Nursing Elites

1. As the immediate supervisor of the Rural Health Midwives, the PHN prepares a supervisory plan. Which of the following would be the PHN's activity?

• A. performing needs assessment
• B. listing supervisory activities
• C. identifying the training needs
• D. formulating objectives for supervision

Correct answer: B

Rationale: The correct answer is B: listing supervisory activities. When preparing a supervisory plan, the Public Health Nurse (PHN) needs to list the specific supervisory activities that need to be carried out. This helps in organizing and outlining the tasks that need to be accomplished to ensure effective supervision. Choices A, C, and D are incorrect because although needs assessment, identifying training needs, and formulating objectives are important aspects of supervisory planning, they are not specifically related to the act of preparing a detailed list of supervisory activities.

2. A Hispanic client confides in the nurse that she is concerned that staff may give her newborn the 'evil eye.' The nurse should communicate to other personnel that the appropriate approach is to

• A. Touch the baby after looking at him
• B. Talk very slowly while speaking to him
• C. Avoid touching the child
• D. Look only at the parents

Correct answer: A

Rationale: In some Hispanic cultures, touching the baby after looking at them is believed to prevent the 'evil eye.' Respecting this cultural belief can help build trust and comfort with the client. Choices B, C, and D are incorrect as they do not address the specific cultural concern raised by the client. Talking slowly or avoiding touching the child does not relate to the belief in the 'evil eye.' Similarly, focusing only on the parents does not address the client's worry about the newborn receiving the 'evil eye.'

3. An infant weighed 7 pounds 8 ounces at birth. If growth occurs at a normal rate, what would be the expected weight at 6 months of age?

• A. Double the birth weight
• B. Triple the birth weight
• C. Gain 6 ounces each week
• D. Add 2 pounds each month

Correct answer: A

Rationale: The correct answer is A: 'Double the birth weight.' Infants typically double their birth weight by 6 months of age. This is a common milestone in healthy infant growth and development. Choice B is incorrect because tripling the birth weight would be excessive and not in line with normal growth patterns. Choice C, 'Gain 6 ounces each week,' is not accurate as infant growth is not linear each week. Choice D, 'Add 2 pounds each month,' is also incorrect as this rate of growth would be too rapid and unrealistic for healthy infant development.

4. The appropriate order of steps in active management of the third stage of labor includes:

• A. Cord clamping and cutting, controlled cord traction, ergometrine administration, and inspection to ensure the placenta is intact.
• B. Intravenous oxytocin, cord clamping and cutting, and fundal massage.
• C. Intramuscular injection of oxytocin, controlled cord traction with counter traction to the uterus, and uterine massage.
• D. Controlled cord traction, fundal massage, and oxytocin.

Correct answer: C

Rationale: The correct sequence of steps in active management of the third stage of labor includes intramuscular injection of oxytocin to prevent postpartum hemorrhage, controlled cord traction with counter traction to the uterus to facilitate placental delivery, and uterine massage to aid in uterine contraction and prevent excessive bleeding. Choice A is incorrect because ergometrine administration is not routinely recommended in active management. Choice B is incorrect as intravenous oxytocin is not the preferred route of administration. Choice D is incorrect as the order of steps is not accurate.

5. Which of the following measures the proportion of the population that exhibits a particular disease at a particular time and includes both new and old cases?

• A. proportionate morbidity rate
• B. case fatality rate
• C. incidence ratio
• D. prevalence ratio

Correct answer: D

Rationale: The correct answer is D, prevalence ratio. Prevalence ratio measures the proportion of the population with a particular disease at a specific time, including both new and existing cases. Choice A, proportionate morbidity rate, is not a standard term and might confuse students. Choice B, case fatality rate, measures the proportion of deaths from a specific disease compared to the total number of cases but does not include both new and old cases. Choice C, incidence ratio, measures the rate of new cases of a disease in a specific population over a defined period, not considering existing cases.

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