Nursing Elites

1. A public health nurse is managing several projects for the community. Which of the following interventions should the nurse identify as a primary prevention strategy?

• A. Teaching parenting skills to expectant mothers and their partners.
• B. Conducting mental health screenings at the local community center
• C. Referring clients with obesity to community exercise programs
• D. Providing crisis intervention through a mobile counseling unit

Correct answer: A

Rationale: The correct answer is teaching parenting skills to expectant mothers and their partners. This intervention is a primary prevention strategy aimed at educating individuals before a problem or condition develops. By teaching parenting skills, the nurse is promoting healthy behaviors and relationships, which can prevent future issues. The other options involve secondary or tertiary prevention strategies by identifying and treating existing conditions or providing interventions after a problem has occurred.

2. When caring for a client who is on contact precautions, which of the following measures should the nurse include in the teaching?

• A. Remove the protective gown after leaving the client's room.
• B. Place the client in a room with negative pressure.
• C. Wear gloves when providing care to the client.
• D. Wear a mask when in the client's room.

Correct answer: C

Rationale: Contact precautions are used for clients with known or suspected infections that are spread by direct or indirect contact. The most important measure for healthcare workers when caring for a client on contact precautions is to wear gloves when providing care. This helps prevent the transmission of infectious agents between the client and the healthcare worker. Removing the protective gown after leaving the client's room, placing the client in a room with negative pressure, and wearing a mask when in the client's room are not specific to contact precautions and may not be necessary for all clients on contact precautions.

3. A healthcare professional is caring for a client who is experiencing respiratory distress. Which of the following early manifestations of hypoxemia should the professional recognize?

• A. Confusion
• B. Pale skin
• C. Bradycardia
• D. Hypotension

Correct answer: B

Rationale: Pale skin is an early manifestation of hypoxemia due to decreased oxygenation of the blood. The skin may appear pale as the body redirects blood flow to vital organs in response to low oxygen levels. Confusion, bradycardia, and hypotension may occur as hypoxemia worsens, but pale skin is one of the initial signs that healthcare professionals should recognize when assessing a client experiencing respiratory distress.

4. What is the best position for examining the rectum?

• A. Prone
• B. Sim's
• C. Knee-chest
• D. Lithotomy

Correct answer: C

Rationale: The knee-chest position is the most optimal position for examining the rectum. In this position, the patient kneels on the examination table with their chest resting on it, creating a straight line from the head to the lower back. This position allows for easier access and visualization of the rectal area, making it the preferred choice for rectal examinations. Prone position (choice A) is lying face down and is not ideal for rectal exams as it does not provide good access. Sim's position (choice B) is lying on the left side with the right knee and thigh flexed, also not ideal for rectal exams. Lithotomy position (choice D) is lying on the back with legs flexed and feet in stirrups, primarily used for gynecological exams and surgery, not for rectal examinations.

5. When discussing hair loss with Mrs. Lim, who begins to cry, the best response would be:

• A. Don’t worry. It’s only temporary
• B. Why are you crying? I didn’t get to the bad news yet
• C. Your hair is really pretty
• D. I know this will be difficult for you, but your hair will grow back after the completion of chemotherapy

Correct answer: D

Rationale: When a patient is emotionally affected, it is essential to acknowledge their feelings while providing reassurance and information. Option D demonstrates empathy by acknowledging the difficulty Mrs. Lim is facing and offers hope by reassuring her that her hair will grow back after chemotherapy, which can provide comfort and support during a challenging time.

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