Nursing Elites

1. A client tells the nurse he is fearful of planned surgery because of evil thoughts about a family member. What is the best initial response by the nurse?

• A. Call a chaplain
• B. Deny the feelings
• C. Cite recovery statistics
• D. Listen to the client

Correct answer: D

Rationale: The correct answer is to listen to the client. Listening allows the nurse to establish therapeutic communication, understand the client's fears and concerns, provide emotional support, and help alleviate anxiety. Calling a chaplain (Choice A) may be appropriate if the client requests spiritual support but should not be the initial response. Denying the feelings (Choice B) is dismissive and can hinder trust and communication. Citing recovery statistics (Choice C) is irrelevant and does not address the client's immediate emotional needs.

2. 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.

3. A client with a peptic ulcer is scheduled for a vagotomy and pyloroplasty. The nurse explains that the purpose of this surgery is to:

• A. Increase acid secretion
• B. Reduce acid secretion
• C. Promote gastric emptying
• D. Remove the ulcerated area

Correct answer: B

Rationale: The correct answer is B: "Reduce acid secretion." Vagotomy is performed to reduce acid secretion by cutting the vagus nerve, which stimulates acid production. Choices A, C, and D are incorrect. A vagotomy does not increase acid secretion, promote gastric emptying, or remove the ulcerated area. It specifically aims to decrease acid production to help in the healing of peptic ulcers.

4. A community health action that focuses on reducing the frequency and severity of asthma in inner-city children by requiring a local incinerator to install particulate filters is an example of:

• A. downstream intervention
• B. risk management
• C. primary prevention
• D. upstream intervention

Correct answer: D

Rationale: The correct answer is D: upstream intervention. Upstream thinking addresses the root causes of health problems to create long-term solutions. In this scenario, requiring the incinerator to install particulate filters tackles the root cause of asthma triggers, which is pollution, rather than just managing the symptoms or risks associated with asthma. Choice A, downstream intervention, would focus more on treating asthma symptoms after they have already occurred rather than preventing them. Choice B, risk management, typically involves strategies to assess, control, or mitigate risks, which may not directly address the root cause. Choice C, primary prevention, usually refers to actions taken to prevent a disease or condition before it occurs, but in this case, the action is targeting the underlying cause rather than preventing asthma itself.

5. As of 2002, the following data was obtained from municipality X: No. of live births - 750, No. of infant deaths - 10, No. of maternal deaths - 6, Total population - 25,000. The 2002 maternal mortality rate of municipality X is:

• A. 15/1000 live births
• B. 12.5/1000 live births
• C. 6/1000 live births
• D. 8/1000 live births

Correct answer: C

Rationale: The maternal mortality rate is calculated as 6 maternal deaths per 1000 live births. The correct answer is C because to calculate the maternal mortality rate, you divide the number of maternal deaths by the number of live births and then multiply by 1000. Choices A, B, and D are incorrect as they do not match the given data on maternal deaths and live births for municipality X.

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