Nursing Elites

1. A community health RN believes that immunization rates in a lower socioeconomic section of the city are probably below the target set by the state health department. What action should the RN take FIRST to intervene with this health problem?

• A. Take a health history of the members of the community
• B. Initiate an immunization program for the community
• C. Review current epidemiological population data that might document a low immunization rate
• D. Refer all clients to the local health department

Correct answer: C

Rationale: The correct first action for the community health RN to take in this situation is to review current epidemiological population data that might document a low immunization rate. By doing so, the RN can gather evidence to support further intervention strategies. Option A is incorrect because taking a health history would not provide immediate data on immunization rates in the community. Option B is incorrect as initiating an immunization program without confirming the actual immunization rates may not address the specific needs of the community. Option D is incorrect as a blanket referral without assessing the situation may not be the most effective first step.

2. While discussing the science of nursing, the nurse identifies the domain of nursing theory. Which linkages should the nurse provide to describe nursing's paradigm?

• A. The person, the environment or situation, and health.
• B. Stress reduction, self-care, and a systems model.
• C. Curative care, restorative care, and terminal care.
• D. Self-actualization, fundamental needs, and belonging.

Correct answer: A

Rationale: The correct answer is A: 'The person, the environment or situation, and health.' In nursing theory, the paradigm includes these core components: the person receiving care, the environment or situation influencing care, and the goal of achieving optimal health outcomes. Choices B, C, and D are incorrect as they do not align with the fundamental aspects of nursing theory and its paradigm.

3. Postoperative orders for a client undergoing a mitral valve replacement include monitoring pulmonary artery pressure together with pulmonary capillary wedge pressure with a pulmonary artery catheter. This action by the nurse will assess

• A. Right ventricular pressure
• B. Left ventricular end-diastolic pressure
• C. Acid-Base balance
• D. Coronary artery stability

Correct answer: B

Rationale: The correct answer is B: Left ventricular end-diastolic pressure. Pulmonary capillary wedge pressure is used to assess left ventricular end-diastolic pressure. This measurement provides valuable information on the filling pressure of the left ventricle. Choices A, C, and D are incorrect because monitoring pulmonary capillary wedge pressure does not directly assess right ventricular pressure, acid-base balance, or coronary artery stability.

4. In reviewing the assessment data of a client suspected of having diabetes insipidus, the nurse expects which of the following after a water deprivation test?

• A. Increased edema and weight gain
• B. Unchanged urine specific gravity
• C. Rapid protein excretion
• D. Decreased blood potassium

Correct answer: B

Rationale: After a water deprivation test in a client suspected of having diabetes insipidus, the nurse would expect the urine specific gravity to remain unchanged. This occurs because in diabetes insipidus, the kidneys are unable to concentrate urine, leading to a low urine specific gravity even after water deprivation. Choices A, C, and D are incorrect. Increased edema and weight gain are not typical findings in diabetes insipidus. Rapid protein excretion is not directly related to the condition, and decreased blood potassium is not a common outcome of a water deprivation test for diabetes insipidus.

5. The following are functions of the Provincial Nurse Supervisor except:

• A. interpreting policies, guidelines, and SDP to nursing and midwifery staff of the province
• B. assessing training needs and planning staff development programs for nursing and midwifery staff
• C. participating in planning, developing, and evaluating OJT for nurses and midwives conducted by the department
• D. collecting, consolidating, analyzing, and interpreting health records and reports and making recommendations as needed

Correct answer: D

Rationale: The correct answer is D. Collecting, consolidating, analyzing, and interpreting health records is not a primary function of a Provincial Nurse Supervisor. The primary functions of a Provincial Nurse Supervisor include interpreting policies, guidelines, and SDP to nursing and midwifery staff, assessing training needs, planning staff development programs, and participating in planning, developing, and evaluating OJT for nurses and midwives. While health records may be accessed for specific purposes, the core responsibilities of a Provincial Nurse Supervisor focus on staff management and development rather than direct involvement in health record analysis.

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