Nursing Elites

1. A school nurse is assessing a child who has frequent absences from school due to asthma. Which of the following is the priority nursing action?

• A. Teaching the child how to use an inhaler
• B. Assessing the child's asthma management plan
• C. Discussing the importance of school attendance with the parents
• D. Referring the child to a pulmonologist

Correct answer: B

Rationale: The correct answer is to assess the child's asthma management plan. This is the priority action as it allows the nurse to evaluate the current treatment regimen, identify any gaps or areas for improvement, and ensure that the plan is being effectively implemented. Teaching the child how to use an inhaler (Choice A) may be important but should come after assessing the management plan. Discussing the importance of school attendance with the parents (Choice C) is secondary to ensuring proper asthma management. Referring the child to a pulmonologist (Choice D) may be necessary but is not the priority at this stage; first, the nurse needs to evaluate the current plan in place.

2. 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.

3. In order to be effective as an occupational health nurse, you should be equipped with knowledge and skills in which of the following:

• A. public health science
• B. research process
• C. interviewing and counseling
• D. oral and written communication

Correct answer: D

Rationale: To be effective as an occupational health nurse, having knowledge and skills in public health science, the research process, interviewing and counseling, and oral and written communication are all important. However, communication skills, both oral and written, are crucial for conveying information, educating employees, documenting findings, and collaborating with other healthcare professionals. While public health science, research process, interviewing, and counseling are essential, oral and written communication is fundamental for effective communication and coordination in the workplace, making it the most critical skill for an occupational health nurse.

4. The nurse is teaching a community group about risks of cardiovascular disease. Several clients ask the nurse to determine their risk. Which client should the nurse identify as having the greatest risk for cardiovascular disease?

• A. A male with a serum cholesterol level of 199 mg/dl.
• B. A female with a serum cholesterol level of 201 mg/dl.
• C. A male with a low-density lipoprotein (LDL) level of 200 mg/dl.
• D. A female with a low-density lipoprotein (LDL) level of 160 mg/dl.

Correct answer: C

Rationale: The correct answer is C. A male with a high LDL level (200 mg/dl) has a significant risk for cardiovascular disease. High levels of LDL cholesterol are associated with an increased risk of atherosclerosis and heart disease. Choices A, B, and D have serum cholesterol levels that are slightly elevated but are not as specific or directly linked to cardiovascular risk as high LDL levels. Therefore, the client with the high LDL level is at the greatest risk for cardiovascular disease.

5. A client with acute pancreatitis is receiving total parenteral nutrition (TPN). The nurse should monitor the client for which of the following complications?

• A. Hypoglycemia
• B. Hyperkalemia
• C. Hyperglycemia
• D. Hyponatremia

Correct answer: C

Rationale: The correct answer is C: Hyperglycemia. Total parenteral nutrition (TPN) contains a high glucose content, which can lead to elevated blood sugar levels, resulting in hyperglycemia. Monitoring for hyperglycemia is crucial in clients receiving TPN to prevent complications such as osmotic diuresis, dehydration, and electrolyte imbalances. Choices A, B, and D are incorrect because TPN is more likely to cause hyperglycemia rather than hypoglycemia, hyperkalemia, or hyponatremia.

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