Nursing Elites

1. A patient who has multiple health issues is discharged after a recent hospitalization. Which of the following comprehensive programs would a community health nurse refer the patient to if the patient is not under medical supervision but does have insurance?

• A. private health care practitioner
• B. a patient-centered medical home
• C. hospital clinic
• D. subacute facility

Correct answer: B

Rationale: A patient-centered medical home is a comprehensive care model that provides coordinated healthcare services across various settings. It is an ideal referral for a patient with multiple health issues who is not under medical supervision but has insurance, as it offers a patient-focused approach to managing the patient's overall health needs.

2. Why is cultural competence important in community health nursing?

• A. It helps nurses provide care that is respectful and responsive to the health beliefs and practices of diverse patients.
• B. It mandates all health care providers to undergo cultural training.
• C. It ensures that nurses are knowledgeable about different medical practices.
• D. It prevents nurses from encountering cultural misunderstandings.

Correct answer: A

Rationale: Cultural competence is essential in community health nursing as it enables nurses to deliver care that respects and responds to the health beliefs and practices of patients from diverse cultural backgrounds. By understanding and incorporating cultural considerations into their practice, nurses can enhance communication, build trust, and improve health outcomes for all individuals within the community.

3. 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.

4. How does critical theory differ from other nursing theories such as the Health Belief Model or Orem’s self-care deficit theory?

• A. Critical theory can be utilized by professionals other than nurses.
• B. Critical theory focuses on oppression and enables group action.
• C. Critical theory is indirectly associated with health promotion.
• D. Critical theory addresses challenging an individual’s beliefs.

Correct answer: B

Rationale: Critical theory differs from other nursing theories like the Health Belief Model or Orem's self-care deficit theory by focusing on oppression and enabling group action. Unlike these nursing theories that may concentrate more on individual beliefs, critical theory aims to address broader societal issues and promote collective action for social change.

5. The healthcare provider should consider the following when assessing the child for chest indrawing EXCEPT

• A. Chest indrawing should be present at all times
• B. The lower chest wall does not move in when the child breathes in
• C. The lower chest moves in when the child breathes in
• D. The child should be calm

Correct answer: A

Rationale: When assessing a child for chest indrawing, it is important to note that chest indrawing should NOT be present at all times, as this would suggest a significant respiratory distress. Chest indrawing is an abnormal inward movement of the lower chest wall during inhalation, indicating increased work of breathing. Therefore, the absence of chest indrawing during normal breathing is a normal finding. The healthcare provider should observe for the lower chest moving in with each breath, which is abnormal, while ensuring that the child is calm during the assessment.

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