Nursing Elites

1. When the nurse identifies what appears to be ventricular tachycardia on the cardiac monitor of a client being evaluated for possible myocardial infarction, the first action the nurse should perform is to

• A. Begin cardiopulmonary resuscitation
• B. Prepare for immediate defibrillation
• C. Notify the 'Code' team and healthcare provider
• D. Assess airway, breathing, and circulation

Correct answer: D

Rationale: The correct first action for the nurse to take when identifying what appears to be ventricular tachycardia in a client being evaluated for possible myocardial infarction is to assess the client's airway, breathing, and circulation. This step is crucial to determine the client's stability and the need for immediate intervention. Beginning cardiopulmonary resuscitation or preparing for immediate defibrillation without first assessing the airway, breathing, and circulation could delay potentially life-saving interventions. Notifying the 'Code' team and healthcare provider should come after ensuring the client's immediate needs are addressed.

2. Which of the following is the earliest school of nursing in the country?

• A. Iloilo Mission Hospital School of Nursing
• B. St. Paul's Hospital School of Nursing
• C. University of Sto. Tomas College of Nursing
• D. Manila Central University

Correct answer: A

Rationale: The correct answer is A: Iloilo Mission Hospital School of Nursing. This nursing school holds the distinction of being the earliest in the Philippines. St. Paul's Hospital School of Nursing, University of Sto. Tomas College of Nursing, and Manila Central University are not the oldest nursing schools in the country, making them incorrect choices.

3. Which statement specifically describes occupational health nursing?

• A. Involves prevention, recognition, and treatment of injury and illness
• B. All of these
• C. The application of nursing principles in conserving the health of workers in all occupations
• D. Requires special skills in the field of health, education, and counseling

Correct answer: B

Rationale: The correct answer is B. Occupational health nursing involves all aspects mentioned in the statements: prevention, recognition, treatment of injury and illness, application of nursing principles in conserving workers' health, and the requirement of special skills in health, education, and counseling. Choice A focuses on prevention, recognition, and treatment but does not encompass all aspects of occupational health nursing. Choice C only mentions the application of nursing principles without including prevention and treatment. Choice D specifically highlights the need for special skills but does not cover all the aspects of occupational health nursing.

4. A client is admitted with the diagnosis of myocardial infarction (MI). Which of the following lab values would be consistent with this diagnosis?

• A. Low serum albumin
• B. High serum cholesterol
• C. Abnormally low white blood cell count
• D. Elevated creatinine phosphokinase (CPK)

Correct answer: D

Rationale: The correct answer is D: Elevated creatinine phosphokinase (CPK). Elevated CPK levels indicate muscle damage, including damage to the cardiac muscle, which aligns with the diagnosis of myocardial infarction. Choice A, low serum albumin, is not directly related to myocardial infarction. Choice B, high serum cholesterol, is more associated with conditions like atherosclerosis rather than acute myocardial infarction. Choice C, abnormally low white blood cell count, is typically not a lab value associated with myocardial infarction; instead, it could suggest other conditions like infections or bone marrow issues.

5. 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.

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