Nursing Elites

1. A client with terminal cancer is experiencing severe pain. The nurse plans to implement which of the following pain management strategies?

• A. Administer analgesics on a fixed schedule
• B. Administer analgesics only when the client requests
• C. Use non-pharmacological methods only
• D. Increase the dose of analgesics when the client complains of pain

Correct answer: A

Rationale: Administering analgesics on a fixed schedule is the most appropriate pain management strategy for a client with terminal cancer experiencing severe pain. This approach ensures consistent pain control and helps prevent breakthrough pain. Administering analgesics only when the client requests (Choice B) may lead to uncontrolled pain as the client may delay requesting medication until the pain becomes unbearable. Using non-pharmacological methods only (Choice C) may not provide adequate pain relief for a client experiencing severe pain. Increasing the dose of analgesics when the client complains of pain (Choice D) may result in inconsistent pain control and could lead to potential overdose or adverse effects.

2. In 1996, there were 15 cases of Acute Respiratory Infection (ARI) in Barangay B, while Barangay C had 20 cases. The total number of children who have ARI is:

• A. higher in Barangay C than in Barangay B
• B. not comparable in Barangay B and C
• C. higher in Barangay B than in Barangay C
• D. data given is insufficient

Correct answer: A

Rationale: The correct answer is A: 'higher in Barangay C than in Barangay B.' This is because Barangay C had more cases of ARI (20) compared to Barangay B (15). Therefore, the total number of children who have ARI is higher in Barangay C. Choices B and C are incorrect because the data clearly shows that Barangay C had more cases than Barangay B. Choice D is also incorrect as there is sufficient data provided to compare the number of ARI cases between the two barangays.

3. A 16-year-old female client returns to the clinic because she is pregnant for the third time by a new boyfriend. Which vaccine should the nurse plan to administer?

• A. MMR
• B. Hepatitis B
• C. Human papillomavirus
• D. Pneumococcal

Correct answer: B

Rationale: The correct answer is B, Hepatitis B. The Hepatitis B vaccine is crucial for pregnant women to prevent transmission of the virus to the baby during childbirth. Option A, MMR (Measles, Mumps, Rubella) vaccine, is not indicated during pregnancy. Option C, Human papillomavirus vaccine, is recommended for prevention of HPV infections but is not specifically indicated during pregnancy. Option D, Pneumococcal vaccine, is important for certain populations but is not the priority vaccine for a pregnant woman in this scenario.

4. The RN is making a home visit to a female client with end-stage heart disease. She has a living will and states she will never go back to the hospital. During the visit, the RN notes that the client is pale and SOB while speaking. The RN discovers 3+ edema in both ankles and bilateral pulmonary crackles. Which intervention should the RN implement first?

• A. Order a chest X-ray
• B. Obtain a peripheral O2 saturation reading
• C. Obtain an order for complete blood count
• D. Tell the patient to stay in bed

Correct answer: B

Rationale: Obtaining a peripheral O2 saturation reading is the priority intervention in this scenario. It helps assess the client's oxygenation status quickly, which is crucial in a client with signs of respiratory distress, such as shortness of breath and bilateral pulmonary crackles. Ordering a chest X-ray (Choice A) may be necessary later but does not address the immediate need for oxygen assessment. Obtaining an order for a complete blood count (Choice C) is not the priority in this situation as it does not directly address the client's respiratory distress. Instructing the patient to stay in bed (Choice D) does not address the underlying issue of potential hypoxia and respiratory compromise.

5. Which of the following activities is an example of tertiary prevention?

• A. Health education
• B. Regular exercise
• C. Screening tests
• D. Physical therapy

Correct answer: D

Rationale: The correct answer is D, physical therapy. Tertiary prevention focuses on rehabilitation and treatment to prevent complications from a disease or injury. Physical therapy falls under this category as it helps individuals recover and improve functionality after an illness or injury. Choices A, B, and C are not examples of tertiary prevention. Health education (choice A) is more aligned with primary prevention by promoting healthy behaviors to prevent disease onset. Regular exercise (choice B) can be categorized under both primary and secondary prevention as it aims to prevent disease development and detect conditions early. Screening tests (choice C) are part of secondary prevention as they aim to detect diseases at an early stage for prompt treatment.

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