Nursing Elites

1. What is usually the first contact between community members and other levels of health facilities called?

• A. Secondary level health care
• B. Primary health care
• C. Tertiary level care
• D. Intermediate level care

Correct answer: B

Rationale: The correct answer is B: Primary health care. Primary health care is the initial point of contact between community members and the healthcare system. This level of care focuses on preventive and primary treatment services. Choices A, C, and D are incorrect because secondary, tertiary, and intermediate care levels are more specialized and are usually accessed after primary care, depending on the complexity of the health issue.

2. During the beginning shift assessment of a client with asthma who is receiving oxygen via nasal cannula at 2 liters per minute, the nurse would be most concerned about which unreported finding?

• A. Pulse oximetry reading of 89%
• B. Crackles at the base of the lungs on auscultation
• C. Rapid shallow respirations with intermittent wheezes
• D. Excessive thirst with a dry cracked tongue

Correct answer: C

Rationale: Rapid, shallow respirations with intermittent wheezes are concerning as they indicate a potential worsening of the client's asthma. This finding suggests airway narrowing, which can lead to respiratory failure. Immediate intervention is required to address this respiratory distress. A pulse oximetry reading of 89% is low and indicates hypoxemia, but the respiratory pattern described in option C takes priority as it directly reflects the client's respiratory status. Crackles at the base of the lungs suggest fluid accumulation, which is important but not as immediately critical as the respiratory distress in asthma. Excessive thirst and a dry cracked tongue may indicate dehydration, which is relevant but not as urgent as the respiratory compromise presented in option C.

3. 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.

4. A client with cirrhosis of the liver is experiencing ascites. The nurse should implement which of the following interventions?

• A. Restrict fluid intake
• B. Increase sodium intake
• C. Encourage high-protein diet
• D. Administer diuretics

Correct answer: D

Rationale: Corrected Rationale: Ascites, the accumulation of fluid in the abdominal cavity, is a common complication of cirrhosis. Diuretics are the primary intervention to manage ascites by promoting the excretion of excess fluid from the body, thus reducing abdominal swelling. Restricting fluid intake (Choice A) would not be appropriate as it may lead to dehydration. Increasing sodium intake (Choice B) is contraindicated as it can worsen fluid retention. Encouraging a high-protein diet (Choice C) is not directly related to managing ascites.

5. In evaluating your client's level of wellness, which of the following indicators can you see?

• A. Appropriate nutritional level
• B. Sense of personal security
• C. Acceptance of oneself and one's limitations
• D. Maladaptations to one's environment

Correct answer: C

Rationale: When evaluating a client's level of wellness, indicators such as appropriate nutritional level, sense of personal security, and acceptance of oneself and one's limitations are crucial. Option C, 'Acceptance of oneself and one's limitations,' directly relates to mental wellness and self-awareness, making it a key indicator of overall well-being. Options A, B, and D are not as directly tied to the psychological and emotional aspects of wellness, making them less relevant indicators in this context. Therefore, the correct answer is C.

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