Nursing Elites

1. The nurse is assigned to a newly delivered woman with HIV/AIDS. The student asks the nurse about how it is determined that a person has AIDS other than a positive HIV test. The nurse responds:

• A. The complaints of at least 3 common findings.
• B. The absence of any opportunistic infection.
• C. CD4 lymphocyte count is less than 200.
• D. Developmental delays in children.

Correct answer: C

Rationale: The correct answer is C. A CD4 count less than 200 cells/mm³ is a diagnostic criterion for AIDS. Choices A, B, and D are incorrect. Choice A is vague and does not reflect the diagnostic criteria for AIDS. Choice B is not accurate, as the presence of opportunistic infections, not their absence, is indicative of AIDS. Choice D is unrelated to the diagnosis of AIDS in adults.

2. The RN is serving on a medical center committee to update goals and protocols based on the national standards. Which goal most directly addresses the Healthy People 2020 initiative?

• A. Reduce ED wait time for indigent clients
• B. Providing transportation for medically challenged clients
• C. Provide access to health services
• D. Refer clients to local health department for medical services

Correct answer: C

Rationale: The correct answer is C: 'Provide access to health services.' This goal most directly addresses the Healthy People 2020 initiative, which aims to improve health care access for all individuals. Option A, 'Reduce ED wait time for indigent clients,' focuses on efficiency rather than access. Option B, 'Providing transportation for medically challenged clients,' addresses a specific need but does not cover overall health service access. Option D, 'Refer clients to local health department for medical services,' involves referral rather than direct access to services.

3. The public health RN is called to investigate a report of several cases of varicella at a daycare center. The daycare workers state that 5 children have been sent home over the past 2 weeks with fever and itchy blisters. Which intervention should the RN implement first?

• A. Validate that the children who were sent home had chickenpox.
• B. Ask the parents to take the child to see their pediatrician.
• C. Ask the parents to not send the child back to daycare until after 6 weeks.
• D. Tell the parents to send the child back to daycare; it was a mistake they were sent home.

Correct answer: A

Rationale: The correct answer is to validate that the children who were sent home had chickenpox. This is crucial in confirming the presence of varicella, which is necessary for appropriate management and control of the outbreak. Option B is not the first intervention because the focus initially is on verifying the cases within the daycare center. Option C is incorrect as it suggests a prolonged exclusion period without confirming the diagnosis. Option D is inappropriate and potentially harmful, as sending a child back without proper assessment can lead to further spread of the infection.

4. In 1996, there were 15 cases of Acute Respiratory Infection (ARI) in Barangay B, while Barangay C had 20 cases. The total number of children who have ARI is:

• A. higher in Barangay C than in Barangay B
• B. not comparable in Barangay B and C
• C. higher in Barangay B than in Barangay C
• D. data given is insufficient

Correct answer: A

Rationale: The correct answer is A: 'higher in Barangay C than in Barangay B.' This is because Barangay C had more cases of ARI (20) compared to Barangay B (15). Therefore, the total number of children who have ARI is higher in Barangay C. Choices B and C are incorrect because the data clearly shows that Barangay C had more cases than Barangay B. Choice D is also incorrect as there is sufficient data provided to compare the number of ARI cases between the two barangays.

5. A client with a fractured femur is in Buck's traction. The nurse should assess for which of the following complications?

• A. Foot drop
• B. Urinary retention
• C. Constipation
• D. Muscle spasms

Correct answer: A

Rationale: Corrected Rationale: Foot drop is a potential complication of prolonged immobility and improper positioning in traction. In Buck's traction, the lower extremity is suspended to immobilize and align the fractured femur. Prolonged suspension of the leg in traction can lead to nerve damage, specifically to the common peroneal nerve, resulting in foot drop. Urinary retention, constipation, and muscle spasms are not directly associated with Buck's traction and a fractured femur.

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