Nursing Elites

1. A client with a history of deep vein thrombosis (DVT) is receiving warfarin (Coumadin). The nurse should monitor the client for which of the following laboratory values?

• A. Prothrombin time (PT)
• B. Serum potassium
• C. Blood urea nitrogen (BUN)
• D. White blood cell count (WBC)

Correct answer: A

Rationale: The correct answer is A: Prothrombin time (PT). Prothrombin time is monitored to assess the effectiveness of warfarin therapy. Warfarin is an anticoagulant medication that works by inhibiting the synthesis of vitamin K-dependent clotting factors, including factors II, VII, IX, and X. Monitoring the PT helps ensure that the client's blood is clotting within the desired therapeutic range to prevent complications such as recurrent DVT or excessive bleeding. Choices B, C, and D are incorrect because serum potassium, blood urea nitrogen, and white blood cell count are not directly related to monitoring warfarin therapy in a client with a history of DVT.

2. Mark, 9 months old, is given oral rehydration solution because of diarrhea with some dehydration. In your follow-up visit, you observed that Mark's eyes become puffy. Which one of the following would you advise Mark's mother?

• A. continue giving ORS but more slowly
• B. show mother how much solution to give
• C. stop ORS and give plain water or milk
• D. reassess patient to determine how much ORS to give

Correct answer: A

Rationale: In this scenario, observing puffy eyes in a child being treated with oral rehydration solution may indicate fluid overload. Continuing to give ORS but more slowly is the correct course of action as it helps manage hydration without overloading fluids. Choice B is not the best option in this situation as the issue is not about the quantity of the solution, but the rate of administration. Choice C is incorrect because plain water or milk is not a suitable alternative for rehydration in cases of dehydration. Choice D is also incorrect as reassessing the patient does not directly address the issue of puffy eyes, which suggests a need to adjust the administration of ORS.

3. While performing an initial assessment on a newborn following a breech delivery, the nurse suspects hip dislocation. Which of the following is most suggestive of the abnormality?

• A. Flexion of lower extremities
• B. Negative Ortolani response
• C. Lengthened leg of affected side
• D. Irregular hip symmetry

Correct answer: D

Rationale: Irregular hip symmetry, such as asymmetry in the gluteal folds, is a common sign of hip dislocation in newborns. This finding indicates a potential abnormality in hip development and requires further evaluation and possible treatment. Choices A, B, and C are incorrect. Flexion of lower extremities is a normal newborn reflex, the Ortolani response is used to detect hip dysplasia rather than hip dislocation, and a lengthened leg of the affected side is not typically associated with hip dislocation in newborns.

4. In order to facilitate the planning and implementation of an income-generating project in a barangay, which of the following actions should the Public Health Nurse NOT do?

• A. Form working groups or committees
• B. Enlist the help of technical professionals for training and guiding the people
• C. Form a core group to coordinate the various projects
• D. Give the people complete freedom to do what they want

Correct answer: D

Rationale: Giving people complete freedom without any guidance or structure can lead to disorganization, lack of focus, and ultimately project failure. In the context of implementing an income-generating project, it is crucial to provide support, direction, and coordination to ensure the project's success. Forming working groups, enlisting technical professionals for training, and establishing a core group for coordination are essential steps to enhance efficiency, productivity, and the overall success of the project.

5. Which presentation of an infectious disease is acquired through an indirect transmission?

• A. Syphilis contracted from a sexual partner.
• B. Measles resulting from a daycare center outbreak.
• C. Malaria following exposure in a mosquito-infested area.
• D. Nosocomial influenza spreading rapidly in a long-term care center.

Correct answer: C

Rationale: The correct answer is C. Malaria is transmitted indirectly through mosquito bites. Choice A is incorrect as syphilis is acquired through direct contact with an infected sexual partner. Choice B is incorrect as measles can be transmitted through respiratory droplets in close contact settings like daycare centers. Choice D is incorrect as nosocomial influenza spreads within healthcare facilities through direct contact or droplets.

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