Nursing Elites

1. A client was re-admitted to the hospital following a recent skull fracture. Which finding requires the nurse's immediate attention?

• A. Lethargy
• B. Agitation
• C. Ataxia
• D. Hearing loss

Correct answer: A

Rationale: Lethargy is a critical finding that requires the nurse's immediate attention when a client with a recent skull fracture is readmitted to the hospital. It can indicate increased intracranial pressure or other serious complications such as hemorrhage or infection. Addressing lethargy promptly is crucial to prevent further deterioration. Agitation, ataxia, and hearing loss are important to assess but do not signify the same level of urgency as lethargy in this context.

2. With the present system, family planning programs at the municipal barangay levels are managed by:

• A. non-governmental organizations
• B. LGUs
• C. all these units/organizations are managing family planning programs
• D. other government organizations

Correct answer: C

Rationale: The correct answer is C because family planning programs at the municipal barangay levels are managed by a combination of non-governmental organizations (NGOs), Local Government Units (LGUs), and other government organizations. Therefore, all these units/organizations are involved in managing family planning programs. Choices A, B, and D are incorrect because they individually do not capture the full scope of the entities involved in managing family planning programs at the specified levels.

3. Who was the first Filipino nurse supervisor appointed in the Bureau of Health in 1919?

• A. Ms. Carmen del Rosario
• B. Mrs. Genara de Guzman
• C. Mrs. Annie Sand
• D. Mrs. Anastacio Giron-Tupas

Correct answer: D

Rationale: The correct answer is Mrs. Anastacio Giron-Tupas, who was the first Filipino nurse supervisor appointed in the Bureau of Health in 1919. Ms. Carmen del Rosario, Mrs. Genara de Guzman, and Mrs. Annie Sand were not the first Filipino nurse supervisors appointed to this position. Therefore, they are incorrect choices.

4. A 16-month-old child has just been admitted to the hospital. As the nurse assigned to this child enters the hospital room for the first time, the toddler runs to the mother, clings to her, and begins to cry. What would be the initial action by the nurse?

• A. Arrange for a change in client care assignments
• B. Explain that this behavior is expected
• C. Discuss the appropriate use of 'time-out'
• D. Explain that the child is in need of extra attention

Correct answer: B

Rationale: The correct answer is to explain that this behavior is expected. At 16 months of age, children commonly experience separation anxiety, especially in unfamiliar environments like hospitals. It is important for the nurse to reassure the child and the parent that such behavior is normal. Option A is incorrect as there is no need to change client care assignments based on the child's behavior. Option C is not appropriate as discussing the use of 'time-out' is more relevant in behavior management for older children. Option D is incorrect as it does not address the underlying cause of the child's behavior related to separation anxiety.

5. A client with chronic congestive heart failure should be instructed to contact the home health nurse if which finding occurs?

• A. Weight gain of 2 pounds or more in a 48-hour period
• B. Urinating 4 to 5 times a day
• C. A significant decrease in appetite
• D. Appearance of non-pitting ankle edema

Correct answer: A

Rationale: A rapid weight gain of 2 pounds or more in a 48-hour period may indicate fluid retention and worsening heart failure, requiring prompt medical evaluation and intervention. This finding is crucial in managing chronic congestive heart failure as it signifies a potential exacerbation of the condition. Choices B, C, and D are less concerning in this context. Urinating 4 to 5 times a day is within the normal range for most individuals and may not be directly related to heart failure. A significant decrease in appetite may be due to various factors and might not be an immediate cause for concern in heart failure patients. The appearance of non-pitting ankle edema, although related to heart failure, is a more chronic and less urgent symptom when compared to a rapid weight gain, which requires immediate attention.

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