Nursing Elites

1. How do integrative models of human health see health factors?

• A. derived solely from physical phenomena
• B. intertwined and interactive, with multiple components such as physical, psychological, and social
• C. generally being attributable to psychosocial problems in individuals
• D. effective only when combined and integrated with alternative therapies

Correct answer: B

Rationale: Integrative models of human health consider health factors as intertwined and interactive, involving various components like physical, psychological, and social aspects. This holistic approach recognizes that health is influenced by a combination of factors, not just physical phenomena (choice A). While psychosocial problems can impact health, integrative models go beyond attributing health solely to psychosocial issues (choice C). Additionally, integrative models do not imply that health is effective only when combined with alternative therapies (choice D), but rather emphasize the interconnectedness of various health components.

2. The home health nursing director is conducting an educational program for registered nurses and practical nurses about Medicare reimbursement. To obtain payment for Medicare services, what must be included in the client's record?

• A. A prescription from the healthcare provider for each visit made.
• B. Documentation of a skilled care service provided during the visit.
• C. A copy of the client's health history and social security card.
• D. A record of the preventative healthcare services provided during the visit.

Correct answer: B

Rationale: The correct answer is B: Documentation of skilled care services is required for Medicare reimbursement. Medicare reimbursement is based on the provision of skilled care services, not on prescriptions or preventative healthcare services. Including a copy of the client's health history and social security card is not a requirement for Medicare reimbursement.

3. A 16-month-old child has just been admitted to the hospital. As the nurse assigned to this child enters the hospital room for the first time, the toddler runs to the mother, clings to her, and begins to cry. What would be the initial action by the nurse?

• A. Arrange for a change in client care assignments
• B. Explain that this behavior is expected
• C. Discuss the appropriate use of 'time-out'
• D. Explain that the child is in need of extra attention

Correct answer: B

Rationale: The correct answer is to explain that this behavior is expected. At 16 months of age, children commonly experience separation anxiety, especially in unfamiliar environments like hospitals. It is important for the nurse to reassure the child and the parent that such behavior is normal. Option A is incorrect as there is no need to change client care assignments based on the child's behavior. Option C is not appropriate as discussing the use of 'time-out' is more relevant in behavior management for older children. Option D is incorrect as it does not address the underlying cause of the child's behavior related to separation anxiety.

4. A client with heart failure is receiving digoxin (Lanoxin). The nurse should monitor the client for which of the following signs of digoxin toxicity?

• A. Tachycardia
• B. Hypotension
• C. Bradycardia
• D. Hyperglycemia

Correct answer: C

Rationale: The correct answer is C: Bradycardia. Digoxin toxicity often presents with bradycardia, which is a common sign of toxicity associated with this medication. Tachycardia (Choice A) is not typically seen with digoxin toxicity. Hypotension (Choice B) can occur but is less specific to digoxin toxicity. Hyperglycemia (Choice D) is not a typical sign of digoxin toxicity. Therefore, monitoring for bradycardia is crucial in clients receiving digoxin to detect toxicity early.

5. A client with HIV/AIDS is receiving zidovudine (Retrovir). The nurse should monitor the client for which of the following adverse effects?

• A. Hyperglycemia
• B. Anemia
• C. Hypertension
• D. Hypercalcemia

Correct answer: B

Rationale: The correct answer is B: Anemia. Zidovudine (Retrovir) can cause bone marrow suppression, leading to anemia. Monitoring for signs of anemia, such as fatigue, pallor, and shortness of breath, is crucial. Choice A, Hyperglycemia, is not a common adverse effect of zidovudine. Choice C, Hypertension, is not directly associated with zidovudine use. Choice D, Hypercalcemia, is also not a typical adverse effect of zidovudine.

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