Nursing Elites

1. A pre-term baby develops nasal flaring, cyanosis, and diminished breath sounds on one side. The provider's diagnosis is spontaneous pneumothorax. Which procedure should the nurse prepare for first?

• A. Cardiopulmonary resuscitation
• B. Insertion of a chest tube
• C. Oxygen therapy
• D. Assisted ventilation

Correct answer: B

Rationale: The correct answer is B: Insertion of a chest tube. In a case of spontaneous pneumothorax, the primary intervention is to insert a chest tube. This procedure allows the trapped air to escape from the pleural space, relieving pressure and enabling the lung to re-expand. Choices A, C, and D are not the initial interventions for spontaneous pneumothorax. Cardiopulmonary resuscitation is indicated for cardiac arrest, oxygen therapy may provide supportive care but does not address the underlying issue of trapped air in the pleural space, and assisted ventilation may be needed later but is not the first-line treatment for a pneumothorax.

2. Under the present system, which of the following is the local government unit responsible for?

• A. Operation and maintenance of health facilities
• B. All of these activities
• C. Implementation of health programs/projects
• D. Delivery of health services

Correct answer: B

Rationale: Under the present system, the local government unit is responsible for all the listed activities. This includes the operation and maintenance of health facilities, implementation of health programs/projects, and delivery of health services. Therefore, choice B, 'All of these activities,' is the correct answer. Choices A, C, and D are incorrect because they are all responsibilities that fall under the local government unit's jurisdiction as well.

3. 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.

4. Community Health Nursing (CHN) in the Philippines encompasses healthcare provisions affecting four clients: individuals, families, population groups, and communities. In the course of our community health work, traditional, non-traditional, alternative, or complementary health care strategies are utilized. The legal basis for this action may be derived from the:

• A. PhilHealth Act
• B. Traditional and Alternative Health Care Law
• C. Philippine Nursing Act
• D. Philippine Medical Act

Correct answer: B

Rationale: The correct answer is B: Traditional and Alternative Health Care Law. This law provides the legal basis for integrating alternative health care strategies. The PhilHealth Act (Choice A) focuses on health insurance, the Philippine Nursing Act (Choice C) regulates the nursing profession, and the Philippine Medical Act (Choice D) pertains to the medical profession. These laws are not directly related to the integration of traditional, non-traditional, alternative, or complementary health care strategies in community health work.

5. The nurse is teaching a group of older adults about medication safety. Which of the following should be included in the teaching?

• A. keeping a list of all medications and dosages
• B. sharing medications with family members if they have the same prescription
• C. stopping medications when symptoms improve
• D. doubling up on missed doses

Correct answer: A

Rationale: The correct answer is A: keeping a list of all medications and dosages. Maintaining a comprehensive list of medications and their dosages is essential for older adults to prevent medication errors and dangerous interactions. Choice B is incorrect because sharing medications, even if family members have the same prescription, can lead to unintended adverse effects or inappropriate dosages. Choice C is incorrect as stopping medications when symptoms improve can be harmful if the full course of treatment is not completed. Choice D is incorrect as doubling up on missed doses can result in overdosing and adverse reactions.

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