Nursing Elites

1. Which one of the following statements, if made by the client, indicates teaching about Inderal (propranolol) has been effective?

• A. ''I may experience seizures if I stop the medication abruptly.''
• B. ''I may experience an increase in my heart rate for a few weeks.''
• C. ''I can expect to feel nervousness the first few weeks.''
• D. ''I can have a heart attack if I stop this medication suddenly.''

Correct answer: D

Rationale: The correct answer is D. Stopping Inderal (propranolol) abruptly can cause rebound hypertension, angina, and even a myocardial infarction (heart attack), so it is crucial to taper off the medication under medical supervision. Choices A, B, and C are incorrect because they do not reflect the serious consequences associated with abrupt discontinuation of propranolol.

2. At a nursing staff meeting, there is a discussion of perceived inequities in weekend staff assignments. As a follow-up, what should the nurse manager do initially?

• A. Allow the staff to change assignments
• B. Clarify reasons for current assignments
• C. Help staff see the complexity of issues
• D. Facilitate creative thinking on staffing

Correct answer: D

Rationale: Facilitating creative thinking on staffing is the most appropriate initial action for the nurse manager in addressing perceived inequities in weekend staff assignments. By encouraging creative thinking, the manager promotes innovative solutions and fosters a sense of ownership and collaboration among staff members. Choices A, B, and C are not the best initial steps in this situation. Allowing staff to change assignments may not address the underlying issues, clarifying reasons for current assignments may not resolve perceived inequities, and helping staff see the complexity of issues may not lead to actionable solutions.

3. Refers to the nurses in the local/national health departments or public schools:

• A. Public health nursing
• B. Public health nurse
• C. Registered midwives
• D. Registered nurses

Correct answer: B

Rationale: The correct term for nurses working in local/national health departments or public schools is 'public health nurse.' This term specifically refers to individual nurses in those settings. Choice A, 'Public health nursing,' is a broader term that refers to the field of nursing focused on improving community health. Choices C and D, 'Registered midwives' and 'Registered nurses,' do not specifically indicate the nurses working in local/national health departments or public schools, making them incorrect.

4. Which statement specifically describes occupational health nursing?

• A. Involves prevention, recognition, and treatment of injury and illness
• B. All of these
• C. The application of nursing principles in conserving the health of workers in all occupations
• D. Requires special skills in the field of health, education, and counseling

Correct answer: B

Rationale: The correct answer is B. Occupational health nursing involves all aspects mentioned in the statements: prevention, recognition, treatment of injury and illness, application of nursing principles in conserving workers' health, and the requirement of special skills in health, education, and counseling. Choice A focuses on prevention, recognition, and treatment but does not encompass all aspects of occupational health nursing. Choice C only mentions the application of nursing principles without including prevention and treatment. Choice D specifically highlights the need for special skills but does not cover all the aspects of occupational health nursing.

5. A female client makes routine visits to a neighborhood community health center. The nurse notes that this client often presents with facial bruising, particularly around the eyes. The nurse discusses prevention of domestic violence with the client even though the client does not admit to being battered. What level of prevention has the nurse applied in this situation?

• A. primary prevention
• B. secondary prevention
• C. tertiary prevention
• D. health promotion

Correct answer: B

Rationale: The correct answer is B: secondary prevention. Secondary prevention involves identifying and addressing issues early to prevent further harm. In this scenario, the nurse is intervening by discussing domestic violence prevention with the client who is showing signs of facial bruising, aiming to prevent further harm even though the client has not disclosed being battered. Choice A (primary prevention) focuses on preventing the onset of a problem before it occurs, like educating about healthy relationships before violence happens. Choice C (tertiary prevention) involves managing and treating the effects of a problem that has already occurred, such as providing counseling to a domestic violence survivor. Choice D (health promotion) aims to enhance well-being and prevent health problems through educational and environmental interventions, which may include aspects of preventing domestic violence, but in this case, the nurse's direct intervention is more about early identification and prevention of harm, aligning it with secondary prevention.

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