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. An example of the continuum health model of health and wellness would be:

• A. a person is either well or not, and the emphasis is on continuously and aggressively treating people who are ill
• B. predicting that a person will most likely continue good health practices, based on his or her health practices in the past, such as getting flu shots
• C. using acupuncture and therapeutic touch to cure disease instead of traditional medical therapies
• D. none of the above

Correct answer: B

Rationale: The continuum health model emphasizes ongoing health practices based on past behaviors. Choice A is incorrect as it describes a more binary approach to health. Choice C is incorrect as it focuses on alternative therapies rather than the continuity of health practices.

3. A client is suspected of being poisoned and presents with symmetric, descending flaccid paralysis, blurred vision, double vision, and dry mouth. The nurse should consider these findings consistent with which potential bioterrorism agent?

• A. ricin
• B. botulism toxin
• C. sulfur mustard
• D. yersinia pestis

Correct answer: B

Rationale: The correct answer is B: botulism toxin. Botulism toxin is associated with symmetric, descending flaccid paralysis, blurred vision, double vision, and dry mouth, which are consistent with the client's presentation. Ricin (Choice A) typically presents with gastrointestinal symptoms. Sulfur mustard (Choice C) is a blistering agent causing skin, eye, and respiratory issues. Yersinia pestis (Choice D) is associated with the bubonic plague, presenting with fever, malaise, and buboes.

4. The nurse working in a community health clinic that serves recent Somali immigrants notes that most mothers refuse to give permission for routine immunizations of their preschoolers. Which individual is likely to have the most influence on these women's perceptions about their children's healthcare needs?

• A. husbands
• B. clinic healthcare providers
• C. older females
• D. tribal chief

Correct answer: D

Rationale: In many Somali communities, the tribal chief holds significant influence over health decisions. The tribal chief often plays a crucial role in shaping community beliefs and practices, including healthcare decisions. While husbands may have some influence, the tribal chief typically holds more authority in community matters. Clinic healthcare providers have a role in educating and advising, but the tribal chief's influence is often more profound in this cultural context. Older females may have some influence, especially in familial matters, but the tribal chief is usually the key decision-maker in community health issues.

5. 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.

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