Nursing Elites

1. An activity designed to diagnose and treat a disease or condition in its earliest stages, before it becomes full-blown, would be classified as:

• A. primary prevention
• B. secondary prevention
• C. tertiary prevention
• D. health education

Correct answer: B

Rationale: The correct answer is B, secondary prevention. Secondary prevention focuses on early diagnosis and intervention to prevent the progression of a disease or condition. This involves detecting and treating the illness in its early stages to reduce its impact. Choice A, primary prevention, aims to prevent the development of a disease or injury before it occurs by promoting healthy behaviors. Choice C, tertiary prevention, involves managing and improving the quality of life of individuals with established conditions to prevent complications and further deterioration. Choice D, health education, refers to providing information and promoting awareness about health issues to enable individuals to make informed decisions and adopt healthy behaviors.

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. A home health nurse is at the home of a client with diabetes and arthritis. The client has difficulty drawing up insulin. It would be most appropriate for the nurse to refer the client to:

• A. A social worker from the local hospital
• B. An occupational therapist from the community center
• C. A physical therapist from the rehabilitation agency
• D. Another client with diabetes mellitus who takes insulin

Correct answer: B

Rationale: An occupational therapist is the most appropriate professional to refer the client to in this situation. Occupational therapists can provide assistance with techniques and tools to help the client manage insulin administration despite arthritis. Referring the client to a social worker (Choice A) may not directly address the client's difficulty with insulin. While physical therapists (Choice C) focus on mobility and strength, they may not specialize in techniques for insulin administration. Referring the client to another client with diabetes (Choice D) is not a professional or appropriate solution to address the client's difficulty.

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. Which intervention should the public health nurse implement to address one of the leading health indicators of Healthy People 2020?

• A. Lead a weekly water aerobics class for the elderly at a community center.
• B. Teach a class on cultural awareness to nursing students at the university.
• C. Design and implement a no smoking campaign at the local high school.
• D. Write a grant to help provide glucometers to individuals who cannot afford one.

Correct answer: C

Rationale: Designing and implementing a no smoking campaign aligns with the objective of reducing tobacco use, which is one of the leading health indicators of Healthy People 2020. This intervention directly targets a significant public health concern. Leading a water aerobics class, teaching cultural awareness, or providing glucometers, while beneficial in other contexts, do not specifically address the leading health indicators outlined by Healthy People 2020.

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