Nursing Elites

1. The nurse administers a booster dose of DTaP (diphtheria, tetanus, and pertussis) vaccine to an infant. Which level of prevention is the nurse implementing?

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

Correct answer: A

Rationale: The correct answer is A: Primary prevention. Administering a booster dose of DTaP vaccine to an infant is an example of primary prevention. Primary prevention aims to prevent disease or injury before it occurs by preventing exposure to risk factors. Tertiary prevention focuses on reducing the impact of a disease or injury that has already occurred, while secondary prevention involves early detection and treatment to prevent the progression of disease. Choice B, tertiary prevention, is incorrect as it deals with managing the consequences of a disease rather than preventing it. Choice C, secondary prevention, is also incorrect as it focuses on early detection and treatment rather than vaccination to prevent the disease. Choice D, primary nursing, is unrelated to the level of prevention being implemented in this scenario.

2. The Food Fortification Act of 2000 provides for the mandatory fortification of staple foods, which includes:

• A. Flour with iron
• B. Refined sugar with iron
• C. Cooking oil with vitamin A
• D. Rice with vitamin A

Correct answer: A

Rationale: The correct answer is A: Flour with iron. The Food Fortification Act of 2000 mandates the fortification of flour with iron to address iron deficiency in the population. Refined sugar is not typically fortified with iron, making choice B incorrect. While cooking oil fortification with vitamin A is common in some regions, it is not specified under the Food Fortification Act of 2000, rendering choice C incorrect. Similarly, rice fortification with vitamin A is not included in the mandatory fortification list according to the act, making choice D incorrect.

3. What action is best for the community health nurse to take if the nurse suspects that an infant is being physically abused?

• A. Follow agency protocols to report suspected abuse.
• B. Report suspicions to the local child abuse reporting hotline.
• C. Educate the child's caregivers about growth and development issues.
• D. Call the police department to have the child removed from the home.

Correct answer: A

Rationale: When a community health nurse suspects that an infant is being physically abused, the best course of action is to follow agency protocols to report the suspected abuse. This is essential to ensure that the appropriate authorities are informed, and proper interventions can be initiated. Reporting suspicions to the local child abuse reporting hotline (Choice B) can be a part of the agency protocols but may not cover all necessary steps. Educating the child's caregivers about growth and development (Choice C) is not appropriate in cases of suspected abuse, as the immediate focus should be on the safety and well-being of the infant. Calling the police department to have the child removed from the home (Choice D) is not the primary role of the nurse; the proper authorities should handle the removal process after an investigation.

4. The nurse is caring for a 4-year-old child with a greenstick fracture. In explaining this type of fracture to the parents, the best response by the nurse should be that

• A. A child's bone is more flexible and can be bent 45 degrees before breaking
• B. Bones of children are more porous than adults and often have incomplete breaks
• C. Compression of porous bones produces a buckle or torus type break
• D. Bone fragments often remain attached by a periosteal hinge

Correct answer: B

Rationale: The correct answer is B. Greenstick fractures are common in children because their bones are softer and more porous than adult bones, leading to incomplete breaks when force is applied. Choice A is incorrect as greenstick fractures are not due to bone flexibility but rather the porous nature of children's bones. Choice C is incorrect as it describes a buckle or torus type break, which is not characteristic of a greenstick fracture. Choice D is incorrect as greenstick fractures do not involve bone fragments remaining attached by a periosteal hinge.

5. Which of the following statements about CHN is wrong?

• A. CHN synthesizes public health with nursing
• B. CHN emphasizes health
• C. Promoting clients' autonomy is a responsibility of public nursing
• D. CHN makes a unique contribution to health care not by the nature of its practice but where it is practiced

Correct answer: D

Rationale: The statement in option D is incorrect. The unique contribution of Community Health Nursing (CHN) is not only where it is practiced but also by the nature of its practice. CHN's distinct value lies in its approach to care delivery, focusing on preventive care, health promotion, and addressing the needs of specific communities. Options A and B are correct as CHN involves synthesizing public health principles with nursing practice and emphasizes holistic health. Option C is incorrect as promoting clients' autonomy is a fundamental aspect of community health nursing, respecting individuals' rights to make decisions about their health.

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