessary folic acid intake. Choice D, eating fish weekly, is not as crucial for preconception diet changes as increasing folic acid intake.

3. What is the FIRST STEP for thermal protection of a newborn?

• A. Drying the baby thoroughly immediately after birth
• B. Covering the baby with a clean, dry cloth after the cord has been cut
• C. Drying the baby thoroughly after the cord has been cut
• D. Covering the baby with a clean, dry cloth immediately after birth

Correct answer: A

Rationale: The correct first step for thermal protection of a newborn is to dry the baby thoroughly immediately after birth. This helps prevent heat loss and is crucial in maintaining the baby's body temperature. Choice B, covering the baby with a clean, dry cloth after the cord has been cut, is not the initial step as drying the baby comes first. Choice C, drying the baby thoroughly after the cord has been cut, is also not the first step. Choice D, covering the baby with a clean, dry cloth immediately after birth, is not as effective as drying the baby to prevent heat loss.

4. Which of the following is a contribution of community health nurses to the community's health?

• A. providing health education to vulnerable populations
• B. coordinating access to integrated care for the population
• C. developing comprehensive health care systems in various settings
• D. all of the above

Correct answer: D

Rationale: Community health nurses play a vital role in promoting community health by providing health education to vulnerable populations (Choice A), coordinating access to integrated care for the population (Choice B), and developing comprehensive health care systems in various settings (Choice C). These contributions work together to enhance the overall health and well-being of the community, making choice D, 'all of the above,' the correct answer. Choices A, B, and C are all essential aspects of the multifaceted approach that community health nurses take to improve the health outcomes of the community.

5. Community organizing is an important part of the community nursing function. Given the following elements: choosing an organizational structure, identifying and recruiting members, defining mission, vision, and goals, clarifying roles and responsibilities; at which stage do these elements belong?

• A. Program maintenance-consolidation
• B. Dissemination-Reassessment
• C. Community Analysis/diagnosis
• D. Design and initiation

Correct answer: D

Rationale: The correct answer is D: Design and initiation. These elements such as choosing an organizational structure, identifying and recruiting members, defining mission, vision, and goals, and clarifying roles and responsibilities belong to the design and initiation stage of community organizing. This stage focuses on setting up the foundation and structure of the community organization. The other choices are incorrect because: A) Program maintenance-consolidation refers to maintaining and strengthening existing programs, not establishing new ones; B) Dissemination-Reassessment involves spreading information and evaluating programs already in place; C) Community Analysis/diagnosis is about assessing community needs and identifying issues, not about setting up the initial structure.

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