Nursing Elites

1. The nurse is planning care for a client with increased intracranial pressure. The best position for this client is

• A. Trendelenburg
• B. Prone
• C. Semi-Fowler's
• D. Side-lying with head flat

Correct answer: C

Rationale: The correct answer is C, Semi-Fowler's. This position helps to reduce intracranial pressure by promoting venous drainage from the head while maintaining adequate oxygenation. Option A, Trendelenburg position, is incorrect as it involves placing the patient with the head lower than the body, which can increase intracranial pressure. Option B, Prone position, is also incorrect as it involves lying on the stomach, which can further elevate intracranial pressure. Option D, Side-lying with head flat, does not provide the same benefits as the Semi-Fowler's position in terms of promoting venous drainage and maintaining oxygenation in a client with increased intracranial pressure.

2. What does the term 'social determinants of health' refer to?

• A. Genetic predispositions
• B. Lifestyle choices
• C. Conditions in which people are born, grow, live, work, and age
• D. Access to medical care

Correct answer: C

Rationale: The term 'social determinants of health' refers to the conditions in which people are born, grow, live, work, and age. This includes factors like socioeconomic status, education, physical environment, employment, and social support networks. These factors have a significant impact on health outcomes. Choices A, B, and D are incorrect because genetic predispositions, lifestyle choices, and access to medical care, although important, are not encompassed by the term 'social determinants of health.'

3. An example of secondary prevention strategy would be:

• A. Screening for breast cancer in women who have no symptoms
• B. Using pain control medications for terminal cancer patients
• C. Educating teenagers about using condoms to prevent STDs
• D. None of the above

Correct answer: A

Rationale: The correct answer is A. Screening for breast cancer is a secondary prevention strategy aimed at early detection, which falls under secondary prevention as it focuses on early identification and intervention before the disease progresses. Choice B is incorrect as it refers to palliative care for symptom management in terminal cancer patients, which is not a secondary prevention strategy. Choice C is incorrect as educating teenagers about condom use is a primary prevention strategy to prevent the initial occurrence of STDs rather than intervening after exposure, making it a primary, not a secondary prevention strategy. Choice D is incorrect as there is a valid example of a secondary prevention strategy provided in choice A.

4. A client is suspected of being poisoned and presents with symmetric, descending flaccid paralysis, blurred vision, double vision, and dry mouth. The nurse should consider these findings consistent with which potential bioterrorism agent?

• A. ricin
• B. botulism toxin
• C. sulfur mustard
• D. yersinia pestis

Correct answer: B

Rationale: The correct answer is B: botulism toxin. Botulism toxin is associated with symmetric, descending flaccid paralysis, blurred vision, double vision, and dry mouth, which are consistent with the client's presentation. Ricin (Choice A) typically presents with gastrointestinal symptoms. Sulfur mustard (Choice C) is a blistering agent causing skin, eye, and respiratory issues. Yersinia pestis (Choice D) is associated with the bubonic plague, presenting with fever, malaise, and buboes.

5. The nurse is evaluating the effectiveness of a community health program aimed at reducing teen pregnancy rates. Which outcome indicates the program was successful?

• A. increased attendance at health education classes
• B. decreased number of repeat pregnancies among teens
• C. higher number of teens seeking prenatal care
• D. greater use of contraception among teens

Correct answer: D

Rationale: The correct answer is D: greater use of contraception among teens. This outcome indicates successful prevention of pregnancies by demonstrating that teens are taking proactive steps to avoid unintended pregnancies. Increased attendance at health education classes (choice A) may show improved knowledge but does not directly measure the prevention of pregnancies. While a decreased number of repeat pregnancies among teens (choice B) is positive, it does not necessarily indicate prevention of initial pregnancies. A higher number of teens seeking prenatal care (choice C) is important for maternal and fetal health but does not directly reflect the prevention of teen pregnancies.

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