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. What is the focus of health promotion activities?

• A. Treating existing health conditions
• B. Preventing the onset of disease
• C. Providing palliative care
• D. Conducting clinical trials

Correct answer: B

Rationale: The correct answer is B: Preventing the onset of disease. Health promotion activities aim to prevent illnesses and promote overall well-being through education, lifestyle changes, and preventive measures. Choice A is incorrect as health promotion is not primarily about treating existing health conditions but rather preventing them. Choice C is incorrect because palliative care focuses on providing relief and comfort to patients with serious illnesses, not on preventing diseases. Choice D is also incorrect as conducting clinical trials is a research activity to test new treatments or interventions, not a focus of health promotion.

3. Which of the following measures the frequency of new cases of the phenomenon during a given period of time?

• A. prevalence rate
• B. proportionate mortality rate
• C. case fatality rate
• D. incidence rate

Correct answer: D

Rationale: The correct answer is D, incidence rate. Incidence rate measures the frequency of new cases of a phenomenon, providing important information about the risk of developing the condition. Prevalence rate (choice A) reflects both old and new cases, proportionate mortality rate (choice B) is the proportion of deaths due to a specific cause, and case fatality rate (choice C) measures the proportion of deaths among confirmed cases, not just new cases.

4. A client has just returned to the medical-surgical unit following a segmental lung resection. After assessing the client, the first nursing action would be to:

• A. Administer pain medication
• B. Suction excessive tracheobronchial secretions
• C. Assist the client to turn, deep breathe, and cough
• D. Monitor oxygen saturation

Correct answer: B

Rationale: After a segmental lung resection, the priority nursing action should be to suction excessive tracheobronchial secretions. This helps in preventing airway obstruction from secretions, ensuring the patency of the airway and optimizing respiratory function. Administering pain medication can be important but addressing airway clearance takes precedence. Assisting the client to turn, deep breathe, and cough is essential for respiratory hygiene but not the first action immediately post-op. Monitoring oxygen saturation is crucial, but ensuring airway clearance is the priority to prevent complications.

5. What title should be given to this role in the occupational health nurse job description? A registered nurse who teaches and prepares nursing students to function as expert clinicians/practitioners, administrators, educators, researchers, or consultants at the work site.

• A. researcher
• B. case manager
• C. health educator
• D. health promotion specialist

Correct answer: C

Rationale: The correct title for the role described in the job description is a health educator. A health educator is responsible for teaching and preparing nursing students for various professional roles. Choice A, researcher, is incorrect because the main focus in the job description is on teaching and preparing students, not conducting research. Choice B, case manager, does not align with the role of teaching and preparing nursing students. Choice D, health promotion specialist, is also not the best fit as the primary focus in the job description is on education and preparation, rather than promoting health within a specific population.

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