Nursing Elites

1. On admission to the psychiatric unit, the client is trembling and appears fearful. The nurse’s initial response should be to

• A. Give the client orientation materials and review the unit rules and regulations
• B. Introduce oneself and accompany the client to their room
• C. Take the client to the day room and introduce them to the other clients
• D. Ask the nursing assistant to get the client’s vital signs and complete the admission search

Correct answer: B

Rationale: In situations where a client is trembling and fearful upon admission to a psychiatric unit, it is essential to prioritize building trust and reducing anxiety. By introducing oneself and accompanying the client to their room, the nurse can establish a therapeutic relationship, provide a sense of security, and address the client's immediate emotional needs. Choices A, C, and D are not the most appropriate initial responses as they do not directly address the client's emotional state or focus on establishing a supportive relationship.

2. While performing an initial assessment on a newborn following a breech delivery, the nurse suspects hip dislocation. Which of the following is most suggestive of the abnormality?

• A. Flexion of lower extremities
• B. Negative Ortolani response
• C. Lengthened leg of affected side
• D. Irregular hip symmetry

Correct answer: D

Rationale: Irregular hip symmetry, such as asymmetry in the gluteal folds, is a common sign of hip dislocation in newborns. This finding indicates a potential abnormality in hip development and requires further evaluation and possible treatment. Choices A, B, and C are incorrect. Flexion of lower extremities is a normal newborn reflex, the Ortolani response is used to detect hip dysplasia rather than hip dislocation, and a lengthened leg of the affected side is not typically associated with hip dislocation in newborns.

3. A public health nurse can say that she is beginning to achieve her goal of more optimal health for her community when:

• A. people learn self-care
• B. people become involved in determining health care policy
• C. all these indicators are present
• D. people assume responsibility for their own health

Correct answer: C

Rationale: Achieving optimal health for a community involves multiple factors and indicators. For a public health nurse to begin achieving this goal, it is essential that all relevant indicators are present, not just one or a few. While choices A, B, and D are important components of promoting community health, optimal health for a community encompasses a comprehensive approach where all indicators are considered and addressed. Therefore, the correct answer is C.

4. The following are functions of the Provincial Nurse Supervisor except:

• A. interpreting policies, guidelines, and SDP to nursing and midwifery staff of the province
• B. assessing training needs and planning staff development programs for nursing and midwifery staff
• C. participating in planning, developing, and evaluating OJT for nurses and midwives conducted by the department
• D. collecting, consolidating, analyzing, and interpreting health records and reports and making recommendations as needed

Correct answer: D

Rationale: The correct answer is D. Collecting, consolidating, analyzing, and interpreting health records is not a primary function of a Provincial Nurse Supervisor. The primary functions of a Provincial Nurse Supervisor include interpreting policies, guidelines, and SDP to nursing and midwifery staff, assessing training needs, planning staff development programs, and participating in planning, developing, and evaluating OJT for nurses and midwives. While health records may be accessed for specific purposes, the core responsibilities of a Provincial Nurse Supervisor focus on staff management and development rather than direct involvement in health record analysis.

5. When planning the care for a young adult client diagnosed with anorexia nervosa, which of these concerns should the nurse determine to be the priority for long term mobility?

• A. Digestive problems
• B. Amenorrhea
• C. Electrolyte imbalance
• D. Blood disorders

Correct answer: B

Rationale: The correct answer is B: Amenorrhea. Amenorrhea, or the absence of menstruation, is a common long-term consequence of anorexia nervosa due to low body weight and hormonal imbalances. Addressing amenorrhea is crucial for the patient's overall health and reproductive potential. Choice A, Digestive problems, may also be a concern in anorexia nervosa, but in terms of long-term mobility, amenorrhea takes priority because of its impact on hormonal balance and bone health. Choice C, Electrolyte imbalance, is important to address in anorexia nervosa due to potential cardiac complications, but it is not directly linked to long-term mobility concerns. Choice D, Blood disorders, while they can occur in anorexia nervosa, are not as directly related to long-term mobility as amenorrhea, which can significantly affect bone health and mobility in the future.

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