Nursing Elites

1. The new graduate nurse interviews for a position in a nursing department of a large health care agency, described by the interviewer as having shared governance. Which of these statements best illustrates the shared governance model?

• A. An appointed board oversees any administrative decisions
• B. Nursing departments share responsibility for client outcomes
• C. Staff groups are appointed to discuss nursing practice and client education issues
• D. Non-nurse managers supervise nursing staff in groups of units

Correct answer: B

Rationale: The correct answer is B because shared governance involves nurses and other staff sharing responsibility for decisions related to patient care and outcomes, promoting collaborative practice and shared accountability. Choice A is incorrect as shared governance includes active participation of frontline staff, not just an appointed board. Choice C is incorrect because shared governance goes beyond just discussing issues to actively sharing responsibility for decision-making. Choice D is incorrect as shared governance encourages nurses to have a significant role in decision-making rather than being supervised by non-nurse managers.

2. When a nurse teaches a community about the importance of hand hygiene, the nurse is engaging in:

• A. Primary prevention
• B. Secondary prevention
• C. Tertiary prevention
• D. Quaternary prevention

Correct answer: A

Rationale: The correct answer is A: Primary prevention. Primary prevention aims to prevent the occurrence of a disease or injury before it happens. Teaching about hand hygiene to the community helps in preventing infections from occurring in the first place. Choice B, Secondary prevention, involves early detection and treatment to halt or slow the progress of a condition. This would involve screening or early intervention after exposure. Choice C, Tertiary prevention, focuses on managing the disease to prevent complications, recurrence, or deterioration. This would include rehabilitation and monitoring to prevent further complications. Choice D, Quaternary prevention, relates to actions taken to avoid unnecessary interventions or over-medicalization. This usually involves questioning the necessity of certain medical procedures or treatments to prevent harm to patients.

3. In which of the following settings would a community health nurse be less likely to be involved?

• A. neighborhood clinic, community clinic, or senior center
• B. physician's office with a focus on individual client care
• C. home-based care
• D. neighborhood planning board

Correct answer: B

Rationale: Community health nurses are less likely to be involved in a physician's office with a focus on individual client care because their role primarily revolves around promoting and maintaining the health of populations and communities rather than providing direct care to individual clients. Options A, C, and D are more aligned with the community health nurse's role as they involve working in community-based settings, providing home-based care, and participating in community planning and advocacy.

4. 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.

5. A 16-year-old female client returns to the clinic because she is pregnant for the third time by a new boyfriend. Which vaccine should the nurse plan to administer?

• A. MMR
• B. Hepatitis B
• C. Human papillomavirus
• D. Pneumococcal

Correct answer: B

Rationale: The correct answer is B, Hepatitis B. The Hepatitis B vaccine is crucial for pregnant women to prevent transmission of the virus to the baby during childbirth. Option A, MMR (Measles, Mumps, Rubella) vaccine, is not indicated during pregnancy. Option C, Human papillomavirus vaccine, is recommended for prevention of HPV infections but is not specifically indicated during pregnancy. Option D, Pneumococcal vaccine, is important for certain populations but is not the priority vaccine for a pregnant woman in this scenario.

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