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. A client presents at a community-based clinic with complaints of shortness of breath, headache, dizziness, and nausea. During the assessment, the nurse learns that the client is a migrant worker who often uses a gasoline-powered pressure washer to clean equipment and farm buildings. Which type of poisoning is the most likely etiology of this client's symptoms?

• A. asbestos
• B. silica dust
• C. histoplasmosis
• D. carbon monoxide

Correct answer: D

Rationale: The client's symptoms of shortness of breath, headache, dizziness, and nausea are indicative of carbon monoxide poisoning, which can result from exposure to gasoline-powered equipment like pressure washers. Asbestos (Choice A) exposure would typically present with respiratory issues and cancer but not the rapid onset of symptoms described. Silica dust (Choice B) exposure is associated with respiratory conditions like silicosis, not the multisystem symptoms in the scenario. Histoplasmosis (Choice C) is a fungal infection that primarily affects the lungs and is not related to the client's exposure to a gasoline-powered pressure washer.

3. Local health boards were established at the provincial, city, and municipal levels. At the municipal level, the chairman of the board is the:

• A. rural health physician
• B. public health nurse
• C. municipal mayor
• D. chairman of the committee on health

Correct answer: C

Rationale: The correct answer is C, the municipal mayor. In the local health board structure, the municipal mayor chairs the board at the municipal level, overseeing health-related matters in that specific locality. Choices A, B, and D are incorrect because while a rural health physician or a public health nurse may be involved in health-related activities, they do not serve as the chairman of the board at the municipal level. Similarly, the chairman of the committee on health may have a role in health matters, but the municipal mayor holds the position of chairman of the local health board at the municipal level.

4. An infant has just returned from surgery for placement of a gastrostomy tube as an initial treatment for tracheoesophageal fistula. The mother asks, 'When can the tube be used for feeding?' The nurse's best response would be which of these comments?

• A. "Feedings can begin in 5 to 7 days."
• B. "The use of the feeding tube can begin immediately."
• C. "The stomach contents and air must be drained first."
• D. "The incision healing must be complete before feeding."

Correct answer: C

Rationale: The correct answer is C: 'The stomach contents and air must be drained first.' Before starting feedings through a gastrostomy tube, it is essential to drain the stomach contents and air. This process helps prevent complications and ensures the proper functioning of the tube after placement. Choice A is incorrect because initiating feedings within 5 to 7 days may lead to complications if the stomach is not adequately prepared. Choice B is incorrect as feeding should not begin immediately to allow for proper preparation of the tube and the stomach. Choice D is incorrect because although incision healing is important, draining the stomach contents and air is a more immediate concern to prevent complications.

5. While performing an initial assessment on a newborn following a breech delivery, the nurse suspects hip dislocation. Which of the following is most suggestive of the abnormality?

• A. Flexion of lower extremities
• B. Negative Ortolani response
• C. Lengthened leg of affected side
• D. Irregular hip symmetry

Correct answer: D

Rationale: Irregular hip symmetry, such as asymmetry in the gluteal folds, is a common sign of hip dislocation in newborns. This finding indicates a potential abnormality in hip development and requires further evaluation and possible treatment. Choices A, B, and C are incorrect. Flexion of lower extremities is a normal newborn reflex, the Ortolani response is used to detect hip dysplasia rather than hip dislocation, and a lengthened leg of the affected side is not typically associated with hip dislocation in newborns.

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