Nursing Elites

1. The school nurse is called to the playground for an episode of mouth trauma. The nurse finds that the front tooth of a 9-year-old child has been avulsed (knocked out). After recovering the tooth, the initial response should be to

• A. Rinse the tooth in water before placing it in the socket
• B. Place the tooth in a clean plastic bag for transport to the dentist
• C. Hold the tooth by the roots until reaching the emergency room
• D. Ask the child to replace the tooth even if the bleeding continues

Correct answer: A

Rationale: The correct immediate action after recovering an avulsed tooth is to rinse it with water and place it back in the socket. This helps preserve the tooth and increases the chances of successful re-implantation. Placing the tooth in a clean plastic bag for transport to the dentist (choice B) is not ideal as immediate re-implantation is preferred. Holding the tooth by the roots until reaching the emergency room (choice C) can further damage the tooth. Asking the child to replace the tooth even if bleeding continues (choice D) is incorrect and may lead to improper re-implantation.

2. A client comes into the community health center upset and crying stating, “I will die of cancer now that I have this disease.” And then the client hands the nurse a paper with one word written on it: 'Pheochromocytoma.' Which response should the nurse state initially?

• A. 'Pheochromocytomas usually aren't cancerous (malignant). But they may be associated with cancerous tumors in other endocrine glands such as the thyroid (medullary carcinoma of the thyroid).'
• B. 'This problem is diagnosed by blood and urine tests that reveal elevated levels of adrenaline and noradrenaline.'
• C. 'Computerized tomography (CT) or magnetic resonance imaging (MRI) are used to detect an adrenal tumor.'
• D. 'You probably have had episodes of sweating, heart pounding, and headaches.'

Correct answer: A

Rationale: The correct initial response for the nurse to provide in this situation is to offer reassurance. Stating that 'Pheochromocytomas usually aren't cancerous (malignant)' helps to alleviate the client's anxiety and fear of having cancer. This response also establishes a foundation for further discussion about the condition, allowing the nurse to address the client's concerns and provide accurate information. Choice B is incorrect as it focuses solely on the diagnostic tests for pheochromocytoma but does not address the client's emotional distress. Choice C is incorrect as it discusses imaging modalities without directly addressing the client's concerns. Choice D is also incorrect as it assumes symptoms without first addressing the client's emotional state and fear of cancer.

3. The nurse is caring for a 5-year-old child who has the left leg in skeletal traction. Which of the following activities would be an appropriate diversional activity?

• A. Kicking balloons with the right leg
• B. Playing 'Simon Says'
• C. Playing handheld games
• D. Throwing bean bags

Correct answer: C

Rationale: Playing handheld games is an appropriate diversional activity for a child in skeletal traction because it does not require physical movement of the affected limb. This activity can help keep the child entertained and engaged without risking any harm to the tractioned leg. Choices A, B, and D involve physical movements that could potentially interfere with the skeletal traction or cause discomfort to the child.

4. A client with a history of alcoholism is admitted to the hospital for detoxification. The nurse knows that the client's risk for withdrawal symptoms is greatest within:

• A. 2-4 hours
• B. 4-6 hours
• C. 6-12 hours
• D. 12-24 hours

Correct answer: D

Rationale: The correct answer is D: 12-24 hours. Withdrawal symptoms typically begin within 12-24 hours after the last drink. This period is when the client is at the highest risk for experiencing withdrawal symptoms. Choices A, B, and C are incorrect because they do not align with the typical timeline for alcohol withdrawal symptoms to manifest. Symptoms usually peak within the first 24 to 48 hours after the last drink, making the 12-24 hour window critical for monitoring and managing any potential withdrawal complications.

5. In combating myths and misconceptions about family planning in the community, what should you do first as a health educator?

• A. Identify the influential leaders of the community
• B. Select an approach to be used in correcting myths and misconceptions
• C. Decide who will be involved in the conference
• D. Identify myths and misconceptions prevailing in the community and their sources

Correct answer: D

Rationale: The correct answer is to identify myths and misconceptions prevailing in the community and their sources. This is the initial step in addressing misconceptions effectively. By understanding the specific myths and where they originate from, a health educator can tailor their approach to correct these misconceptions. Choice A is incorrect because while influential leaders can play a role, identifying myths comes first. Choice B is incorrect as selecting an approach should come after understanding the myths. Choice C is incorrect as deciding who will be involved in a conference is not the primary step in combating myths and misconceptions.

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