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A nurse is preparing to perform a sterile wound irrigation and dressing change for a client. Which of the following actions by the nurse breaks in surgical aseptic technique?
- A. Balancing the bottle on the sterile basin while pouring the liquid
- B. Clarify the reason for the referral
- C. Identify family needs and interventions
- D. Provide discharge teaching
Correct Answer: A
Rationale: The correct answer is A because balancing the bottle on the sterile basin contaminates the sterile field. Sterile technique requires keeping all items above waist level, avoiding leaning over the sterile field, and maintaining a safe distance to prevent contamination. Choices B, C, and D are unrelated to sterile technique and do not involve direct contact with the sterile field. Clarifying the reason for referral, identifying family needs, and providing discharge teaching are important aspects of nursing care but do not pertain to maintaining a sterile field during wound irrigation and dressing change.
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Which statement describes the actions of a nurse who follows Nightingale's Environmental Theory?
- A. Identifying strategies to reduce climate change
- B. Encouraging the use of public transportation
- C. Promoting environmental justice for all people
- D. Using the client's environment to assist in recovery
Correct Answer: D
Rationale: The correct answer is D because Nightingale's Environmental Theory emphasizes the importance of the environment in promoting health and recovery. By using the client's environment to assist in recovery, the nurse is applying Nightingale's principles of creating a healing environment. Choices A, B, and C focus on broader environmental issues, which are important but not directly related to Nightingale's theory of nursing. The nurse's primary focus should be on utilizing the immediate environment to support the client's healing process.
A nurse successfully persuades an obese client to perform a weekly weigh-in at homeusing a digital scale and record the weight in a log. This strategy is an example of:
- A. Telehealth
- B. Health information technology
- C. Personal responsibility for health
- D. Evidenc
Correct Answer: C
Rationale: The correct answer is C, "Personal responsibility for health." This is because by persuading the client to monitor and record their weight at home, the nurse is empowering the client to take ownership of their health and actively participate in managing their weight. This strategy encourages the client to be accountable for their health outcomes and promotes self-care. Option A, "Telehealth," is incorrect because it refers to the delivery of healthcare services through technology, not necessarily personal responsibility. Option B, "Health information technology," is also incorrect as it pertains to the use of technology to manage health information, not about individual responsibility. Option D is cut off, but if it were "Evidence-based practice," it would be incorrect as it does not directly relate to the client's responsibility for their health.
The nurse is developing a PICOT question to study methods to promote smoking cessation in high school students in a rural community. Which statement identifies the targeted population?
- A. The rural community
- B. Community members who smoke
- C. All high school students in the community
- D. High school students in the rural community who smoke
Correct Answer: D
Rationale: The correct answer is D because it specifically identifies the targeted population as high school students in the rural community who smoke, which aligns with the study's focus on smoking cessation in this specific group. Choice A is too broad, choice B includes all community members who smoke, choice C includes all high school students without specifying smoking status. By choosing D, the nurse can focus on a more precise and relevant population for the study.
A community health nurse is reviewing the reports for a group of clients. The nurse should identify that which of the following disorders is on the CDC's national notifiable conditions list?
- A. Lyme disease
- B. Providing care with a focus on the aggregates needs
- C. Having the goal of health promotion and disease prevention
- D. Health disparities among any groups are morally and legally wrong
Correct Answer: A
Rationale: The correct answer is A: Lyme disease. The CDC's national notifiable conditions list includes diseases that are required to be reported to the CDC for public health monitoring and control. Lyme disease is on this list due to its potential for widespread transmission and public health impact. The other choices are incorrect as they do not relate to the concept of notifiable conditions or public health surveillance. Providing care with a focus on aggregate needs, having goals of health promotion, and addressing health disparities are important aspects of community health nursing but are not directly related to notifiable conditions.
A staff nurse is observing a newly licensed nurse suction a client’s tracheostomy. Which of the following actions by the newly-licensed nurse requires intervention by the staff nurse?
- A. Waits for 2 minutes between suctions
- B. Engaging in policy development and encourage and assist persons to communicate their needs
- C. Giving a very informative and engaging presentation
- D. Identifying and planning for high-risk populations
Correct Answer: A
Rationale: The correct answer is A because waiting for 2 minutes between suctions is not recommended practice for tracheostomy care. Suctioning should be performed as needed based on the patient's clinical presentation, not on a fixed time interval. Waiting too long between suctions can lead to ineffective removal of secretions, compromising the patient's airway.
Choice B, C, and D are incorrect because they are unrelated to the scenario of suctioning a tracheostomy. Choice B refers to policy development and communication skills, Choice C mentions giving a presentation, and Choice D involves planning for high-risk populations. These choices do not pertain to the immediate nursing intervention needed during tracheostomy care.