Nursing Elites

1. Which of the following is the best intervention for a client with less than 6 months to live who is seeking comfort care?

• A. Set up a meeting with the hospice team
• B. Arrange a meeting with the client’s family
• C. Discuss advance directives (DNR & living will) with the patient
• D. Ask the provider to decrease the patient’s heart medications

Correct answer: A

Rationale: Setting up a meeting with the hospice team is the most appropriate intervention for a client with less than 6 months to live who is seeking comfort care. Hospice care focuses on providing comfort and support for individuals with terminal illnesses. By involving the hospice team, the client can receive specialized care aimed at improving their quality of life and managing symptoms effectively during this challenging time.

2. The community health nurse is involved in public health work. Which of these statements by the nurse reflects an understanding of upstream interventions?

• A. I will engage in policy initiatives in my urban area.
• B. I will administer the flu shot to interested seniors.
• C. I will help manage a senior's diabetes needs at home.
• D. I will work with a local school to provide asthma education.

Correct answer: A

Rationale: The correct answer is A because engaging in policy initiatives reflects an understanding of upstream interventions. Upstream interventions focus on influencing broader determinants of health, such as policies and social factors, to prevent health issues before they occur. This approach addresses the root causes of health problems rather than just treating symptoms or providing individual care.

3. Why is environmental health more challenging than other variables related to an individual’s health?

• A. Environmental health affects susceptible individuals more than groups.
• B. Environmental health demands that individuals be willing to change their beliefs.
• C. Environmental health is dependent on social neighborhoods and geography.
• D. Environmental health requires social, economic, and political changes to improve.

Correct answer: D

Rationale: Improving environmental health necessitates broader changes beyond individual actions, including social, economic, and political transformations to address root causes of environmental issues. These changes are crucial for sustainable improvements in environmental health outcomes.

4. What procedure is performed prior to a blood transfusion to detect incompatibilities?

• A. Grouping and crossmatching
• B. Complete blood count
• C. D-dimer test
• D. Blood clotting test

Correct answer: A

Rationale: Grouping and crossmatching is the procedure performed prior to a blood transfusion to determine the blood type and identify any potential incompatibilities between the donor and recipient. This process involves testing the recipient's blood for ABO and Rh antigens and crossmatching it with the donor's blood to ensure compatibility and prevent adverse reactions during the transfusion. Complete blood count, D-dimer test, and blood clotting test are other laboratory tests that serve different purposes and are not specifically done to detect incompatibilities prior to blood transfusion.

5. How should contaminated instruments used during delivery be handled?

• A. Wash with soap and water and soak in 0.5% chlorine solution for 10 minutes
• B. Soak in 0.5% chlorine solution for 30 minutes
• C. Wash with soap and water and boil for 2 hours
• D. Soak in 0.5% chlorine solution for 10 minutes

Correct answer: B

Rationale: When dealing with contaminated instruments used during delivery, it is crucial to soak them in a 0.5% chlorine solution for 30 minutes to ensure proper disinfection. This practice helps eliminate potential pathogens and ensures the safety of both the healthcare provider and the patient.

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