Nursing Elites

1. During the beginning shift assessment of a client with asthma who is receiving oxygen via nasal cannula at 2 liters per minute, the nurse would be most concerned about which unreported finding?

• A. Pulse oximetry reading of 89%
• B. Crackles at the base of the lungs on auscultation
• C. Rapid shallow respirations with intermittent wheezes
• D. Excessive thirst with a dry cracked tongue

Correct answer: C

Rationale: Rapid, shallow respirations with intermittent wheezes are concerning as they indicate a potential worsening of the client's asthma. This finding suggests airway narrowing, which can lead to respiratory failure. Immediate intervention is required to address this respiratory distress. A pulse oximetry reading of 89% is low and indicates hypoxemia, but the respiratory pattern described in option C takes priority as it directly reflects the client's respiratory status. Crackles at the base of the lungs suggest fluid accumulation, which is important but not as immediately critical as the respiratory distress in asthma. Excessive thirst and a dry cracked tongue may indicate dehydration, which is relevant but not as urgent as the respiratory compromise presented in option C.

2. The home health nursing director is conducting an educational program for registered nurses and practical nurses about Medicare reimbursement. To obtain payment for Medicare services, what must be included in the client's record?

• A. A prescription from the healthcare provider for each visit made.
• B. Documentation of a skilled care service provided during the visit.
• C. A copy of the client's health history and social security card.
• D. A record of the preventative healthcare services provided during the visit.

Correct answer: B

Rationale: The correct answer is B: Documentation of skilled care services is required for Medicare reimbursement. Medicare reimbursement is based on the provision of skilled care services, not on prescriptions or preventative healthcare services. Including a copy of the client's health history and social security card is not a requirement for Medicare reimbursement.

3. Health activities are designed to:

• A. prevent people from being exposed to germs
• B. ignore spiritual factors as they can confuse medical issues
• C. increase communities' control over their health and well-being
• D. ensure that the community health nurse leads health programs

Correct answer: C

Rationale: Health activities are structured to enhance communities' autonomy and influence over their health and well-being, aiming to empower them to make informed choices and take control of their health. Choice A is incorrect as health activities encompass a broader scope beyond just preventing exposure to germs. Choice B is incorrect because spiritual factors are crucial components that should not be disregarded in healthcare. Choice D is incorrect as health activities are not solely about the community health nurse being in charge, but about empowering the community as a whole.

4. A 16-year-old female client returns to the clinic because she is pregnant for the third time by a new boyfriend. Which vaccine should the nurse plan to administer?

• A. Measles-mumps-rubella.
• B. Hepatitis B.
• C. Human papillomavirus.
• D. Pneumococcal.

Correct answer: B

Rationale: The correct answer is B: Hepatitis B. The Hepatitis B vaccine is crucial for pregnant women as it helps prevent transmission of the virus to the baby during childbirth. Measles-mumps-rubella vaccine (choice A) is not directly related to the current situation of the client being pregnant. Human papillomavirus vaccine (choice C) is recommended for adolescents but is not specifically indicated in this case. Pneumococcal vaccine (choice D) is not a priority in this scenario compared to Hepatitis B, which is crucial for preventing vertical transmission.

5. As a community health nurse covering a cluster of Barangays, your population coverage includes the following:

• A. Families in their homes, School population, Workers in factories
• B. Families in their homes, School population, Patients in hospital
• C. All except workers in factories
• D. All except patients in hospital

Correct answer: A

Rationale: The correct answer is A: 'Families in their homes, School population, Workers in factories.' As a community health nurse, you are responsible for providing healthcare services and promoting health within the community. This includes visiting families in their homes to assess their health needs, working with the school population to educate them on preventive health measures, and ensuring the health and safety of workers in factories. Choices B, C, and D are incorrect because they do not encompass the full scope of a community health nurse's responsibilities. Choice B does not include workers in factories, Choice C excludes an important population group, and Choice D excludes an essential setting where healthcare services are provided.

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