Nursing Elites

1. The nurse is caring for a child who has just returned from surgery following a tonsillectomy and adenoidectomy. Which action by the nurse is appropriate?

• A. Offer ice chips every 2 hours
• B. Place the child in a semi-Fowler's position
• C. Encourage the child to drink from a cup
• D. Observe swallowing patterns

Correct answer: D

Rationale: Observing swallowing patterns is crucial post-tonsillectomy and adenoidectomy to detect signs of bleeding. Offering ice chips instead of ice cream helps prevent throat irritation. Placing the child in a semi-Fowler's position promotes airway patency and reduces the risk of aspiration. Encouraging the child to drink from a cup instead of a straw minimizes the risk of dislodging the surgical site.

2. Tertiary prevention would best be described as:

• A. recovery from physical limitation and psychological regression
• B. health teaching and immunization
• C. rehabilitation of alcoholic and drug dependents
• D. preventing disability and maximum use of remaining capacity

Correct answer: D

Rationale: Tertiary prevention is the stage of prevention that aims at preventing disability and maximizing the use of remaining capacity. Choice A is more aligned with rehabilitation rather than tertiary prevention. Choice B refers to primary prevention by promoting health and preventing diseases. Choice C focuses on rehabilitation specific to alcohol and drug dependence, which is a form of secondary prevention, not tertiary prevention.

3. The healthcare provider is screening children at a local community health clinic for infectious diseases. Which child is at the highest risk for hepatitis B virus?

• A. a newborn
• B. a 3-year-old
• C. a 7-year-old
• D. an 11-year-old

Correct answer: A

Rationale: Newborns are at the highest risk for hepatitis B virus due to potential transmission from the mother. The hepatitis B virus can be transmitted from an infected mother to her baby during childbirth. Children born to mothers infected with hepatitis B are at the highest risk of acquiring the infection. Choices B, C, and D are at lower risk compared to a newborn as they are less likely to have been exposed to the virus during childbirth.

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. The nurse is working in a community health clinic that serves a diverse population. Which of the following actions best demonstrates cultural competence?

• A. Learning about the cultural practices of the clinic's client population
• B. Providing translation services for non-English speaking clients
• C. Treating all clients the same regardless of their background
• D. Encouraging clients to adopt mainstream health practices

Correct answer: A

Rationale: Learning about the cultural practices of the clinic's client population is the best way to demonstrate cultural competence. This action shows respect for the diverse backgrounds of the clients and helps in providing care that is sensitive to their cultural beliefs and practices. Providing translation services (Choice B) is important for effective communication but may not address the deeper aspects of cultural competence. Treating all clients the same (Choice C) may overlook the unique needs that arise from cultural differences. Encouraging clients to adopt mainstream health practices (Choice D) may not be appropriate or respectful of their cultural traditions and preferences.

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