Nursing Elites

1. From January 1 to 15, 1996, there were 8 cases of Tetanus neonatorum in San Lazaro Hospital. There were two deaths. What is the case fatality ratio of this disease?

• A. 20%
• B. 30%
• C. 28%
• D. 25%

Correct answer: D

Rationale: The case fatality ratio is calculated as (deaths/cases) * 100. In this case, there were 2 deaths out of 8 cases. Therefore, the calculation is (2/8) * 100 = 25%. Choices A, B, and C are incorrect as they do not match the correct calculation.

2. Mark, 9 months old, is given oral rehydration solution because of diarrhea with some dehydration. In your follow-up visit, you observed that Mark's eyes become puffy. Which one of the following would you advise Mark's mother?

• A. continue giving ORS but more slowly
• B. show mother how much solution to give
• C. stop ORS and give plain water or milk
• D. reassess patient to determine how much ORS to give

Correct answer: A

Rationale: In this scenario, observing puffy eyes in a child being treated with oral rehydration solution may indicate fluid overload. Continuing to give ORS but more slowly is the correct course of action as it helps manage hydration without overloading fluids. Choice B is not the best option in this situation as the issue is not about the quantity of the solution, but the rate of administration. Choice C is incorrect because plain water or milk is not a suitable alternative for rehydration in cases of dehydration. Choice D is also incorrect as reassessing the patient does not directly address the issue of puffy eyes, which suggests a need to adjust the administration of ORS.

3. A public health nurse is working with a community to develop a disaster response plan. Which of the following is the priority action?

• A. Identifying available resources and services
• B. Conducting disaster drills
• C. Educating the community about disaster preparedness
• D. Developing a communication plan

Correct answer: A

Rationale: Identifying available resources and services is the priority action when developing a disaster response plan. This step is crucial as it helps the community understand what resources and services are already in place and what additional support may be needed during a disaster. Conducting disaster drills, educating the community about disaster preparedness, and developing a communication plan are important steps in disaster preparedness but come after identifying available resources and services. Without knowing the available resources, it would be challenging to effectively plan and respond to a disaster.

4. 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.

5. A client with asthma has low-pitched wheezes present on the final half of exhalation. One hour later the client has high-pitched wheezes extending throughout exhalation. This change in assessment indicates to the nurse that the client

• A. Has increased airway obstruction
• B. Has improved airway obstruction
• C. Needs to be suctioned
• D. Exhibits hyperventilation

Correct answer: A

Rationale: The correct answer is A: 'Has increased airway obstruction.' High-pitched wheezes extending throughout exhalation indicate a worsening airway obstruction, leading to increased resistance in the airways. Low-pitched wheezes present on the final half of exhalation may suggest some level of obstruction, but the change to high-pitched wheezes throughout exhalation indicates a progression in the obstruction. Choice B is incorrect as the change in wheeze characteristics signifies deterioration rather than improvement. Choice C is incorrect as suctioning is not indicated based on the wheeze assessment findings. Choice D is incorrect as hyperventilation does not typically present with wheezes and is not supported by the information provided.

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