Nursing Elites

1. A community health nurse is overwhelmed with all that needs to be done in one day. Which task could most easily be postponed?

• A. Reviewing the most recent hospital patient data collected by the local college of nursing
• B. Deciding which of several possible new clinic options would be most effective in better meeting the needs of the local community
• C. Evaluating the results of the most recent community-wide screening program before planning for the next community health program
• D. Giving testimony to the state legislature on a new health and safety bill

Correct answer: A

Rationale: The most easily postponed task among the options provided is reviewing the most recent hospital patient data collected by the local college of nursing. This task focuses on data collection and analysis, which can be delayed without immediate impact on decision-making related to new clinic options, community-wide screening program evaluation, or legislative testimony on health and safety bills.

2. Which sign or reflex is used to diagnose meningitis?

• A. Homan's sign
• B. Brudzinski
• C. Startle
• D. Anterior drawer

Correct answer: B

Rationale: Brudzinski sign is a physical exam finding used to diagnose meningitis. It is elicited by flexing the patient's neck, resulting in involuntary flexion of the hips and knees. This maneuver indicates meningeal irritation, a common feature in meningitis. Homan's sign is used to assess for deep vein thrombosis, Startle is a reflex response to sudden stimuli, and the Anterior drawer test is used to diagnose ligamentous instability in the knee.

3. All of the following are characteristics of the Patient Centered Medical Home (PCMH) except:

• A. Comprehensive in scope of care
• B. Guarantees safety at home
• C. Patient needs come first
• D. Providers work together

Correct answer: B

Rationale: The Patient Centered Medical Home (PCMH) model is designed to provide comprehensive care, prioritize patient needs, and ensure that healthcare providers work together to coordinate care effectively. However, guaranteeing safety at home is not a specific characteristic of the PCMH model. Home safety is an important aspect of patient care but is not explicitly part of the PCMH model's core principles.

4. Which of the following is not a therapeutic indication of bone marrow puncture?

• A. Analgesia
• B. Antibiotics
• C. Anaesthesia
• D. Inflammation

Correct answer: A

Rationale: Bone marrow puncture is not typically performed for analgesia purposes. It is primarily done for diagnostic or therapeutic reasons, such as obtaining a sample for testing, administering medications like antibiotics, providing anesthesia during the procedure, or treating conditions related to inflammation. Analgesia, which refers to pain relief, is not a direct therapeutic indication for bone marrow puncture.

5. When caring for a first-time mom and baby, the community RN would focus on which of the following as the first priority when developing appropriate interventions?

• A. Education
• B. Safety
• C. Policy-making
• D. Vaccination

Correct answer: B

Rationale: The primary priority when caring for a first-time mom and baby is ensuring safety. Safety encompasses various aspects such as preventing accidents, promoting a safe environment for both the mother and baby, and reducing risks of harm. By prioritizing safety, the community RN can address immediate concerns and create a foundation for the well-being of the mother and baby.

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