Public health services are provided by government facilities. What is the most appropriate response of a public health nurse to the statement: The government should give these health services free of charge to people?

Correct Answer: D

Rationale: The most appropriate response is "Many of the health services are given free, but we people pay for them just the same through our taxes." This response acknowledges the fact that public health services are funded by taxpayers, even though they may be perceived as free by the public. It highlights the connection between government funding and the provision of health services, emphasizing that these services are not truly free but are paid for through taxes. It also addresses the misconception that these services are entirely free without any costs involved.

Correct Answer: C

Rationale: The initial action the nurse should take when faced with a situation where a patient refuses to take medication after education and explanation is to notify the physician. The physician may need to be informed so they can reassess the medication and potentially explore alternative options or make adjustments based on the patient's concerns and preferences. It is important for medical decisions to be made in collaboration with the healthcare team to ensure the best care for the patient. Consulting the physician also helps in avoiding any potential negative outcomes resulting from the patient's refusal to take the prescribed medication. Once the physician is aware, further actions can be discussed and implemented to address the patient's concerns.

Correct Answer: D

Rationale: A hard mass and a reddened area on one breast are key clinical signs that confirm the diagnosis of mastitis. Mastitis is an infection of the breast tissue that often presents with localized redness, warmth, and swelling of the breast. The presence of a hard mass along with the other symptoms suggests inflammation and infection within the breast tissue. In contrast, the other findings such as enlarged glands in the axilla, normal temperature, and engorged breasts are not specific findings for mastitis and may be present in other conditions. Therefore, the presence of a hard mass and reddened area on one breast is the additional finding that strongly confirms the diagnosis of mastitis in this case.

Correct Answer: B

Rationale: Digitalis therapy, commonly prescribed for heart conditions, is known for its narrow therapeutic range and potential for toxicity. In the case of Patient Lily, who has been on digitalis therapy since she was pregnant, the nurse would anticipate the continuation of the same dosage to maintain the therapeutic effects and reduce the risks of toxicity. It is essential to monitor the patient's digitalis levels regularly and adjust the dosage if necessary based on the patient's response and any changes in their clinical status. Switching to a more potent drug, changing the medication, or adding a diuretic would not be appropriate without further assessment and consultation with the healthcare provider managing Lily's digitalis therapy.

Correct Answer: C

Rationale: The primary nursing care delivery model is represented by option C, where the nurse performs all tasks needed by the individual patient to optimize health. In this model, the nurse is responsible for coordinating and providing comprehensive care to a specific group of patients throughout their stay. The primary nurse establishes a close relationship with the patient and takes accountability for their care, ensuring continuity, communication, and personalized attention. This approach emphasizes the importance of the nurse-patient relationship and holistic care delivery, which can lead to improved patient outcomes and satisfaction.