Nursing Elites

1. A male client who had abdominal surgery has a nasogastric tube for suction, oxygen via nasal cannula, and complains of dry mouth. Which action should the nurse implement?

• A. Apply a petroleum-based lubricant to the lips.
• B. Give sips of water.
• C. Provide ice chips.
• D. Apply a water-soluble lubricant to the lips, oral mucosa, and nares.

Correct answer: D

Rationale: In this scenario, the correct action is to apply a water-soluble lubricant to the lips, oral mucosa, and nares. This helps in keeping the mucous membranes moist, which is essential for a client with a dry mouth due to the nasogastric tube and oxygen therapy. Choice A, applying a petroleum-based lubricant to the lips, is not suitable as it may not be safe for internal use. Choice B, giving sips of water, is contraindicated as the client has a nasogastric tube in place for suction. Choice C, providing ice chips, is also not recommended as the client needs proper lubrication to address dryness, not cold stimulation.

2. During the physical assessment, which finding should the nurse recognize as a normal finding?

• A. Regular pulsation at the epigastric area when the client is supine.
• B. A loud, harsh murmur at the second right intercostal space.
• C. Dullness over the lung fields.
• D. Increased tactile fremitus.

Correct answer: A

Rationale: The regular pulsation at the epigastric area when the client is supine is a normal finding. This phenomenon is caused by the regular and recurrent expansion and contraction of an artery due to waves of pressure caused by the ejection of blood from the left ventricle. Choices B, C, and D describe abnormal findings during a physical assessment. A loud, harsh murmur at the second right intercostal space indicates an abnormal heart sound, dullness over the lung fields may suggest consolidation or fluid in the lungs, and increased tactile fremitus can be a sign of lung consolidation or pathology.

3. The nurse is developing a program to educate parents on the importance of childhood immunizations. Which topic should be prioritized?

• A. the benefits of immunizations
• B. the potential side effects of vaccines
• C. the immunization schedule
• D. ways to comfort children during vaccinations

Correct answer: A

Rationale: The correct answer is A: the benefits of immunizations. Emphasizing the benefits of immunizations helps parents understand the importance of vaccines in protecting their children from preventable diseases. This choice should be prioritized as it focuses on the positive outcomes of immunizations, which can motivate parents to vaccinate their children. Choices B, C, and D are not the top priority because while it's important to address potential side effects, the immunization schedule, and comforting children during vaccinations, the main focus should be on highlighting the benefits to encourage parents to make informed decisions regarding their child's immunizations.

4. A public health nurse is working with a community to improve access to mental health services. Which intervention is most likely to be effective?

• A. Setting up mental health clinics in accessible locations
• B. Distributing flyers with information about mental health services
• C. Offering transportation vouchers for mental health appointments
• D. Partnering with local businesses to promote mental health

Correct answer: A

Rationale: The correct answer is A: Setting up mental health clinics in accessible locations. This intervention is the most effective as it directly addresses the issue of access to mental health services by physically bringing the services closer to the community members. Distributing flyers (choice B) may raise awareness but does not guarantee improved access. Offering transportation vouchers (choice C) helps with transportation but does not address the primary issue of service availability. Partnering with local businesses (choice D) may help promote mental health awareness but does not ensure improved access to services like setting up clinics in accessible locations.

5. A male client leaves his job at a nearby restaurant and visits the health clinic where he is diagnosed with viral conjunctivitis. While receiving discharge instructions from the nurse, the client states that he is feeling much better and plans to return to work for the afternoon shift. How should the nurse respond?

• A. advise the client to wear a face mask around other people
• B. ask the client what type of work he does at the restaurant
• C. instruct the client to use dark glasses if lighting is bright
• D. explain that the client should stay home for the next few days

Correct answer: D

Rationale: The correct answer is D: explain that the client should stay home for the next few days. Viral conjunctivitis is highly contagious, and the client should avoid close contact with others until it resolves. Returning to work while still contagious can lead to the spread of the infection to coworkers and customers. Choice A is incorrect because wearing a face mask may not provide sufficient protection against spreading the virus in a close work environment. Choice B is irrelevant to the situation as the focus should be on the client's health and preventing the spread of the infection. Choice C is also unrelated to the management of viral conjunctivitis and does not address the contagious nature of the condition.

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