Nursing Elites

1. Joseph, 45 years of age, a community resident of Barangay 22-A, suddenly had 2 bouts of soft to almost watery stools after having taken his lunch. While observing his condition further at home and later deciding whether to refer him for medical treatment, you recommended that he boil a decoction for 15 minutes at low fire using 10-15 leaves of which medicinal plant?

• A. Bayabas
• B. Pancit pacitan
• C. Sambong
• D. Lagundi

Correct answer: A

Rationale: The correct answer is Bayabas (guava) leaves. Guava leaves are known for their anti-diarrheal properties, which can help alleviate Joseph's condition. Pancit pacitan, Sambong, and Lagundi are not commonly used for treating diarrhea and do not possess the same anti-diarrheal properties as guava leaves.

2. A 4-month-old child taking digoxin (Lanoxin) has a blood pressure of 92/78; resting pulse of 78; respirations 28, and a potassium level of 4.8 mEq/L. The client is irritable and has vomited twice since the morning dose of digoxin. Which finding is most indicative of digoxin toxicity?

• A. Bradycardia
• B. Lethargy
• C. Irritability
• D. Vomiting

Correct answer: A

Rationale: Bradycardia (abnormally slow heart rate) is a key sign of digoxin toxicity. In this scenario, the child's symptoms of irritability, vomiting, along with the resting pulse of 78 despite being on digoxin, suggest an impending bradycardia due to digoxin toxicity. Lethargy can also be a sign, but in this case, the child is irritable rather than lethargic. Vomiting, though a symptom, is not as specific to digoxin toxicity as bradycardia. Irritability, while present, is not the most indicative finding of digoxin toxicity compared to bradycardia.

3. Which topic should be included in planning a secondary prevention project for the local retirement community?

• A. Safety measures in the home.
• B. Adult immunization program.
• C. Rehabilitation after surgery.
• D. Vision and hearing screening.

Correct answer: D

Rationale: In planning a secondary prevention project for the local retirement community, vision and hearing screening should be included. This is crucial as sensory impairments are common among older adults and early detection through screening can help in preventing further complications. Safety measures in the home, adult immunization programs, and rehabilitation after surgery are important but fall more under primary or tertiary prevention strategies rather than secondary prevention, which focuses on early detection and intervention to prevent the progression of health conditions.

4. A client is admitted with a diagnosis of myocardial infarction (MI). The client is complaining of chest pain. The nurse knows that pain related to an MI is due to

• A. Insufficient oxygenation of the cardiac muscle
• B. Potential circulatory overload
• C. Left ventricular overload
• D. Electrolyte imbalance

Correct answer: A

Rationale: The correct answer is A: Insufficient oxygenation of the cardiac muscle. Myocardial infarction pain is primarily caused by inadequate oxygen reaching the heart muscle, leading to ischemia and tissue damage. Choices B, C, and D are incorrect because circulatory overload, left ventricular overload, and electrolyte imbalance are not the primary causes of chest pain in myocardial infarction. Circulatory overload may lead to other symptoms like edema, left ventricular overload can result in heart failure symptoms, and electrolyte imbalance may present with various manifestations, but none of these directly cause the characteristic chest pain associated with an MI.

5. Which of the following is a major focus of tertiary prevention?

• A. Preventing the onset of disease
• B. Early detection and treatment
• C. Reducing the impact of an ongoing illness
• D. Health education

Correct answer: C

Rationale: The correct answer is C, 'Reducing the impact of an ongoing illness.' Tertiary prevention aims to minimize the effects of a disease or condition that is already established. Choices A, 'Preventing the onset of disease,' and B, 'Early detection and treatment,' are aspects of primary and secondary prevention, respectively. Choice D, 'Health education,' is more related to promoting awareness and knowledge rather than specifically focusing on reducing the impact of an ongoing illness.

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