Nursing Elites

1. After 3 days, the nurse notes that James has chest indrawing and stridor. His mother returned him to the health center immediately. The nurse should:

• A. Change the antibiotic to second-line antibiotics
• B. Advise the mother to observe the child and continue giving the antibiotics
• C. Give the first dose of antibiotics and refer urgently
• D. Observe the child at the center

Correct answer: C

Rationale: Chest indrawing and stridor are signs of severe respiratory distress. In this situation, immediate referral is essential. Giving the first dose of antibiotics before referral can help initiate treatment, but urgent referral for further evaluation and management is crucial. Choice A is incorrect because simply changing the antibiotic without assessing the severity of the symptoms and providing urgent care is not appropriate. Choice B is incorrect as advising the mother to observe the child and continue antibiotics delays necessary intervention for a potentially life-threatening condition. Choice D is incorrect as observing the child at the center is not sufficient when signs of severe illness are present.

2. The healthcare provider would expect which eating disorder to have the greatest fluctuations in potassium?

• A. Binge eating disorder
• B. Anorexia nervosa
• C. Bulimia
• D. Purge syndrome

Correct answer: C

Rationale: The correct answer is C: Bulimia. Bulimia involves cycles of binge eating and purging, where individuals may induce vomiting or use laxatives and diuretics. These purging behaviors can lead to significant fluctuations in potassium levels due to electrolyte imbalances caused by excessive loss of potassium through vomiting and purging. In contrast, Binge eating disorder (A) does not involve purging behaviors, so it is less likely to cause significant potassium fluctuations. Anorexia nervosa (B) is characterized by severe food restriction rather than purging, leading to a different pattern of electrolyte imbalances. Purge syndrome (D) is not a recognized eating disorder and is not associated with specific patterns of potassium fluctuations seen in bulimia.

3. Which of the following measures the risk of dying from causes related to pregnancy, childbirth, and puerperium?

• A. maternal mortality
• B. neonatal death rate
• C. fetal death rate
• D. infant mortality rate

Correct answer: A

Rationale: The correct answer is A, maternal mortality. Maternal mortality specifically measures the risk of dying from pregnancy-related causes. Neonatal death rate, fetal death rate, and infant mortality rate focus on different populations and timeframes. Neonatal death rate refers to deaths within the first 28 days of life, fetal death rate measures stillbirths, and infant mortality rate includes deaths of infants under one year of age. Therefore, A is the most appropriate measure for assessing the risk of dying from causes related to pregnancy, childbirth, and puerperium.

4. The emphasis of community health nursing is on:

• A. treatment of health problems
• B. preventing problems and promoting optimum health
• C. identification and assessment of health problems
• D. illness end of the wellness-illness continuum

Correct answer: B

Rationale: Community health nursing primarily focuses on preventive measures and promoting overall health within a community. Choice A is incorrect as treatment is not the main emphasis. Choice C is incorrect as identification and assessment are steps that may be involved but not the main focus. Choice D is incorrect as it refers to the illness end rather than the preventive end of the wellness-illness continuum.

5. A nurse working in a community health setting is performing primary health screenings. Which individual is at highest risk for contracting an HIV infection?

• A. A 17-year-old who is sexually active with numerous partners.
• B. A 45-year-old lesbian who has been sexually active with two partners in the past year.
• C. A 30-year-old cocaine user who inhales the drug and works in a topless bar.
• D. A 34-year-old male homosexual who is in a monogamous relationship.

Correct answer: A

Rationale: The correct answer is A. A 17-year-old who is sexually active with numerous partners is at the highest risk for contracting an HIV infection due to engaging in risky sexual behavior with multiple partners, increasing the likelihood of exposure to the virus. Choice B is less risky as the individual has had a relatively lower number of sexual partners in the past year. Choice C, although involving drug use, does not directly correlate with a higher risk of contracting HIV unless needles are shared. Choice D, a 34-year-old male homosexual in a monogamous relationship, has a lower risk compared to choice A as long as the relationship remains monogamous.

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