Nursing Elites

1. A client with terminal cancer is experiencing severe pain. The nurse plans to implement which of the following pain management strategies?

• A. Administer analgesics on a fixed schedule
• B. Administer analgesics only when the client requests
• C. Use non-pharmacological methods only
• D. Increase the dose of analgesics when the client complains of pain

Correct answer: A

Rationale: Administering analgesics on a fixed schedule is the most appropriate pain management strategy for a client with terminal cancer experiencing severe pain. This approach ensures consistent pain control and helps prevent breakthrough pain. Administering analgesics only when the client requests (Choice B) may lead to uncontrolled pain as the client may delay requesting medication until the pain becomes unbearable. Using non-pharmacological methods only (Choice C) may not provide adequate pain relief for a client experiencing severe pain. Increasing the dose of analgesics when the client complains of pain (Choice D) may result in inconsistent pain control and could lead to potential overdose or adverse effects.

2. A health program that aims to reduce the incidence of chronic diseases through lifestyle modifications is an example of:

• 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 focuses on preventing the development of diseases or injuries before they occur by promoting healthy behaviors and lifestyles. In this scenario, the health program targeting lifestyle modifications to reduce chronic diseases aligns with primary prevention efforts. Choice B, secondary prevention, involves early detection and treatment to prevent the progression of disease. Choice C, tertiary prevention, focuses on managing and treating existing diseases to prevent complications. Choice D, quaternary prevention, relates to actions taken to mitigate or avoid the consequences of unnecessary or excessive interventions in healthcare.

3. In evaluating your client's level of wellness, which of the following indicators can you see?

• A. Appropriate nutritional level
• B. Sense of personal security
• C. Acceptance of oneself and one's limitations
• D. Maladaptations to one's environment

Correct answer: C

Rationale: When evaluating a client's level of wellness, indicators such as appropriate nutritional level, sense of personal security, and acceptance of oneself and one's limitations are crucial. Option C, 'Acceptance of oneself and one's limitations,' directly relates to mental wellness and self-awareness, making it a key indicator of overall well-being. Options A, B, and D are not as directly tied to the psychological and emotional aspects of wellness, making them less relevant indicators in this context. Therefore, the correct answer is C.

4. When designing a community health project based on a report provided by the World Health Organization that describes healthcare problems in the United States, which healthcare issue should the nurse prioritize the highest when planning the project?

• A. Overuse of diagnostic technology.
• B. Government-based health insurance.
• C. The neonatal and infant mortality rates.
• D. Number of people without access to health care.

Correct answer: C

Rationale: The neonatal and infant mortality rates should be given the highest priority when planning the project because they are critical indicators of the overall health and healthcare system's effectiveness. High neonatal and infant mortality rates signify underlying issues in prenatal care, access to healthcare services, and quality of care for newborns and infants. Choice A, overuse of diagnostic technology, though important, may not be as critical as addressing neonatal and infant mortality rates. Choice B, government-based health insurance, is significant but may not directly impact neonatal and infant mortality rates. Choice D, the number of people without access to healthcare, is a crucial issue, but addressing neonatal and infant mortality rates should take precedence due to their immediate impact on the health and well-being of the most vulnerable population.

5. The nurse is preparing an orientation class for new employees at an inner city clinic that serves a low-income population. Which information should the nurse include in the presentation to these new employees?

• A. A lack of transportation is a major barrier for the clinic's clients.
• B. Basic physiologic needs are likely to be unmet in this clinic's client population.
• C. Printed material is less effective for this population with limited reading skills.
• D. Group education classes are often poorly attended by non-compliant clients.

Correct answer: B

Rationale: The correct answer is B because addressing basic physiologic needs is crucial for low-income populations. Ensuring that basic needs such as food, shelter, and safety are met is essential for these clients to engage effectively in their healthcare. Choice A talks about transportation, which can be a barrier but may not be the major impediment. Choice C focuses on printed material and reading skills, which are important but not as fundamental as addressing basic physiologic needs. Choice D makes assumptions about client attendance based on compliance, which is not the most critical information to include in an orientation about serving a low-income population.

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