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. Which of the following measures the risk of dying from causes related to pregnancy, childbirth, and puerperium?

• A. maternal mortality
• B. neonatal death rate
• C. fetal death rate
• D. infant mortality rate

Correct answer: A

Rationale: The correct answer is A, maternal mortality. Maternal mortality specifically measures the risk of dying from pregnancy-related causes. Neonatal death rate, fetal death rate, and infant mortality rate focus on different populations and timeframes. Neonatal death rate refers to deaths within the first 28 days of life, fetal death rate measures stillbirths, and infant mortality rate includes deaths of infants under one year of age. Therefore, A is the most appropriate measure for assessing the risk of dying from causes related to pregnancy, childbirth, and puerperium.

3. The Food Fortification Act of 2000 provides for the mandatory fortification of staple foods, which includes:

• A. Flour with iron
• B. Refined sugar with iron
• C. Cooking oil with vitamin A
• D. Rice with vitamin A

Correct answer: A

Rationale: The correct answer is A: Flour with iron. The Food Fortification Act of 2000 mandates the fortification of flour with iron to address iron deficiency in the population. Refined sugar is not typically fortified with iron, making choice B incorrect. While cooking oil fortification with vitamin A is common in some regions, it is not specified under the Food Fortification Act of 2000, rendering choice C incorrect. Similarly, rice fortification with vitamin A is not included in the mandatory fortification list according to the act, making choice D incorrect.

4. What is the measure of the number of new cases of a disease in a specific population during a certain time period called?

• A. Prevalence
• B. Incidence
• C. Mortality rate
• D. Morbidity rate

Correct answer: B

Rationale: The correct answer is B, Incidence. Incidence refers to the number of new cases of a disease in a specific population during a certain time period. Prevalence (choice A) refers to the total number of cases of a disease in a population at a specific point in time. Mortality rate (choice C) is the measure of the number of deaths in a particular population due to a specific cause. Morbidity rate (choice D) is a broader term that encompasses the incidence and prevalence of a disease in a population.

5. The RN is making a home visit to a female client with end-stage heart disease. She has a living will and states she will never go back to the hospital. During the visit, the RN notes that the client is pale and SOB while speaking. The RN discovers 3+ edema in both ankles and bilateral pulmonary crackles. Which intervention should the RN implement first?

• A. Order a chest X-ray
• B. Obtain a peripheral O2 saturation reading
• C. Obtain an order for complete blood count
• D. Tell the patient to stay in bed

Correct answer: B

Rationale: Obtaining a peripheral O2 saturation reading is the priority intervention in this scenario. It helps assess the client's oxygenation status quickly, which is crucial in a client with signs of respiratory distress, such as shortness of breath and bilateral pulmonary crackles. Ordering a chest X-ray (Choice A) may be necessary later but does not address the immediate need for oxygen assessment. Obtaining an order for a complete blood count (Choice C) is not the priority in this situation as it does not directly address the client's respiratory distress. Instructing the patient to stay in bed (Choice D) does not address the underlying issue of potential hypoxia and respiratory compromise.

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