Nursing Elites

1. What are the basic reasons American families are having difficulty adequately performing their vital health care function?

• A. structure of the health care system and family structure
• B. psychological factors affecting men and women seeking health care
• C. conditions labeled as disabilities and considered too time-consuming
• D. health care organizations (HMOs) and disconnected families

Correct answer: A

Rationale: The correct answer is the 'structure of the health care system and family structure'. Scholars suggest that the reasons families are having difficulty providing health care for their members lie with both the structure of the health care system and the family structure. Major factors explaining differences in utilization patterns of medical services include the lack of healthcare insurance coverage, lack of services for special populations (such as teenage males), perception by families of the health care system and the health care provider, and lack of partnership between health care providers and families in mutually addressing health care issues. Choices B, C, and D are incorrect as they do not address the fundamental reasons related to the health care system and family structure as discussed in the provided extract.

2. A client is brought to the emergency department after a motor vehicle accident. The client is alert and cooperative but has sustained multiple fractures of the legs. How should the nurse proceed with data collection?

• A. Collect health history information first while initiating emergency measures.
• B. Ask health history questions while performing the examination and initiating emergency measures.
• C. Collect all information requested on the history form, including social support, strengths, and coping patterns.
• D. Perform emergency measures and delay health history questions until after treating the fractures in the operating room.

Correct answer: B

Rationale: When a client is alert and cooperative but has sustained multiple fractures, the nurse should prioritize obtaining health history information while performing the examination and initiating emergency measures. This approach allows the nurse to gather essential information without delaying immediate interventions. Option A is incorrect because collecting health history information before addressing the immediate need for treatment may lead to a delay in necessary interventions. Option C is incorrect as it includes non-urgent aspects of data collection that are not a priority in this critical situation. Option D is incorrect because delaying health history questions until after treating the fractures may result in missing crucial information essential for the client's immediate care.

3. Which of the following is not a nursing responsibility when preparing the client for central line insertion?

• A. advancing the guidewire
• B. explaining the procedure to the client
• C. maintaining sterile technique
• D. ensuring necessary consents are signed

Correct answer: A

Rationale: When preparing a client for central line insertion, nursing responsibilities include explaining the procedure to the client, ensuring necessary consents are signed according to the facility policy, and maintaining sterile technique when preparing the equipment and supplies. Advancing the guidewire is typically performed by the practitioner inserting the central line, not the nurse. It requires specialized training and expertise beyond the scope of nursing practice. Therefore, the correct answer is advancing the guidewire. Option A is the correct answer because it delineates an activity that is not within the usual scope of nursing practice during central line insertion preparation. Options B, C, and D are incorrect as they reflect essential nursing responsibilities in this context.

4. The nurse is assessing the dental status of an 18-month-old child. How many teeth should the nurse expect to examine?

• A. 6
• B. 8
• C. 12
• D. 16

Correct answer: C

Rationale: An 18-month-old child should have approximately 12 teeth. Children typically start getting teeth around 6 months of age. By subtracting 6 from the number of months in the child's age, you can calculate the expected number of teeth. For an 18-month-old child, 18 - 6 = 12 teeth. Therefore, the correct answer is 12 teeth. Choices A, B, and D are incorrect because they do not align with the expected dental development in an 18-month-old child.

5. When planning for the physical assessment of the woman, the nurse ensures that which occurs?

• A. The woman is examined by a female health care provider.
• B. The woman's husband remains in the examining room at all times.
• C. The woman is examined without any other people in the examining room.
• D. Written permission is obtained from the woman to obtain subjective health data.

Correct answer: A

Rationale: In many cultures, including Muslim, Hindu, and Latino, modesty is important, and exposure of a woman's genitals to men is considered demeaning. To respect the patient's cultural beliefs and modesty, it is best for a female health care provider to perform the examination. This practice helps to ensure the patient's comfort and adherence to cultural norms. Having the woman examined without any other people in the room (Choice C) may not address the cultural sensitivity required for this situation. Having the woman's husband remain in the examining room at all times (Choice B) may not align with the patient's cultural preferences and may cause discomfort. Written permission from the woman to obtain subjective health data (Choice D) is not directly related to ensuring a culturally sensitive physical assessment in this context.

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