Nursing Elites

1. 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.

2. The nurse is caring for a client admitted to the hospital with right lower lobe (RLL) pneumonia. On assessment, the nurse notes crackles over the RLL. The client has significant pleuritic pain and is unable to take in a deep breath in order to cough effectively.

• A. Impaired gas exchange related to acute infection and sputum production
• B. Ineffective airway clearance related to sputum production and ineffective cough
• C. Ineffective breathing pattern related to acute infection
• D. Anxiety related to hospitalization and role conflict

Correct answer: B

Rationale: The client's inability to effectively clear the airway due to pain and sputum production hinders the cough mechanism, making 'Ineffective airway clearance' the most appropriate nursing diagnosis. Although impaired gas exchange may occur due to the pneumonia, the immediate issue is the inability to clear the airway. 'Ineffective breathing pattern' does not address the specific issue of airway clearance. 'Anxiety' is not the priority when the focus should be on the physical complications of pneumonia.

3. A client with asthma is receiving albuterol (Proventil). The nurse should monitor the client for which of the following side effects?

• A. Hypoglycemia
• B. Hyperkalemia
• C. Tachycardia
• D. Hypotension

Correct answer: C

Rationale: The correct answer is C: Tachycardia. Albuterol can cause tachycardia as a side effect due to its stimulant effect on the heart. It acts as a beta-2 adrenergic agonist, leading to increased heart rate. Hypoglycemia (choice A) is not a common side effect of albuterol. Hyperkalemia (choice B) is also not typically associated with albuterol use. Hypotension (choice D) is less likely to occur as albuterol usually causes tachycardia rather than hypotension.

4. What is the measure of the number of existing cases of a disease in a specific population at a given time?

• A. Incidence
• B. Prevalence
• C. Mortality rate
• D. Morbidity rate

Correct answer: B

Rationale: Prevalence is the correct answer as it refers to the number of existing cases of a disease in a specific population at a given time. Incidence, on the other hand, refers to the number of new cases of a disease in a defined population over a specific period. Mortality rate is the measure of the number of deaths in a particular population due to a specific cause, while morbidity rate is the frequency of a disease in a specific population.

5. A client asks the nurse about including her 2 and 12-year-old sons in the care of their newborn sister. Which of the following is an appropriate initial statement by the nurse?

• A. Focus on your sons' needs during the first days at home.
• B. Tell each child what he can do to help with the baby.
• C. Suggest that your husband spend more time with the boys.
• D. Ask the children what they would like to do for the newborn.

Correct answer: A

Rationale: The correct answer is A. Focusing on the older children's needs during the initial days at home is crucial as it helps them feel secure and valued during the transition. This approach allows the children to adjust to the new family dynamics and feel included in the care of their newborn sister. Choice B is incorrect as it focuses on tasks rather than addressing the children's emotional needs. Choice C is not the initial step and does not involve directly addressing the children's needs. Choice D puts the decision-making burden on the children rather than providing guidance and support.

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