Nursing Elites

1. In a long term rehabilitation care unit a client with spinal cord injury complains of a pounding headache. The client is sitting in a wheelchair watching television in the assigned room. Further assessment by the nurse reveals excessive sweating, a splotchy rash, pilomotor erection, facial flushing, congested nasal passages and a heart rate of 50. The nurse should do which action next?

• A. Take the client's respirations, blood pressure (BP), temperature and then pupillary responses
• B. Place the client into the bed and administer the ordered PRN analgesic
• C. Check the client for bladder distention and the client's urinary catheter for kinks
• D. Turn the television off and then assist client to use relaxation techniques

Correct answer: C

Rationale: These symptoms suggest autonomic dysreflexia, often triggered by bladder distention.

2. The social ecological model considers the complex interplay between which levels of influence?

• A. Individual, interpersonal, organizational, community, and policy
• B. Genetic, biological, environmental, social, and economic
• C. Personal, family, community, national, and global
• D. Health, wealth, education, environment, and politics

Correct answer: A

Rationale: The correct answer is A: Individual, interpersonal, organizational, community, and policy. The social ecological model examines how individual, interpersonal, organizational, community, and policy factors interact to influence health and well-being. Choice B is incorrect because it includes genetic and biological factors that are not part of the social ecological model. Choice C is incorrect as it does not include organizational and policy levels of influence. Choice D is incorrect as it includes wealth and politics, which are not typically considered in the social ecological model.

3. 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.

4. Which of the following would be the best strategy for the nurse to use when teaching insulin injection techniques to a newly diagnosed client with diabetes?

• A. Provide written pre and post tests
• B. Ask questions during practice
• C. Allow another diabetic to assist
• D. Observe a return demonstration

Correct answer: D

Rationale: The best strategy for the nurse to use when teaching insulin injection techniques to a newly diagnosed client with diabetes is to observe a return demonstration. This method ensures that the client can correctly perform the technique. Providing written pre and post tests (choice A) may assess knowledge but not application. Asking questions during practice (choice B) may help with understanding but not necessarily with the actual performance. Allowing another diabetic to assist (choice C) may provide peer support but does not guarantee correct technique demonstration.

5. What is the aim of the Magna Carta of Public Health Workers?

• A. Develop skills and capabilities of health workers to deliver health projects/programs
• B. All of these
• C. Encourage those with proper qualifications to remain in government service
• D. Promote social and economic well-being of health workers

Correct answer: B

Rationale: The correct answer is B - 'All of these.' The Magna Carta of Public Health Workers aims to achieve multiple objectives, including developing the skills and capabilities of health workers to deliver health projects/programs, encouraging those with proper qualifications to remain in government service, and promoting the social and economic well-being of health workers. Choice A, C, and D are all part of the comprehensive goals outlined in the Magna Carta for Public Health Workers.

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