Nursing Elites

1. A client with peptic ulcer disease is receiving ranitidine (Zantac). The nurse should monitor the client for which of the following side effects?

• A. Hypertension
• B. Constipation
• C. Diarrhea
• D. Hypotension

Correct answer: C

Rationale: The correct answer is C: Diarrhea. Ranitidine, which is used to treat peptic ulcer disease, can lead to gastrointestinal disturbances such as diarrhea. Choices A, B, and D are incorrect. Hypertension and hypotension are not common side effects of ranitidine. Constipation is also not a typical side effect associated with ranitidine use.

2. Health activities are designed to:

• A. prevent people from being exposed to germs
• B. ignore spiritual factors as they can confuse medical issues
• C. increase communities' control over their health and well-being
• D. ensure that the community health nurse leads health programs

Correct answer: C

Rationale: Health activities are structured to enhance communities' autonomy and influence over their health and well-being, aiming to empower them to make informed choices and take control of their health. Choice A is incorrect as health activities encompass a broader scope beyond just preventing exposure to germs. Choice B is incorrect because spiritual factors are crucial components that should not be disregarded in healthcare. Choice D is incorrect as health activities are not solely about the community health nurse being in charge, but about empowering the community as a whole.

3. The nurse working in a community health clinic that serves recent Somali immigrants notes that most mothers refuse to give permission for routine immunizations of their preschoolers. Which individual is likely to have the most influence on these women's perceptions about their children's healthcare needs?

• A. husbands
• B. clinic healthcare providers
• C. older females
• D. tribal chief

Correct answer: D

Rationale: In many Somali communities, the tribal chief holds significant influence over health decisions. The tribal chief often plays a crucial role in shaping community beliefs and practices, including healthcare decisions. While husbands may have some influence, the tribal chief typically holds more authority in community matters. Clinic healthcare providers have a role in educating and advising, but the tribal chief's influence is often more profound in this cultural context. Older females may have some influence, especially in familial matters, but the tribal chief is usually the key decision-maker in community health issues.

4. 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.

5. During which phase of the community organizing process are the leaders or groups given training to develop their knowledge, skills, and attitudes in managing their own programs?

• A. Sustenance and strengthening phase
• B. Pre-entry phase
• C. Organizing-building phase
• D. Entry phase

Correct answer: C

Rationale: The correct answer is C, the organizing-building phase. This phase involves providing training to leaders and groups to develop their knowledge, skills, and attitudes in managing their own programs. Choice A, the sustenance and strengthening phase, focuses more on maintaining and enhancing existing programs rather than training. Choice B, the pre-entry phase, occurs before actual organizing and training take place. Choice D, the entry phase, is about initiating the community organizing process, not specifically about training leaders and groups.

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