Nursing Elites

1. While assessing a client in an outpatient facility with a panic disorder, the nurse completes a thorough health history and physical exam. Which finding is most significant for this client?

• A. Compulsive behavior
• B. Sense of impending doom
• C. Fear of flying
• D. Predictable episodes

Correct answer: B

Rationale: The correct answer is B: 'Sense of impending doom.' In panic disorder, a sense of impending doom is a hallmark symptom often experienced by clients. This intense feeling of dread or fear is a key feature of panic attacks. Compulsive behavior (choice A) may be more indicative of obsessive-compulsive disorder rather than panic disorder. Fear of flying (choice C) may be more related to specific phobias rather than panic disorder. Predictable episodes (choice D) do not align with the unpredictable nature of panic attacks.

2. A client with terminal cancer is experiencing severe pain. The nurse plans to implement which of the following pain management strategies?

• A. Administer analgesics on a fixed schedule
• B. Administer analgesics only when the client requests
• C. Use non-pharmacological methods only
• D. Increase the dose of analgesics when the client complains of pain

Correct answer: A

Rationale: Administering analgesics on a fixed schedule is the most appropriate pain management strategy for a client with terminal cancer experiencing severe pain. This approach ensures consistent pain control and helps prevent breakthrough pain. Administering analgesics only when the client requests (Choice B) may lead to uncontrolled pain as the client may delay requesting medication until the pain becomes unbearable. Using non-pharmacological methods only (Choice C) may not provide adequate pain relief for a client experiencing severe pain. Increasing the dose of analgesics when the client complains of pain (Choice D) may result in inconsistent pain control and could lead to potential overdose or adverse effects.

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. What is the primary function of a public health nurse?

• A. Provide bedside care
• B. Administer medications
• C. Promote and protect the health of populations
• D. Perform surgical procedures

Correct answer: C

Rationale: The primary function of a public health nurse is to promote and protect the health of populations. Public health nurses focus on preventing diseases, promoting healthy behaviors, and addressing health disparities within communities. Providing bedside care (choice A) is typically done by nurses in clinical settings, not public health nurses. Administering medications (choice B) is part of nursing practice but not the primary role of a public health nurse. Performing surgical procedures (choice D) is usually the responsibility of surgical nurses or healthcare providers specializing in surgery, not public health nurses.

5. A client with a history of seizures is receiving phenytoin (Dilantin). The nurse should monitor the client for which of the following side effects?

• A. Hypertension
• B. Hyperglycemia
• C. Gingival hyperplasia
• D. Hypokalemia

Correct answer: C

Rationale: The correct answer is C: Gingival hyperplasia. Phenytoin can cause gingival hyperplasia, characterized by an overgrowth of gum tissue. It is important for the nurse to monitor the client for this side effect as it can lead to oral health issues. Choices A, B, and D are incorrect. Phenytoin does not typically cause hypertension, hyperglycemia, or hypokalemia as common side effects.

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