Nokea
The new graduate nurse interviews for a position in a nursing department of a large health care agency, described by the interviewer as having shared governance. Which of these statements best illustrates the shared governance model?
- A. An appointed board oversees any administrative decisions
- B. Nursing departments share responsibility for client outcomes
- C. Staff groups are appointed to discuss nursing practice and client education issues
- D. Non-nurse managers supervise nursing staff in groups of units
Correct Answer: B
Rationale: The correct answer is B because shared governance involves nurses and other staff sharing responsibility for decisions related to patient care and outcomes, promoting collaborative practice and shared accountability. Choice A is incorrect as shared governance includes active participation of frontline staff, not just an appointed board. Choice C is incorrect because shared governance goes beyond just discussing issues to actively sharing responsibility for decision-making. Choice D is incorrect as shared governance encourages nurses to have a significant role in decision-making rather than being supervised by non-nurse managers.
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A client comes into the community health center upset and crying stating, "I will die of cancer now that I have this disease." And then the client hands the nurse a paper with one word written on it: 'Pheochromocytoma.' Which response should the nurse state initially?
- A. 'Pheochromocytomas usually aren't cancerous (malignant). But they may be associated with cancerous tumors in other endocrine glands such as the thyroid (medullary carcinoma of the thyroid).'
- B. 'This problem is diagnosed by blood and urine tests that reveal elevated levels of adrenaline and noradrenaline.'
- C. 'Computerized tomography (CT) or magnetic resonance imaging (MRI) are used to detect an adrenal tumor.'
- D. 'You probably have had episodes of sweating, heart pounding, and headaches.'
Correct Answer: A
Rationale: The correct initial response for the nurse to provide in this situation is to offer reassurance. Stating that 'Pheochromocytomas usually aren't cancerous (malignant)' helps to alleviate the client's anxiety and fear of having cancer. This response also establishes a foundation for further discussion about the condition, allowing the nurse to address the client's concerns and provide accurate information. Choice B is incorrect as it focuses solely on the diagnostic tests for pheochromocytoma but does not address the client's emotional distress. Choice C is incorrect as it discusses imaging modalities without directly addressing the client's concerns. Choice D is also incorrect as it assumes symptoms without first addressing the client's emotional state and fear of cancer.
When planning the care for a young adult client diagnosed with anorexia nervosa, which of these concerns should the nurse determine to be the priority for long term mobility?
- A. Digestive problems
- B. Amenorrhea
- C. Electrolyte imbalance
- D. Blood disorders
Correct Answer: B
Rationale: The correct answer is B: Amenorrhea. Amenorrhea, or the absence of menstruation, is a common long-term consequence of anorexia nervosa due to low body weight and hormonal imbalances. Addressing amenorrhea is crucial for the patient's overall health and reproductive potential.
Choice A, Digestive problems, may also be a concern in anorexia nervosa, but in terms of long-term mobility, amenorrhea takes priority because of its impact on hormonal balance and bone health.
Choice C, Electrolyte imbalance, is important to address in anorexia nervosa due to potential cardiac complications, but it is not directly linked to long-term mobility concerns.
Choice D, Blood disorders, while they can occur in anorexia nervosa, are not as directly related to long-term mobility as amenorrhea, which can significantly affect bone health and mobility in the future.
In the implementation of the national family planning program, the government assumes the role of a:
- A. decision-maker in the practice of family planning methods
- B. regulator
- C. facilitator
- D. dictator
Correct Answer: C
Rationale: The correct answer is C: 'facilitator.' In the implementation of a national family planning program, the government plays a role as a facilitator, meaning it helps to support and enable the access to family planning services and information. The government's role is to ensure that services are available, accessible, and of good quality, rather than making decisions for individuals or regulating them. Choices A, B, and D are incorrect because the government's role is not to make decisions on behalf of individuals (decision-maker), strictly regulate family planning practices (regulator), or impose decisions without considering individual choices (dictator).
A community health nurse is conducting a neighborhood discussion group about disaster planning. What information regarding the transmission of anthrax should the nurse provide to the group?
- A. Infection is acquired when anthrax spores enter a host.
- B. Mature anthrax bacteria live dormant on inanimate objects.
- C. Spores cannot survive for extended periods outside of a living host.
- D. Anthrax is transmitted by respiratory droplets from person to person.
Correct Answer: A
Rationale: The correct information that the nurse should provide to the group is that anthrax infection occurs when spores enter a host. Choice B is incorrect because mature anthrax bacteria do not live dormant on inanimate objects. Choice C is incorrect because anthrax spores can survive for extended periods outside of a living host. Choice D is incorrect because anthrax is not transmitted by respiratory droplets from person to person; it is acquired through spores entering a host.
The RN is making a home visit to a female client with end-stage heart disease. She has a living will and states she will never go back to the hospital. During the visit, the RN notes that the client is pale and SOB while speaking. The RN discovers 3+ edema in both ankles and bilateral pulmonary crackles. Which intervention should the RN implement first?
- A. Order a chest X-ray
- B. Obtain a peripheral O2 saturation reading
- C. Obtain an order for complete blood count
- D. Tell the patient to stay in bed
Correct Answer: B
Rationale: Obtaining a peripheral O2 saturation reading is the priority intervention in this scenario. It helps assess the client's oxygenation status quickly, which is crucial in a client with signs of respiratory distress, such as shortness of breath and bilateral pulmonary crackles. Ordering a chest X-ray (Choice A) may be necessary later but does not address the immediate need for oxygen assessment. Obtaining an order for a complete blood count (Choice C) is not the priority in this situation as it does not directly address the client's respiratory distress. Instructing the patient to stay in bed (Choice D) does not address the underlying issue of potential hypoxia and respiratory compromise.