Nursing Elites

1. The client diagnosed with a mild concussion is being discharged from the emergency department. Which discharge instruction should the nurse teach the client's significant other?

• A. Awaken the client every two (2) hours.
• B. Monitor for increased intracranial pressure.
• C. Observe frequently for hypervigilance.
• D. Offer the client food every three (3) to four (4) hours.

Correct answer: A

Rationale: In a client with a mild concussion, it is important to monitor for signs of deterioration, which includes changes in the client's level of consciousness. Waking the client every two hours helps in assessing their neurological status, ensuring they can awaken and respond appropriately. This intervention aids in detecting any worsening symptoms promptly and seeking medical assistance if needed.

2. What is the term for creating a surgical airway in the front of the neck (cervical region) to remove copious secretions?

• A. Bronchoscopy
• B. Tracheostomy
• C. Thoracentesis
• D. Underwater seal drainage

Correct answer: B

Rationale: Tracheostomy is the process of surgically creating an airway in the front of the neck to aid in breathing or remove secretions from the airway. Bronchoscopy involves visualizing the airways using a scope, not creating an airway. Thoracentesis is the procedure to remove fluid or air from the pleural space around the lungs, not related to creating an airway. Underwater seal drainage is a method used in chest drainage systems to remove air or fluid from the pleural space, not the creation of an airway.

3. A patient in Mindanao was diagnosed with Dengue Hemorrhagic Fever. The therapeutic regimen for the patient includes the following EXCEPT:

• A. Rapid replacement of plasma loss
• B. Aspirin for high fever
• C. Rapid fluid and electrolyte replacement
• D. Oxygen therapy

Correct answer: B

Rationale: In cases of Dengue Hemorrhagic Fever, aspirin is contraindicated due to the risk of bleeding. The therapeutic regimen focuses on rapid replacement of plasma loss, rapid fluid and electrolyte replacement, and oxygen therapy to manage the condition effectively.

4. What is a common challenge in promoting health literacy?

• A. Limited access to health resources
• B. Low literacy levels among patients
• C. Complex medical instructions
• D. Cultural barriers

Correct answer: B

Rationale: Low literacy levels among patients present a common challenge in promoting health literacy. When individuals have low literacy levels, it becomes difficult for them to understand health information, leading to barriers in effectively promoting health literacy.

5. The public health RN is working with a client who desires to quit smoking. The client says to the RN, 'I want to quit but I just don't think I have it in me to really make it happen.' According to the Health Belief Model, this response relates to which factor:

• A. Susceptibility
• B. Self-efficacy
• C. Severity
• D. Cue to action

Correct answer: B

Rationale: The correct answer is B, 'Self-efficacy.' In the Health Belief Model, self-efficacy refers to a person's belief in their capacity to execute behaviors necessary to achieve specific goals or outcomes. In this scenario, the client's statement reflects a lack of confidence in their ability to successfully quit smoking, indicating low self-efficacy. By addressing and enhancing the client's self-efficacy, the public health RN can help empower the client to take steps towards successful smoking cessation.

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