Nursing Elites

1. 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.

2. What does the infant mortality rate measure?

• A. dying for every thousand of the population
• B. dying from 0-5 years old in every thousand population
• C. dying in the first 4 weeks in every thousand children born alive that year
• D. dying before 1 year old in every thousand children born alive that year

Correct answer: D

Rationale: The infant mortality rate measures the number of deaths occurring before 1 year old per 1000 live births. This is a crucial indicator of a population's health status and access to healthcare for infants. Choices A, B, and C are incorrect because the infant mortality rate specifically focuses on deaths within the first year of life, not the entire population or different age ranges.

3. In the implementation of the national family planning program, the government assumes the role of a:

• A. decision-maker in the practice of family planning methods
• B. regulator
• C. facilitator
• D. dictator

Correct answer: C

Rationale: The correct answer is C: 'facilitator.' In the implementation of a national family planning program, the government plays a role as a facilitator, meaning it helps to support and enable the access to family planning services and information. The government's role is to ensure that services are available, accessible, and of good quality, rather than making decisions for individuals or regulating them. Choices A, B, and D are incorrect because the government's role is not to make decisions on behalf of individuals (decision-maker), strictly regulate family planning practices (regulator), or impose decisions without considering individual choices (dictator).

4. When a nurse teaches a community about the importance of hand hygiene, the nurse is engaging in:

• A. Primary prevention
• B. Secondary prevention
• C. Tertiary prevention
• D. Quaternary prevention

Correct answer: A

Rationale: The correct answer is A: Primary prevention. Primary prevention aims to prevent the occurrence of a disease or injury before it happens. Teaching about hand hygiene to the community helps in preventing infections from occurring in the first place. Choice B, Secondary prevention, involves early detection and treatment to halt or slow the progress of a condition. This would involve screening or early intervention after exposure. Choice C, Tertiary prevention, focuses on managing the disease to prevent complications, recurrence, or deterioration. This would include rehabilitation and monitoring to prevent further complications. Choice D, Quaternary prevention, relates to actions taken to avoid unnecessary interventions or over-medicalization. This usually involves questioning the necessity of certain medical procedures or treatments to prevent harm to patients.

5. What are the sources of information about the family?

• A. Interview results with members of the family
• B. Family folder
• C. Actual observation of the family situation
• D. All these sources of information

Correct answer: D

Rationale: The correct answer is D because all the listed sources - interview results with family members, family folder, and actual observation of the family situation - provide comprehensive information about the family. Choice A alone (interview results) might not capture the complete picture of the family, as it may be biased or limited. Choice B (family folder) could contain valuable information but might not be up to date or comprehensive. Choice C (actual observation) is essential to understand the family dynamics, but it alone may not provide all the necessary information. Therefore, the combination of all these sources (D) is needed for a thorough understanding of the family.

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