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. 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.

3. The nurse is caring for a child who has just returned from surgery following a tonsillectomy and adenoidectomy. Which action by the nurse is appropriate?

• A. Offer ice chips every 2 hours
• B. Place the child in a semi-Fowler's position
• C. Encourage the child to drink from a cup
• D. Observe swallowing patterns

Correct answer: D

Rationale: Observing swallowing patterns is crucial post-tonsillectomy and adenoidectomy to detect signs of bleeding. Offering ice chips instead of ice cream helps prevent throat irritation. Placing the child in a semi-Fowler's position promotes airway patency and reduces the risk of aspiration. Encouraging the child to drink from a cup instead of a straw minimizes the risk of dislodging the surgical site.

4. A client with acute pancreatitis is experiencing severe abdominal pain. The nurse should implement which of the following interventions?

• A. Encourage oral intake
• B. Administer opioid analgesics
• C. Apply a heating pad to the abdomen
• D. Place the client in a supine position

Correct answer: B

Rationale: The correct intervention for a client with acute pancreatitis experiencing severe abdominal pain is to administer opioid analgesics. Opioids are effective in managing the severe pain associated with acute pancreatitis. Encouraging oral intake may exacerbate the symptoms and is contraindicated due to the need for bowel rest. Applying a heating pad to the abdomen can worsen inflammation and should be avoided. Placing the client in a supine position may not provide relief and could potentially lead to increased discomfort.

5. Which organization is primarily responsible for global public health?

• A. World Health Organization (WHO)
• B. Centers for Disease Control and Prevention (CDC)
• C. National Institutes of Health (NIH)
• D. United Nations (UN)

Correct answer: A

Rationale: The correct answer is A: World Health Organization (WHO). The WHO is the primary organization responsible for global public health initiatives, coordinating international health efforts, setting norms and standards, providing technical support, and monitoring health trends. Choices B, C, and D are incorrect because while they play significant roles in health and global affairs, they do not have the primary responsibility for global public health like the WHO does.

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