Nursing Elites

1. During the care of a client with Legionnaire's disease, which finding would require the nurse's immediate attention?

• A. Pleuritic pain on inspiration
• B. Dry mucus membranes in the mouth
• C. A decrease in respiratory rate from 34 to 24
• D. Decrease in chest wall expansion

Correct answer: D

Rationale: A decrease in chest wall expansion suggests that the client may be experiencing a serious complication, such as worsening pneumonia or respiratory failure, requiring immediate medical attention. This finding indicates a potential decrease in lung function, which could lead to respiratory distress. Pleuritic pain on inspiration may be related to the disease process but does not indicate an immediate need for intervention. Dry mucus membranes in the mouth may require attention but are not as critical as a decrease in chest wall expansion. A decrease in respiratory rate could be concerning but is not as urgent as a decrease in chest wall expansion, which directly impacts respiratory function.

2. For whom is the community health nurse primarily responsible?

• A. individuals
• B. populations
• C. families
• D. class E citizens

Correct answer: B

Rationale: Community health nurses are primarily responsible for populations. While they do provide care and support to individuals and families within the community, their focus is on the health and well-being of entire populations. Choice A is incorrect as the primary responsibility is broader than just individuals. Choice C is incorrect as families are part of the population but not the sole focus. Choice D, 'class E citizens', is too specific and not a standard term in public health, making it an incorrect choice.

3. What does the term 'health disparity' refer to?

• A. Equal access to healthcare for all individuals
• B. Differences in health outcomes between different population groups
• C. High-quality healthcare for everyone
• D. Providing the same treatments to everyone

Correct answer: B

Rationale: The correct answer is B. 'Health disparity' refers to differences in health outcomes between different population groups. This term highlights variations in health status or in the distribution of health determinants between different population groups. Choice A is incorrect as health disparity is about health outcomes, not just access to healthcare. Choice C is too broad and not specific to the concept of health disparity. Choice D is incorrect as health disparity recognizes that different populations may need tailored or different treatments based on their specific health needs.

4. Which topic should the nurse include in planning a primary prevention class for adolescents?

• A. Risk factors for heart disease.
• B. Dietary management of obesity.
• C. Suicide risks and prevention.
• D. Coping with stressful situations.

Correct answer: C

Rationale: The correct topic that the nurse should include in planning a primary prevention class for adolescents is suicide risks and prevention. Adolescents are particularly vulnerable to mental health issues, including suicidal ideation. Educating them about suicide risks and prevention strategies is crucial for early intervention and support. Choices A, B, and D are important topics, but when considering primary prevention for adolescents, addressing suicide risks and prevention takes precedence due to its immediate life-saving implications.

5. A client has just returned to the medical-surgical unit following a segmental lung resection. After assessing the client, the first nursing action would be to:

• A. Administer pain medication
• B. Suction excessive tracheobronchial secretions
• C. Assist the client to turn, deep breathe, and cough
• D. Monitor oxygen saturation

Correct answer: B

Rationale: After a segmental lung resection, the priority nursing action should be to suction excessive tracheobronchial secretions. This helps in preventing airway obstruction from secretions, ensuring the patency of the airway and optimizing respiratory function. Administering pain medication can be important but addressing airway clearance takes precedence. Assisting the client to turn, deep breathe, and cough is essential for respiratory hygiene but not the first action immediately post-op. Monitoring oxygen saturation is crucial, but ensuring airway clearance is the priority to prevent complications.

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