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 nurse is assessing a client with portal hypertension. Which of the following findings would the nurse expect?

• A. Expiratory wheezes
• B. Blurred vision
• C. Ascites
• D. Dilated pupils

Correct answer: C

Rationale: Ascites is a common finding in clients with portal hypertension. Portal hypertension results in increased pressure in the portal vein, leading to the development of ascites, which is the accumulation of fluid in the abdominal cavity. Expiratory wheezes (Choice A) are associated with respiratory conditions. Blurred vision (Choice B) is more commonly linked to eye disorders or neurological issues. Dilated pupils (Choice D) can be related to neurological conditions or drug effects, but not specifically to portal hypertension.

3. The nurse is caring for a client with status epilepticus. The most important nursing assessment of this client is

• A. Intravenous fluid infusion
• B. Level of consciousness
• C. Pulse and respirations
• D. Extremities for injuries

Correct answer: B

Rationale: In status epilepticus, the most crucial nursing assessment is the level of consciousness. Assessing the client's level of consciousness is vital as prolonged seizures can result in hypoxia, brain damage, and require immediate intervention. Pulse and respirations (choice C) are important assessments, but in status epilepticus, the priority is to monitor the client's neurological status. Checking intravenous fluid infusion (choice A) and extremities for injuries (choice D) are not the primary assessments needed in managing a client experiencing status epilepticus.

4. Environmental sanitation is the primary problem in community Y. As a stranger to the health unit, one of the major strategies in your plan is the improvement of the environmental health conditions of the community. To indicate this, which of the following would you do?

• A. meet with youth officials and parents' group leaders
• B. meet with religious and educational leaders
• C. request mayors to create a task force to help implement your project
• D. inform local announcers to disseminate the what and why of your project

Correct answer: C

Rationale: In this scenario, requesting mayors to create a task force is the most effective strategy to improve environmental health conditions in the community. Engaging with local government officials ensures the allocation of resources, coordination of efforts, and the implementation of sustainable solutions. While meeting with youth officials, parents' group leaders, religious and educational leaders are important, involving mayors in creating a task force will lead to broader community involvement and support. Informing local announcers about the project, although helpful for awareness, is not as impactful as engaging with local authorities for tangible change.

5. A nurse manager is using the technique of brainstorming to help solve a problem. One nurse criticizes another nurse’s contribution and begins to find objections to the suggestion. The nurse manager's best response is to

• A. Let’s move on to a new action that deals with the problem.
• B. I think you need to reserve judgment until after all suggestions are offered.
• C. Very well thought out. Your analytic skills and interest are incredible.
• D. Let’s move to the ‘what if…’ as related to these objections for an exploration of spin-off ideas.

Correct answer: D

Rationale: Encouraging the group to explore 'what if' scenarios based on the objections helps to maintain a positive and creative brainstorming atmosphere, while also validating the concerns raised by the nurse. Choice A is dismissive and does not address the issue at hand. Choice B suggests postponing judgment, which may not resolve the tension caused by the criticism. Choice C is complimentary but does not address the critical feedback provided by the nurse, missing an opportunity to turn objections into opportunities for further exploration.

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