Nursing Elites

1. 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.

2. With an alert of an internal disaster and the need for beds, the charge nurse is asked to list clients who are potential discharges within the next hour. Which client should the charge nurse select?

• A. An elderly client who has had type 2 diabetes for over 20 years, admitted with diabetic ketoacidosis 24 hours ago
• B. An adolescent admitted the prior night with Tylenol intoxication
• C. A middle-aged client with an internal automatic defibrillator and complaints of 'passing out at unknown times' admitted yesterday
• D. A school-age child diagnosed with suspected bacterial meningitis and was admitted at the change of shifts

Correct answer: A

Rationale: The correct answer is A because a client with diabetic ketoacidosis (DKA) that is being well-managed and has shown improvement within 24 hours is more stable and can be considered for discharge sooner than those with more acute or unstable conditions. Choice B is incorrect as Tylenol intoxication may require further monitoring and intervention. Choice C is incorrect as a client with an automatic defibrillator and episodes of passing out needs careful evaluation and monitoring. Choice D is incorrect as suspected bacterial meningitis is a serious condition that typically requires a longer hospital stay for treatment and observation.

3. In planning the use of resources for secondary prevention in a community clinic serving migrant families, which activity should be the priority?

• A. Skin testing for tuberculosis.
• B. Glucose monitoring for diabetes.
• C. Blood work for cardiovascular disease.
• D. Height and weight for altered nutrition.

Correct answer: A

Rationale: The correct answer is A: Skin testing for tuberculosis. In a community clinic serving migrant families, tuberculosis is a significant health concern due to close living conditions and potential exposure during migration. Skin testing for tuberculosis is crucial for secondary prevention as it helps in early detection and prevention of the spread of the disease within the community. Choices B, C, and D are important health screenings but may not be the priority in this specific population where tuberculosis poses a higher risk.

4. The nurse is caring for a client admitted to the hospital with right lower lobe (RLL) pneumonia. On assessment, the nurse notes crackles over the RLL. The client has significant pleuritic pain and is unable to take in a deep breath in order to cough effectively.

• A. Impaired gas exchange related to acute infection and sputum production
• B. Ineffective airway clearance related to sputum production and ineffective cough
• C. Ineffective breathing pattern related to acute infection
• D. Anxiety related to hospitalization and role conflict

Correct answer: B

Rationale: The client's inability to effectively clear the airway due to pain and sputum production hinders the cough mechanism, making 'Ineffective airway clearance' the most appropriate nursing diagnosis. Although impaired gas exchange may occur due to the pneumonia, the immediate issue is the inability to clear the airway. 'Ineffective breathing pattern' does not address the specific issue of airway clearance. 'Anxiety' is not the priority when the focus should be on the physical complications of pneumonia.

5. What is the term for a learning process whereby knowledge, attitudes, and practice of people are changed to improve the health status of individuals, families, or communities?

• A. Motivating
• B. Counseling
• C. Disease prevention
• D. Health education

Correct answer: D

Rationale: Health education is the correct term for the learning process that involves changing knowledge, attitudes, and practices to enhance health status. Choice A, 'Motivating,' is incorrect as it refers to inspiring action rather than the educational aspect. Choice B, 'Counseling,' focuses on providing guidance and support rather than specifically targeting knowledge and practice changes. Choice C, 'Disease prevention,' is related to strategies aimed at avoiding the occurrence of illnesses rather than the broader concept of educating for overall health improvement.

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