Nursing Elites

1. In a long term rehabilitation care unit a client with spinal cord injury complains of a pounding headache. The client is sitting in a wheelchair watching television in the assigned room. Further assessment by the nurse reveals excessive sweating, a splotchy rash, pilomotor erection, facial flushing, congested nasal passages and a heart rate of 50. The nurse should do which action next?

• A. Take the client's respirations, blood pressure (BP), temperature and then pupillary responses
• B. Place the client into the bed and administer the ordered PRN analgesic
• C. Check the client for bladder distention and the client's urinary catheter for kinks
• D. Turn the television off and then assist client to use relaxation techniques

Correct answer: C

Rationale: These symptoms suggest autonomic dysreflexia, often triggered by bladder distention.

2. As an important tool for planning a community health survey was conducted, the first tangible outcome of collaboration and teamwork with the Local Health Department and its Rural Health Units (RHUs) was seen. This later led to case-finding activities via collection and examination of stools from children for suspected parasitism. Which of the following community nursing diagnoses will guide the Parish Health Team for concrete action?

• A. Parasitism as a foreseeable crisis
• B. Malnutrition as a health deficit
• C. Parasitism as a health deficit
• D. Parasitism as a health threat

Correct answer: D

Rationale: The correct answer is 'Parasitism as a health threat.' This choice accurately describes the ongoing issue of parasitic infections in the community, highlighting the seriousness and urgency of the problem. Choice A ('Parasitism as a foreseeable crisis') is incorrect as it does not emphasize the immediate danger posed by parasitic infections. Choice B ('Malnutrition as a health deficit') is not the most relevant diagnosis considering the context provided. Choice C ('Parasitism as a health deficit') is also incorrect as it fails to capture the level of risk and urgency associated with parasitic infections in this scenario.

3. Which of the following is an example of a social determinant of health?

• A. Blood pressure
• B. Genetic mutations
• C. Housing conditions
• D. Age

Correct answer: C

Rationale: The correct answer is C: Housing conditions. Social determinants of health are the conditions in which people are born, grow, live, work, and age. Housing conditions directly impact health outcomes as they can affect exposure to toxins, safety, and overall well-being. Choice A, blood pressure, is a physiological measure and not a social determinant. Choice B, genetic mutations, relates to an individual's genetic makeup and is not influenced by social factors. Choice D, age, is a demographic factor and not a social determinant of health.

4. In terms of CHN practice, how is the nurse in the community trained?

• A. nurse-midwife
• B. practice nursing
• C. generalist in nursing
• D. midwife

Correct answer: C

Rationale: In community health nursing practice, nurses are trained as generalists in nursing. They receive education that equips them to address a wide range of health concerns in the community. Choice A, nurse-midwife, is incorrect as it refers to a specific role focusing on childbirth and maternal health. Choice B, practice nursing, is vague and does not specifically describe the training of community health nurses. Choice D, midwife, is also incorrect as it refers to a specialized role in maternal and newborn care, different from the generalist training of community health nurses.

5. A 16-year-old client is admitted to a psychiatric unit with a diagnosis of attempted suicide. The nurse is aware that the most frequent cause for suicide in adolescents is

• A. Progressive failure to adapt
• B. Feelings of anger or hostility
• C. Reunion wish or fantasy
• D. Feelings of alienation or isolation

Correct answer: D

Rationale: Feelings of alienation or isolation are common triggers for suicidal behavior in adolescents. This sense of being disconnected or isolated from others can lead to despair and hopelessness, increasing the risk of suicidal ideation. Choices A, B, and C are less commonly associated with suicide in adolescents. Progressive failure to adapt may contribute to stress, but it is not typically the primary cause of suicide. Feelings of anger or hostility, while negative emotions, do not always lead to suicidal behavior in adolescents. Reunion wish or fantasy is not a recognized primary cause of suicide in this age group.

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