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. A community health action that focuses on reducing the frequency and severity of asthma in inner-city children by requiring a local incinerator to install particulate filters is an example of:

• A. downstream intervention
• B. risk management
• C. primary prevention
• D. upstream intervention

Correct answer: D

Rationale: The correct answer is D: upstream intervention. Upstream thinking addresses the root causes of health problems to create long-term solutions. In this scenario, requiring the incinerator to install particulate filters tackles the root cause of asthma triggers, which is pollution, rather than just managing the symptoms or risks associated with asthma. Choice A, downstream intervention, would focus more on treating asthma symptoms after they have already occurred rather than preventing them. Choice B, risk management, typically involves strategies to assess, control, or mitigate risks, which may not directly address the root cause. Choice C, primary prevention, usually refers to actions taken to prevent a disease or condition before it occurs, but in this case, the action is targeting the underlying cause rather than preventing asthma itself.

3. The following statements pertain to devolution as mandated by the local government code. Which of these is not correct?

• A. People can participate in policymaking relative to healthcare delivery.
• B. Devolution will enhance the quality of community life.
• C. The barangay shall set criteria as to who shall be given priority in the delivery of healthcare services.
• D. The DOH shall transfer regulatory function of inspecting food establishments to local government units.

Correct answer: D

Rationale: The correct answer is D. The Department of Health (DOH) retains regulatory functions for inspecting food establishments, and it is not transferred to local government units. Choices A, B, and C are correct because devolution allows people to participate in policymaking for healthcare, enhances community life quality, and empowers the barangay to set criteria for healthcare service prioritization.

4. While caring for a client with infective endocarditis, the nurse must be alert for signs of pulmonary embolism. Which of the following assessment findings suggests this complication?

• A. Positive Homan's sign
• B. Fever and chills
• C. Dyspnea and cough
• D. Sensory impairment

Correct answer: C

Rationale: The correct answer is C: 'Dyspnea and cough.' Pulmonary embolism often presents with a sudden onset of dyspnea (difficulty breathing) and cough, which are due to the obstruction of blood flow in the pulmonary arteries. Choices A, B, and D are incorrect. Positive Homan's sign is associated with deep vein thrombosis, fever and chills are nonspecific symptoms commonly seen in infective endocarditis, and sensory impairment is not typically indicative of pulmonary embolism.

5. Manny Pacquiao, a Filipino and world boxing champion, used to advertise a muscle pain-relieving drug popularly known in the Philippine market. What can be an equally effective medicinal alternative, especially in far-flung communities and provinces, to relieve muscles and joint pains and prove to be non-costly?

• A. Sambong
• B. Lagundi
• C. Akapulko
• D. Yerba Buena

Correct answer: D

Rationale: Yerba Buena is a suitable alternative for muscle and joint pain relief, particularly in remote areas due to its cost-effectiveness and proven efficacy. Sambong is more commonly used for urinary tract problems, Lagundi is known for respiratory conditions, and Akapulko is primarily used for skin diseases, making them less effective alternatives for muscle and joint pain relief.

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