Nursing Elites

1. After 3 days, the nurse notes that James has chest indrawing and stridor. His mother returned him to the health center immediately. The nurse should:

• A. Change the antibiotic to second-line antibiotics
• B. Advise the mother to observe the child and continue giving the antibiotics
• C. Give the first dose of antibiotics and refer urgently
• D. Observe the child at the center

Correct answer: C

Rationale: Chest indrawing and stridor are signs of severe respiratory distress. In this situation, immediate referral is essential. Giving the first dose of antibiotics before referral can help initiate treatment, but urgent referral for further evaluation and management is crucial. Choice A is incorrect because simply changing the antibiotic without assessing the severity of the symptoms and providing urgent care is not appropriate. Choice B is incorrect as advising the mother to observe the child and continue antibiotics delays necessary intervention for a potentially life-threatening condition. Choice D is incorrect as observing the child at the center is not sufficient when signs of severe illness are present.

2. Which topic should be included in planning a secondary prevention project for the local retirement community?

• A. Safety measures in the home.
• B. Adult immunization program.
• C. Rehabilitation after surgery.
• D. Vision and hearing screening.

Correct answer: D

Rationale: In planning a secondary prevention project for the local retirement community, vision and hearing screening should be included. This is crucial as sensory impairments are common among older adults and early detection through screening can help in preventing further complications. Safety measures in the home, adult immunization programs, and rehabilitation after surgery are important but fall more under primary or tertiary prevention strategies rather than secondary prevention, which focuses on early detection and intervention to prevent the progression of health conditions.

3. Which one of the following statements, if made by the client, indicates teaching about Inderal (propranolol) has been effective?

• A. ''I may experience seizures if I stop the medication abruptly.''
• B. ''I may experience an increase in my heart rate for a few weeks.''
• C. ''I can expect to feel nervousness the first few weeks.''
• D. ''I can have a heart attack if I stop this medication suddenly.''

Correct answer: D

Rationale: The correct answer is D. Stopping Inderal (propranolol) abruptly can cause rebound hypertension, angina, and even a myocardial infarction (heart attack), so it is crucial to taper off the medication under medical supervision. Choices A, B, and C are incorrect because they do not reflect the serious consequences associated with abrupt discontinuation of propranolol.

4. Which of the following health behavior choices are essential to promoting health and preventing diseases?

• A. Getting the right kind of food, adequate sleep, physical activity, and effectively handling stress
• B. Stopping smoking and taking vacations
• C. Making sure that all prescription medications are taken properly and at the right time
• D. Avoiding crowds during flu season

Correct answer: A

Rationale: The correct answer is A. Proper nutrition, adequate sleep, engaging in physical activity, and effective stress management are crucial for promoting health and preventing diseases. Choices B, C, and D do not encompass the comprehensive approach needed for overall health and disease prevention. Stopping smoking is important for health but is not the only factor to consider. Taking vacations can contribute to well-being but is not a core health behavior choice. Ensuring proper medication intake is essential for managing specific health conditions but does not cover all aspects of health promotion. Avoiding crowds during flu season is a preventive measure for infectious diseases but is not a fundamental health behavior choice for overall well-being.

5. Which of the following behaviors is influenced by cultural expectations?

• A. talking openly about the details of the illness
• B. deciding whether to 'feed a cold' or 'starve a fever'
• C. taking herbal supplements to boost the immune system
• D. all of the above

Correct answer: D

Rationale: Cultural expectations can influence all the listed behaviors. Talking openly about the details of an illness may be culturally acceptable or taboo. The decision to 'feed a cold' or 'starve a fever' is often influenced by cultural beliefs and practices. Additionally, the use of herbal supplements to boost the immune system can also be shaped by cultural norms and traditions. Therefore, all the behaviors listed can be influenced by cultural expectations, making option D the correct answer. Choices A, B, and C are incorrect because cultural expectations can impact each of these behaviors.

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