Nursing Elites

1. A pre-term baby develops nasal flaring, cyanosis, and diminished breath sounds on one side. The provider's diagnosis is spontaneous pneumothorax. Which procedure should the nurse prepare for first?

• A. Cardiopulmonary resuscitation
• B. Insertion of a chest tube
• C. Oxygen therapy
• D. Assisted ventilation

Correct answer: B

Rationale: The correct answer is B: Insertion of a chest tube. In a case of spontaneous pneumothorax, the primary intervention is to insert a chest tube. This procedure allows the trapped air to escape from the pleural space, relieving pressure and enabling the lung to re-expand. Choices A, C, and D are not the initial interventions for spontaneous pneumothorax. Cardiopulmonary resuscitation is indicated for cardiac arrest, oxygen therapy may provide supportive care but does not address the underlying issue of trapped air in the pleural space, and assisted ventilation may be needed later but is not the first-line treatment for a pneumothorax.

2. A 6-month-old infant who is being treated for developmental dysplasia of the hip has been placed in a hip spica cast. The nurse should teach the parents to

• A. Gently rub the skin with a cotton swab to relieve itching
• B. Place the favorite books and push-pull toys in the crib
• C. Check every few hours for the next day or 2 for swelling in the baby's feet
• D. Turn the baby with the abduction stabilizer bar every 2 hours

Correct answer: C

Rationale: The correct answer is to check every few hours for the next day or 2 for swelling in the baby's feet. Swelling in the baby's feet could indicate compromised circulation due to the cast, and frequent checks are necessary to ensure that there are no complications. Choices A, B, and D are incorrect because rubbing the skin with a cotton swab, placing favorite items in the crib, and turning the baby with the abduction stabilizer bar do not address the potential issue of compromised circulation and swelling in the baby's feet.

3. On admission to the psychiatric unit, the client is trembling and appears fearful. The nurse’s initial response should be to

• A. Give the client orientation materials and review the unit rules and regulations
• B. Introduce oneself and accompany the client to their room
• C. Take the client to the day room and introduce them to the other clients
• D. Ask the nursing assistant to get the client’s vital signs and complete the admission search

Correct answer: B

Rationale: In situations where a client is trembling and fearful upon admission to a psychiatric unit, it is essential to prioritize building trust and reducing anxiety. By introducing oneself and accompanying the client to their room, the nurse can establish a therapeutic relationship, provide a sense of security, and address the client's immediate emotional needs. Choices A, C, and D are not the most appropriate initial responses as they do not directly address the client's emotional state or focus on establishing a supportive relationship.

4. Refers to the nurses in the local/national health departments or public schools:

• A. Public health nursing
• B. Public health nurse
• C. Registered midwives
• D. Registered nurses

Correct answer: B

Rationale: The correct term for nurses working in local/national health departments or public schools is 'public health nurse.' This term specifically refers to individual nurses in those settings. Choice A, 'Public health nursing,' is a broader term that refers to the field of nursing focused on improving community health. Choices C and D, 'Registered midwives' and 'Registered nurses,' do not specifically indicate the nurses working in local/national health departments or public schools, making them incorrect.

5. What are the requirements and qualifications for a regional nurse supervisor?

• A. BSN, RN
• B. at least 5 years of experience in public health
• C. Master's in public health
• D. all of the above

Correct answer: D

Rationale: To become a regional nurse supervisor, one must possess a BSN and RN credentials to ensure clinical competency. Additionally, a minimum of 5 years of experience in public health is required to demonstrate a solid understanding of the field. Lastly, holding a Master's degree in public health is essential for leadership and decision-making roles. Therefore, all the choices (BSN, RN; at least 5 years of experience in public health; Master's in public health) are necessary qualifications for a regional nurse supervisor.

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