Nursing Elites

1. A hospitalized child suddenly has a seizure while his family is visiting. The nurse notes whole body rigidity followed by general jerking movements. The child vomits immediately after the seizure. A priority nursing diagnosis for the child is

• A. High risk for infection related to vomiting
• B. Altered family processes related to chronic illness
• C. Fluid volume deficit related to vomiting
• D. Risk for aspiration related to loss of consciousness

Correct answer: D

Rationale: Risk for aspiration is a priority concern following a seizure, especially when the child vomits, as there is a danger of aspirating the vomit into the lungs, leading to respiratory complications. The other options are not the priority in this situation. While infection risk and fluid volume deficit are important, ensuring the child's airway is clear and there is no risk of aspiration takes precedence. Altered family processes may be a concern but addressing the immediate physiological risk is the priority.

2. In order to determine what specific health teaching should be appropriate for the people of this municipality, which of the following is the best method to use?

• A. interviewing midwives
• B. reviewing records and reports
• C. studying knowledge, attitudes, and practices of the people
• D. reviewing health statistics

Correct answer: C

Rationale: Studying knowledge, attitudes, and practices of the people is the best method to determine appropriate health teaching for a community. This approach provides valuable insights into the specific needs, beliefs, and behaviors of the population, allowing for tailored and effective health education interventions. Interviewing midwives may offer some insights, but focusing on the broader community is more comprehensive. Reviewing records and reports can provide historical data but may not capture current community needs as effectively as studying current knowledge, attitudes, and practices. Reviewing health statistics is important but may not provide the detailed understanding of community perceptions and behaviors that directly impact health education planning.

3. 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.

4. A 16-month-old child has just been admitted to the hospital. As the nurse assigned to this child enters the hospital room for the first time, the toddler runs to the mother, clings to her, and begins to cry. What would be the initial action by the nurse?

• A. Arrange for a change in client care assignments
• B. Explain that this behavior is expected
• C. Discuss the appropriate use of 'time-out'
• D. Explain that the child is in need of extra attention

Correct answer: B

Rationale: The correct answer is to explain that this behavior is expected. At 16 months of age, children commonly experience separation anxiety, especially in unfamiliar environments like hospitals. It is important for the nurse to reassure the child and the parent that such behavior is normal. Option A is incorrect as there is no need to change client care assignments based on the child's behavior. Option C is not appropriate as discussing the use of 'time-out' is more relevant in behavior management for older children. Option D is incorrect as it does not address the underlying cause of the child's behavior related to separation anxiety.

5. In which of the following settings would a community health nurse be less likely to be involved?

• A. neighborhood clinic, community clinic, or senior center
• B. physician's office with a focus on individual client care
• C. home-based care
• D. neighborhood planning board

Correct answer: B

Rationale: Community health nurses are less likely to be involved in a physician's office with a focus on individual client care because their role primarily revolves around promoting and maintaining the health of populations and communities rather than providing direct care to individual clients. Options A, C, and D are more aligned with the community health nurse's role as they involve working in community-based settings, providing home-based care, and participating in community planning and advocacy.

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