Nursing Elites

1. A 67-year-old client is admitted with substernal chest pain with radiation to the jaw. His admitting diagnosis is Acute Myocardial Infarction (MI). The priority nursing diagnosis for this client during the immediate 24 hours is

• A. Constipation related to immobility
• B. High risk for infection
• C. Impaired gas exchange
• D. Fluid volume deficit

Correct answer: C

Rationale: The correct answer is C: Impaired gas exchange. In a client with an acute myocardial infarction, impaired gas exchange is a priority nursing diagnosis due to compromised heart function, which affects oxygenated blood circulation. Close monitoring and interventions are crucial to ensure adequate oxygenation. Choices A, B, and D are incorrect: A) Constipation related to immobility is not the priority in this acute situation; B) High risk for infection is not the immediate concern related to the client's primary diagnosis; D) Fluid volume deficit, while important, is not the priority compared to addressing impaired gas exchange in acute MI.

2. The nurse is teaching a community group about risks of cardiovascular disease. Several clients ask the nurse to determine their risk. Which client should the nurse identify as having the greatest risk for cardiovascular disease?

• A. A male with a serum cholesterol level of 199 mg/dl.
• B. A female with a serum cholesterol level of 201 mg/dl.
• C. A male with a low-density lipoprotein (LDL) level of 200 mg/dl.
• D. A female with a low-density lipoprotein (LDL) level of 160 mg/dl.

Correct answer: C

Rationale: The correct answer is C. A male with a high LDL level (200 mg/dl) has a significant risk for cardiovascular disease. High levels of LDL cholesterol are associated with an increased risk of atherosclerosis and heart disease. Choices A, B, and D have serum cholesterol levels that are slightly elevated but are not as specific or directly linked to cardiovascular risk as high LDL levels. Therefore, the client with the high LDL level is at the greatest risk for cardiovascular disease.

3. A unit of Girl Scouts went hiking over Mt. Makiling. While resting, scout Jaymee, 14 years of age, complained of a sudden moderately bearable toothache. In checking their first-aid kit, they found none of mefenamic acid, BUT they luckily chanced upon a home that uses alternative pain-relieving medicinal plants. What would this plant be?

• A. Bawang
• B. Lagundi
• C. Sambong
• D. Tsaang gubat

Correct answer: A

Rationale: The correct answer is A, Bawang (garlic), which is traditionally used for its pain-relieving properties. While Lagundi, Sambong, and Tsaang gubat are also medicinal plants with various health benefits, they are not specifically known for their pain-relieving properties like garlic.

4. Which individual has the highest risk of developing community-acquired pneumonia?

• A. A 40-year-old first-grade teacher who works with underprivileged children.
• B. A 75-year-old retired secretary with exercise-induced wheezing.
• C. A 60-year-old homeless person who is an alcoholic and smokes.
• D. A 35-year-old aerobics instructor who skips meals and eats only vegetables.

Correct answer: C

Rationale: The correct answer is the 60-year-old homeless person who is an alcoholic and smokes. This individual has the highest risk of developing community-acquired pneumonia due to factors such as homelessness, alcoholism, and smoking, which weaken the immune system and make them more susceptible to respiratory infections. Choice A is incorrect as working with underprivileged children, while potentially exposing the individual to various illnesses, does not directly increase the risk of pneumonia. Choice B is less likely as exercise-induced wheezing may suggest asthma but does not directly correlate with pneumonia risk. Choice D, an aerobics instructor who eats only vegetables and skips meals, does not have the same level of risk factors for pneumonia as the homeless person in choice C.

5. All of the following are objectives of FHSIS EXCEPT:

• A. To complete the clinical picture of chronic diseases and describe their natural history
• B. To provide a standardized, facility-level database that can be accessed for more in-depth studies
• C. To minimize recording and reporting burden, allowing more time for patient care and promotive activities
• D. To ensure that data reported are useful and accurate and are disseminated in a timely and easy-to-use fashion

Correct answer: A

Rationale: The correct answer is A. Completing the clinical picture of chronic diseases and describing their natural history is not an objective of FHSIS. The objectives of FHSIS include providing a standardized, facility-level database for more in-depth studies (B), minimizing recording and reporting burden to allow more time for patient care and promotive activities (C), and ensuring that reported data are useful, accurate, and disseminated in a timely and easy-to-use manner (D). Therefore, A is the exception among the listed objectives.

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