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. As a supervisor, you plan to conduct a seminar in response to the midwife's training need for skills in community diagnosis. Which is an appropriate method to use to enable midwives to apply the knowledge they will gain in actual practice?

• A. lecture
• B. problem-solving
• C. group discussion
• D. nominal group technique

Correct answer: B

Rationale: Problem-solving is an effective method to enable midwives to apply the knowledge gained in actual practice. By engaging in problem-solving activities during the seminar, midwives can enhance their critical thinking skills and directly apply the information to real-life scenarios they may encounter in community diagnosis. Choice A (lecture) is less effective as it primarily involves passive listening and may not provide the hands-on experience needed for practical application. Choice C (group discussion) can be helpful for sharing perspectives but may not directly translate to practical application as problem-solving would. Choice D (nominal group technique) focuses more on generating ideas and reaching consensus rather than hands-on application of knowledge.

3. The nurse is assigned to a newly delivered woman with HIV/AIDS. The student asks the nurse about how it is determined that a person has AIDS other than a positive HIV test. The nurse responds:

• A. The complaints of at least 3 common findings.
• B. The absence of any opportunistic infection.
• C. CD4 lymphocyte count is less than 200.
• D. Developmental delays in children.

Correct answer: C

Rationale: The correct answer is C. A CD4 count less than 200 cells/mm³ is a diagnostic criterion for AIDS. Choices A, B, and D are incorrect. Choice A is vague and does not reflect the diagnostic criteria for AIDS. Choice B is not accurate, as the presence of opportunistic infections, not their absence, is indicative of AIDS. Choice D is unrelated to the diagnosis of AIDS in adults.

4. A client with bipolar disorder is receiving lithium (Lithobid). The nurse should monitor the client for which of the following side effects?

• A. Hypernatremia
• B. Hyponatremia
• C. Hyperglycemia
• D. Hypercalcemia

Correct answer: B

Rationale: The correct answer is B: Hyponatremia. Lithium can lead to hyponatremia by affecting sodium balance in the body. Hypernatremia (Choice A) is unlikely with lithium use. Hyperglycemia (Choice C) and hypercalcemia (Choice D) are not typically associated with lithium therapy for bipolar disorder.

5. In order to be effective as an occupational health nurse, you should be equipped with knowledge and skills in which of the following:

• A. public health science
• B. research process
• C. interviewing and counseling
• D. oral and written communication

Correct answer: D

Rationale: To be effective as an occupational health nurse, having knowledge and skills in public health science, the research process, interviewing and counseling, and oral and written communication are all important. However, communication skills, both oral and written, are crucial for conveying information, educating employees, documenting findings, and collaborating with other healthcare professionals. While public health science, research process, interviewing, and counseling are essential, oral and written communication is fundamental for effective communication and coordination in the workplace, making it the most critical skill for an occupational health nurse.

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