Nursing Elites

1. In 1996, there were 15 cases of Acute Respiratory Infection (ARI) in Barangay B, while Barangay C had 20 cases. The total number of children who have ARI is:

• A. higher in Barangay C than in Barangay B
• B. not comparable in Barangay B and C
• C. higher in Barangay B than in Barangay C
• D. data given is insufficient

Correct answer: A

Rationale: The correct answer is A: 'higher in Barangay C than in Barangay B.' This is because Barangay C had more cases of ARI (20) compared to Barangay B (15). Therefore, the total number of children who have ARI is higher in Barangay C. Choices B and C are incorrect because the data clearly shows that Barangay C had more cases than Barangay B. Choice D is also incorrect as there is sufficient data provided to compare the number of ARI cases between the two barangays.

2. The nurse is teaching a group of adults about modifiable cardiac risk factors. Which of the following should the nurse focus on first?

• A. Weight reduction
• B. Stress management
• C. Physical exercise
• D. Smoking cessation

Correct answer: D

Rationale: The correct answer is D, smoking cessation. Smoking is a major and modifiable risk factor for cardiovascular disease. It is often the highest priority in cardiac risk reduction because stopping smoking has immediate and long-term benefits for heart health. Choices A, B, and C are also important in reducing cardiac risk factors, but smoking cessation takes precedence due to its significant impact on cardiovascular health.

3. The RN is planning care at a team meeting for a 2-month-old child in bilateral leg casts for congenital clubfoot. Which of these suggestions by the PN should be considered the priority nursing goal following cast application?

• A. Infant will experience minimal pain
• B. Muscle spasms will be relieved
• C. Mobility will be managed as tolerated
• D. Tissue perfusion will be maintained

Correct answer: D

Rationale: Following cast application for congenital clubfoot in a 2-month-old child, the priority nursing goal should be to maintain tissue perfusion. This is crucial to prevent complications like compartment syndrome and ensure proper healing. While managing pain, relieving muscle spasms, and promoting mobility are important aspects of care, they are secondary to ensuring adequate tissue perfusion in this scenario.

4. When assessing a newborn infant with low set ears, short palpebral fissures, flat nasal bridge, and an indistinct philtrum, a priority maternal assessment by the nurse should be to ask about

• A. Alcohol use during pregnancy
• B. Usual nutritional intake
• C. Family genetic disorders
• D. Maternal and paternal ages

Correct answer: A

Rationale: The correct answer is A: Alcohol use during pregnancy. The physical features mentioned are indicative of fetal alcohol syndrome, a condition caused by maternal alcohol consumption during pregnancy. It is crucial for the nurse to inquire about alcohol use as it can help in diagnosing and managing the infant's condition. Choices B, C, and D are incorrect as they are not directly associated with the physical findings described in the newborn, which specifically point towards a potential history of alcohol exposure during pregnancy.

5. A client with a history of deep vein thrombosis (DVT) is receiving warfarin (Coumadin). The nurse should monitor the client for which of the following laboratory values?

• A. Prothrombin time (PT)
• B. Serum potassium
• C. Blood urea nitrogen (BUN)
• D. White blood cell count (WBC)

Correct answer: A

Rationale: The correct answer is A: Prothrombin time (PT). Prothrombin time is monitored to assess the effectiveness of warfarin therapy. Warfarin is an anticoagulant medication that works by inhibiting the synthesis of vitamin K-dependent clotting factors, including factors II, VII, IX, and X. Monitoring the PT helps ensure that the client's blood is clotting within the desired therapeutic range to prevent complications such as recurrent DVT or excessive bleeding. Choices B, C, and D are incorrect because serum potassium, blood urea nitrogen, and white blood cell count are not directly related to monitoring warfarin therapy in a client with a history of DVT.

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