Nursing Elites

1. A male client is brought to the emergency department as the result of a motorcycle accident. He was not wearing a helmet at the time of the accident and states that he has no intention of ever wearing one. Within the framework of the Transtheoretical Model (TTM), which response should the nurse provide?

• A. Wearing a helmet or not is certainly an individual decision.
• B. You should seriously consider wearing a helmet.
• C. Riding a motorcycle with a helmet increases your safety.
• D. I really think you don't have the facts about helmet use.

Correct answer: C

Rationale: Providing information on safety aligns with the TTM framework.

2. An infant has just returned from surgery for placement of a gastrostomy tube as an initial treatment for tracheoesophageal fistula. The mother asks, 'When can the tube be used for feeding?' The nurse's best response would be which of these comments?

• A. "Feedings can begin in 5 to 7 days."
• B. "The use of the feeding tube can begin immediately."
• C. "The stomach contents and air must be drained first."
• D. "The incision healing must be complete before feeding."

Correct answer: C

Rationale: The correct answer is C: 'The stomach contents and air must be drained first.' Before starting feedings through a gastrostomy tube, it is essential to drain the stomach contents and air. This process helps prevent complications and ensures the proper functioning of the tube after placement. Choice A is incorrect because initiating feedings within 5 to 7 days may lead to complications if the stomach is not adequately prepared. Choice B is incorrect as feeding should not begin immediately to allow for proper preparation of the tube and the stomach. Choice D is incorrect because although incision healing is important, draining the stomach contents and air is a more immediate concern to prevent complications.

3. 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.

4. In order to establish priorities in planning and implementing the occupational health program, which of the following data will the nurse need?

• A. disease trends, birth and death rates, and social environmental conditions
• B. birth and death rates
• C. disease trends
• D. social environmental conditions

Correct answer: A

Rationale: To effectively plan and implement an occupational health program, the nurse needs comprehensive data, including disease trends, birth and death rates, and social environmental conditions. This holistic approach ensures that the program addresses a wide range of health aspects impacting the target population. Option A is the correct choice as it considers multiple factors influencing occupational health. Choices B, C, and D are each individually important but do not provide the breadth of information required to establish priorities in a comprehensive occupational health program.

5. A client with myasthenia gravis is receiving pyridostigmine (Mestinon). The nurse should monitor the client for which of the following side effects?

• A. Constipation
• B. Hypertension
• C. Muscle weakness
• D. Bradycardia

Correct answer: D

Rationale: The correct answer is D: Bradycardia. Pyridostigmine, a cholinesterase inhibitor used in myasthenia gravis, can lead to bradycardia as a side effect. Choice A, constipation, is not a common side effect of pyridostigmine. Choice B, hypertension, is unlikely as pyridostigmine is more likely to cause hypotension. Choice C, muscle weakness, is actually a symptom of myasthenia gravis itself and not a side effect of pyridostigmine.

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