Nursing Elites

1. In reviewing the assessment data of a client suspected of having diabetes insipidus, the nurse expects which of the following after a water deprivation test?

• A. Increased edema and weight gain
• B. Unchanged urine specific gravity
• C. Rapid protein excretion
• D. Decreased blood potassium

Correct answer: B

Rationale: After a water deprivation test in a client suspected of having diabetes insipidus, the nurse would expect the urine specific gravity to remain unchanged. This occurs because in diabetes insipidus, the kidneys are unable to concentrate urine, leading to a low urine specific gravity even after water deprivation. Choices A, C, and D are incorrect. Increased edema and weight gain are not typical findings in diabetes insipidus. Rapid protein excretion is not directly related to the condition, and decreased blood potassium is not a common outcome of a water deprivation test for diabetes insipidus.

2. The nurse is screening children at a local community health clinic for infectious diseases. Which child is at highest risk for hepatitis B virus (HBV)?

• A. A newborn.
• B. A 3-year-old.
• C. A 7-year-old.
• D. An 11-year-old.

Correct answer: A

Rationale: The correct answer is A: a newborn. Newborns are at the highest risk for HBV due to potential transmission from the mother. The hepatitis B virus can be transmitted from an infected mother to her baby during childbirth. Choices B, C, and D are incorrect because newborns have a higher risk due to this mode of transmission, making them more vulnerable compared to older children.

3. Which of the following statements about breastfeeding is correct?

• A. Breastfeeding within 30 minutes after birth can stimulate breastmilk production
• B. Breastmilk should be started 24 hours after delivery
• C. Breastmilk given exclusively for the first 4 to 6 months of life helps avoid introduction of infection
• D. Breastfeeding should be done as often as the baby wants

Correct answer: C

Rationale: The correct statement about breastfeeding is that breastmilk given exclusively for the first 4 to 6 months of life helps avoid the introduction of infection. This practice is recommended by health experts for optimal infant health. Choice A is incorrect because breastfeeding should ideally start within the first hour after birth to stimulate breastmilk production. Choice B is incorrect because breastmilk should be initiated as soon as possible after delivery, not after 24 hours. Choice D is incorrect because while feeding on demand is generally encouraged, it should also follow a schedule to ensure adequate nutrition and growth for the baby.

4. 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.

5. What role does a community health nurse play in disaster management?

• A. Providing direct patient care
• B. Conducting research on disaster impacts
• C. Coordinating emergency response efforts
• D. Developing new healthcare policies

Correct answer: C

Rationale: Community health nurses are primarily responsible for coordinating emergency response efforts during disasters. This involves organizing and implementing strategies to address the health needs of the community in crisis situations. Providing direct patient care (Choice A) is often carried out by other healthcare professionals such as doctors and paramedics during disasters. Conducting research on disaster impacts (Choice B) is important for understanding the effects of disasters but is not the primary role of a community health nurse. Developing new healthcare policies (Choice D) is typically the responsibility of policymakers and public health officials rather than community health nurses.

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