Nursing Elites

1. You are teaching a client about the patient-controlled analgesia (PCA) planned for post-operative care. Which statement indicates further teaching may be needed by the client?

• A. ''I will be receiving continuous doses of medication.''
• B. ''I should call the nurse before I take additional doses.''
• C. ''I will call for assistance if my pain is not relieved.''
• D. ''The machine will prevent an overdose.''

Correct answer: B

Rationale: PCA allows patients to self-administer pain medication within prescribed limits, without the need to call the nurse before taking an additional dose. Choice B suggests a misunderstanding of how PCA works, as the patient should be educated that they can self-administer doses within the safety parameters set by the healthcare provider. Choices A, C, and D demonstrate proper understanding of PCA, hence are not indicative of needing further teaching.

2. A female client diagnosed with genital herpes simplex virus 2 (HSV 2) complains of dysuria, dyspareunia, leukorrhea, and lesions on the labia and perianal skin. A primary nursing action with the focus of comfort should be to

• A. Suggest 3 to 4 warm sitz baths per day
• B. Cleanse the genitalia twice a day with soap and water
• C. Spray warm water over genitalia after urination
• D. Apply heat or cold to lesions as desired

Correct answer: A

Rationale: The correct answer is to suggest 3 to 4 warm sitz baths per day. Warm sitz baths can soothe the irritated genital area, reduce pain, and promote healing of the lesions associated with genital herpes. Cleansing the genitalia with soap and water or spraying warm water over the genitalia after urination may further irritate the lesions. Applying heat or cold to lesions as desired may not provide the same level of comfort and healing as warm sitz baths.

3. When a nurse teaches a community about the importance of regular health screenings, this activity falls under which level of prevention?

• A. Primary prevention
• B. Secondary prevention
• C. Tertiary prevention
• D. Quaternary prevention

Correct answer: B

Rationale: The correct answer is B: Secondary prevention. Secondary prevention aims to detect and treat disease early to prevent complications. Teaching about the importance of regular health screenings helps in early detection and intervention, which aligns with the goals of secondary prevention. Choice A, Primary prevention, involves actions to prevent the onset of a health condition. Choice C, Tertiary prevention, focuses on managing and treating existing conditions to prevent further complications. Choice D, Quaternary prevention, relates to actions taken to mitigate or avoid unnecessary interventions, over-medicalization, and the consequences of unnecessary treatment.

4. Which of the following statements is correct regarding community health nursing?

• A. Evaluation of the health status of individuals and families should be done in consultation with them.
• B. The public health nurse (PHN) who works with communication for 6 can solely determine the needs of the community.
• C. Provision of PHN care is not in any way affected by policies of the agency where the nurse works.
• D. Professional growth and development of the PHN is the responsibility of the Department of Health (DOH).

Correct answer: A

Rationale: The correct statement is that evaluation of the health status of individuals and families should be done in consultation with them. This approach ensures that the assessment is accurate and takes into account the perspectives and concerns of the individuals and families involved. Choice B is incorrect because determining the needs of the community should involve input from various stakeholders, not solely the PHN. Choice C is incorrect as the provision of PHN care can be influenced by the policies of the agency or organization where the nurse works. Choice D is also incorrect as while the DOH may play a role in setting standards, the professional growth and development of a PHN is typically a personal and professional responsibility.

5. Environmental sanitation is the primary problem in community Y. As a stranger to the health unit, one of the major strategies in your plan is the improvement of the environmental health conditions of the community. To indicate this, which of the following would you do?

• A. meet with youth officials and parents' group leaders
• B. meet with religious and educational leaders
• C. request mayors to create a task force to help implement your project
• D. inform local announcers to disseminate the what and why of your project

Correct answer: C

Rationale: In this scenario, requesting mayors to create a task force is the most effective strategy to improve environmental health conditions in the community. Engaging with local government officials ensures the allocation of resources, coordination of efforts, and the implementation of sustainable solutions. While meeting with youth officials, parents' group leaders, religious and educational leaders are important, involving mayors in creating a task force will lead to broader community involvement and support. Informing local announcers about the project, although helpful for awareness, is not as impactful as engaging with local authorities for tangible change.

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