Nursing Elites

1. An infant has just returned from surgery for placement of a gastrostomy tube as an initial treatment for tracheoesophageal fistula. The mother asks, 'When can the tube be used for feeding?' The nurse's best response would be which of these comments?

• A. "Feedings can begin in 5 to 7 days."
• B. "The use of the feeding tube can begin immediately."
• C. "The stomach contents and air must be drained first."
• D. "The incision healing must be complete before feeding."

Correct answer: C

Rationale: The correct answer is C: 'The stomach contents and air must be drained first.' Before starting feedings through a gastrostomy tube, it is essential to drain the stomach contents and air. This process helps prevent complications and ensures the proper functioning of the tube after placement. Choice A is incorrect because initiating feedings within 5 to 7 days may lead to complications if the stomach is not adequately prepared. Choice B is incorrect as feeding should not begin immediately to allow for proper preparation of the tube and the stomach. Choice D is incorrect because although incision healing is important, draining the stomach contents and air is a more immediate concern to prevent complications.

2. Which bioterrorism agent poses a high risk for use as a potential biological weapon due to its ability to be readily transmitted through several portals of entry?

• A. Anthrax.
• B. Smallpox.
• C. Botulism.
• D. Tularemia.

Correct answer: A

Rationale: The correct answer is Anthrax. Anthrax is a high-risk bioterrorism agent because it can be readily transmitted through multiple portals of entry such as inhalation, ingestion, or skin contact. This makes it a significant concern for use as a biological weapon. Smallpox, though highly contagious, is not known for multiple portals of entry like Anthrax. Botulism is a potent toxin but is not as easily transmissible through various routes as Anthrax. Tularemia, while a serious bacterial infection, does not have the same ease of transmission through multiple portals of entry as Anthrax.

3. In order to establish priorities in planning and implementing the occupational health program, which of the following data will the nurse need?

• A. disease trends, birth and death rates, and social environmental conditions
• B. birth and death rates
• C. disease trends
• D. social environmental conditions

Correct answer: A

Rationale: To effectively plan and implement an occupational health program, the nurse needs comprehensive data, including disease trends, birth and death rates, and social environmental conditions. This holistic approach ensures that the program addresses a wide range of health aspects impacting the target population. Option A is the correct choice as it considers multiple factors influencing occupational health. Choices B, C, and D are each individually important but do not provide the breadth of information required to establish priorities in a comprehensive occupational health program.

4. The healthcare professional enters the room as a 3-year-old is having a generalized seizure. Which intervention should the healthcare professional do first?

• A. Clear the area of any hazards
• B. Place the child on the side
• C. Restrain the child
• D. Give the prescribed anticonvulsant

Correct answer: B

Rationale: Placing the child on the side is the priority intervention during a generalized seizure as it helps maintain an open airway and prevents aspiration. Clearing the area of any hazards is important but should come after ensuring the child's safety. Restraining the child is not recommended during a seizure as it can lead to injury. Giving the prescribed anticonvulsant is important but should not be the first action during an ongoing seizure.

5. The emphasis of community health nursing is on:

• A. treatment of health problems
• B. preventing problems and promoting optimum health
• C. identification and assessment of health problems
• D. illness end of the wellness-illness continuum

Correct answer: B

Rationale: Community health nursing primarily focuses on preventive measures and promoting overall health within a community. Choice A is incorrect as treatment is not the main emphasis. Choice C is incorrect as identification and assessment are steps that may be involved but not the main focus. Choice D is incorrect as it refers to the illness end rather than the preventive end of the wellness-illness continuum.

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