Nursing Elites

1. James is an 18-month-old child who has had a cough for 7 days with no general danger signs, a temperature of 37.5°C, and a respiratory rate of 41 breaths per minute. How will you classify James' breathing?

• A. Slow breathing
• B. Fast breathing
• C. Normal breathing
• D. Very fast breathing

Correct answer: C

Rationale: The correct answer is 'Normal breathing.' A respiratory rate of 41 breaths per minute is considered normal for an 18-month-old child. Choices A, B, and D are incorrect because a respiratory rate of 41 breaths per minute falls within the normal range for a child of James' age and does not indicate slow, fast, or very fast breathing.

2. Which of the following is an example of a modifiable risk factor for chronic diseases?

• A. Age
• B. Gender
• C. Genetic predisposition
• D. Physical inactivity

Correct answer: D

Rationale: Physical inactivity is a modifiable risk factor for chronic diseases because individuals have control over their level of physical activity. By increasing physical activity, the risk of chronic diseases can be reduced. Choices A, B, and C are not modifiable risk factors: Age is a non-modifiable factor, gender is a biological characteristic, and genetic predisposition is inherent and cannot be altered.

3. A 23-year-old single client is in the 33rd week of her first pregnancy. She tells the nurse that she has everything ready for the baby and has made plans for the first weeks together at home. Which normal emotional reaction does the nurse recognize?

• A. Acceptance of the pregnancy
• B. Focus on fetal development
• C. Anticipation of the birth
• D. Ambivalence about pregnancy

Correct answer: C

Rationale: The correct answer is C: 'Anticipation of the birth.' In the third trimester, it is common for expectant mothers to feel excited and prepared for the upcoming birth of their baby. This includes making plans for the baby's arrival and the early days at home. Choice A, 'Acceptance of the pregnancy,' may occur earlier in the pregnancy and does not specifically relate to the third trimester. Choice B, 'Focus on fetal development,' is more common in the earlier stages of pregnancy when the mother may be more concerned with the baby's growth and milestones. Choice D, 'Ambivalence about pregnancy,' suggests conflicting feelings which are less likely in this scenario where the client expresses readiness and plans for the baby's arrival.

4. Iwa, two years old, was brought to the health center because of diarrhea for 4 days. Assessment revealed that Iwa has under-nutrition. Which of the following actions will you take?

• A. Advise the mother to give milk and juices between meals at home
• B. Give nutritious food available at home
• C. Refer to the hospital for proper management
• D. Provide mother with ORS solution and show her how to give the solution

Correct answer: A

Rationale: In the case of a child with under-nutrition and diarrhea, advising the mother to give milk and juices between meals at home is the appropriate action. This helps address the nutritional needs of the child while also providing hydration. Option B, giving nutritious food available at home, may not be sufficient in addressing immediate needs such as dehydration. Option C, referring to the hospital, may be necessary in severe cases but is not the first-line action. Option D, providing ORS solution, is important but does not directly address the under-nutrition concern.

5. The nurse uses the DRG (Diagnosis Related Group) manual to

• A. Classify nursing diagnoses from the client's health history
• B. Identify findings related to a medical diagnosis
• C. Determine reimbursement for a medical diagnosis
• D. Implement nursing care based on case management protocol

Correct answer: C

Rationale: The DRG manual is used to determine the reimbursement rate for medical diagnoses and treatments under the prospective payment system used by healthcare facilities. Choice A is incorrect because the DRG manual is not used to classify nursing diagnoses, but rather to group medical diagnoses for billing purposes. Choice B is incorrect as the DRG manual is not used to identify findings related to medical diagnoses, but rather to standardize payments for medical services. Choice D is incorrect as the DRG manual is not used to implement nursing care based on case management protocol, but rather to set reimbursement rates.

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