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. In providing comprehensive family health care, the nurse utilizes four (4) basic processes. These are listed in the order in which they are carried out as follows:

• A. assessment, planning, intervention, and evaluation
• B. assessment, intervention, planning, and evaluation
• C. planning, assessment, intervention, and evaluation
• D. planning, intervention, evaluation, and assessment

Correct answer: A

Rationale: The correct order for the basic processes in providing comprehensive family health care is assessment, planning, intervention, and evaluation. Assessment is the first step to gather information, followed by planning to set goals and strategies, then intervention to implement the plan, and finally evaluation to assess the outcomes. Choice A is correct as it follows this logical sequence. Choices B, C, and D are incorrect because they do not follow the correct order of these essential processes in nursing care.

4. As a community Health Nurse, you are a change agent. Which of the following roles must you play to succeed as a change agent?

• A. information provider
• B. information seeker
• C. motivator
• D. leader

Correct answer: B

Rationale: To succeed as a change agent, being an information seeker is crucial. While being an information provider, motivator, and leader are important roles, actively seeking information is fundamental to understanding the community's needs, concerns, and challenges before implementing effective changes. This active information seeking helps in making informed decisions and developing strategies that address the specific issues faced by the community. Therefore, the correct choice is B. Choices A, C, and D are also important roles but may not be as fundamental as actively seeking information.

5. For Barangay Mabulaklak, you intend to conduct health education sessions for a group of mothers. Which of the following topics for discussion will be given least priority:

• A. proper selection and preparation of food
• B. handwashing before preparing food
• C. cutting children's fingernails short
• D. overcrowding and its effect

Correct answer: D

Rationale: The correct answer is D - 'overcrowding and its effect.' While overcrowding is an important topic, it will be given least priority compared to the other choices when conducting health education sessions for a group of mothers. Proper selection and preparation of food (Choice A) is crucial for ensuring adequate nutrition, handwashing before preparing food (Choice B) is essential for preventing foodborne illnesses, and cutting children's fingernails short (Choice C) is important for maintaining good hygiene. Overcrowding, although significant in the context of public health, might be considered less immediately relevant for a group of mothers in a health education session focused on more direct and practical aspects of family health and hygiene.

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