Nursing Elites

1. At a nursing staff meeting, there is a discussion of perceived inequities in weekend staff assignments. As a follow-up, what should the nurse manager do initially?

• A. Allow the staff to change assignments
• B. Clarify reasons for current assignments
• C. Help staff see the complexity of issues
• D. Facilitate creative thinking on staffing

Correct answer: D

Rationale: Facilitating creative thinking on staffing is the most appropriate initial action for the nurse manager in addressing perceived inequities in weekend staff assignments. By encouraging creative thinking, the manager promotes innovative solutions and fosters a sense of ownership and collaboration among staff members. Choices A, B, and C are not the best initial steps in this situation. Allowing staff to change assignments may not address the underlying issues, clarifying reasons for current assignments may not resolve perceived inequities, and helping staff see the complexity of issues may not lead to actionable solutions.

2. The nurse is preparing to discharge an elderly, recently widowed female client following a mild stroke. At this time she is able to walk with the aid of a walker. As part of the discharge planning, what referral is most important for the nurse to make?

• A. Pastoral care.
• B. Meals-on-Wheels.
• C. Grief support group.
• D. Physical therapy.

Correct answer: B

Rationale: The most important referral for the nurse to make for the elderly, recently widowed female client who had a mild stroke and limited mobility is Meals-on-Wheels. This service will ensure she receives proper nutrition and support given her circumstances. Pastoral care may provide emotional and spiritual support but is not as essential in this scenario. Grief support group could be beneficial but addressing her nutritional needs takes precedence. Physical therapy may be important for rehabilitation but ensuring proper nutrition is more critical at this time.

3. After accepting the position of school nurse in a public elementary school, what strategy is best for the nurse to use to obtain an overview understanding of the student body?

• A. Review all health records of the students currently enrolled in classes.
• B. Talk with the current members of the parent-teacher association.
• C. Send a survey form to parents of third-grade students.
• D. Conduct a windshield survey of the geographic areas served by the school.

Correct answer: D

Rationale: Conducting a windshield survey is the best strategy for the nurse to obtain an overview understanding of the student body. This method allows the nurse to observe the community, its resources, potential health hazards, and demographic information. Reviewing health records (Choice A) would provide detailed health information but not an overview of the student body. Talking with the parent-teacher association (Choice B) may offer insights but not a comprehensive overview. Sending a survey form to parents (Choice C) may provide specific information but may not capture a broad understanding of the student body.

4. When a nurse teaches a community about the importance of regular health screenings, this activity falls under which level of prevention?

• A. Primary prevention
• B. Secondary prevention
• C. Tertiary prevention
• D. Quaternary prevention

Correct answer: B

Rationale: The correct answer is B: Secondary prevention. Secondary prevention aims to detect and treat disease early to prevent complications. Teaching about the importance of regular health screenings helps in early detection and intervention, which aligns with the goals of secondary prevention. Choice A, Primary prevention, involves actions to prevent the onset of a health condition. Choice C, Tertiary prevention, focuses on managing and treating existing conditions to prevent further complications. Choice D, Quaternary prevention, relates to actions taken to mitigate or avoid unnecessary interventions, over-medicalization, and the consequences of unnecessary treatment.

5. A female adult walks into a local community health clinic and tells the nurse that she is homeless and cannot seem to find help. Which statement indicates to the nurse that a client is feeling separated from society and helpless?

• A. "I'm feeling really isolated from everyone and scared."
• B. "I feel like I cannot get enough food to live any longer."
• C. "I know that I will always be poor so what's the use of trying?"
• D. "People like me are never respected, no matter how well we do."

Correct answer: A

Rationale: The correct answer is A. The statement "I'm feeling really isolated from everyone and scared" indicates a sense of separation from society and helplessness. This choice reflects feelings of loneliness and fear, which are common among individuals who feel disconnected and helpless. Choices B, C, and D do not directly convey a sense of isolation and helplessness. Choice B focuses on food insecurity, choice C on a resigned attitude towards poverty, and choice D on lack of respect, none of which directly address the feelings of being separated from society and helpless as indicated in the scenario.

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