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. An infant has just returned from surgery for placement of a gastrostomy tube as an initial treatment for tracheoesophageal fistula. The mother asks, 'When can the tube be used for feeding?' The nurse's best response would be which of these comments?

• A. "Feedings can begin in 5 to 7 days."
• B. "The use of the feeding tube can begin immediately."
• C. "The stomach contents and air must be drained first."
• D. "The incision healing must be complete before feeding."

Correct answer: C

Rationale: The correct answer is C: 'The stomach contents and air must be drained first.' Before starting feedings through a gastrostomy tube, it is essential to drain the stomach contents and air. This process helps prevent complications and ensures the proper functioning of the tube after placement. Choice A is incorrect because initiating feedings within 5 to 7 days may lead to complications if the stomach is not adequately prepared. Choice B is incorrect as feeding should not begin immediately to allow for proper preparation of the tube and the stomach. Choice D is incorrect because although incision healing is important, draining the stomach contents and air is a more immediate concern to prevent complications.

3. A client has been admitted for meningitis. In reviewing the laboratory analysis of cerebrospinal fluid (CSF), the nurse would expect to note

• A. High protein
• B. Clear color
• C. Elevated sed rate
• D. Increased glucose

Correct answer: A

Rationale: High protein levels in the cerebrospinal fluid are indicative of bacterial meningitis, as the presence of bacteria in the CSF leads to increased protein production. Elevated protein levels can be seen in inflammatory conditions like meningitis. Choice B, clear color, is not expected in meningitis as it is typically associated with cloudy or turbid CSF. Elevated sed rate (choice C) and increased glucose (choice D) are not typically associated with the laboratory findings seen in meningitis.

4. Which of the following statements about CHN is wrong?

• A. CHN synthesizes public health with nursing
• B. CHN emphasizes health
• C. Promoting clients' autonomy is a responsibility of public nursing
• D. CHN makes a unique contribution to health care not by the nature of its practice but where it is practiced

Correct answer: D

Rationale: The statement in option D is incorrect. The unique contribution of Community Health Nursing (CHN) is not only where it is practiced but also by the nature of its practice. CHN's distinct value lies in its approach to care delivery, focusing on preventive care, health promotion, and addressing the needs of specific communities. Options A and B are correct as CHN involves synthesizing public health principles with nursing practice and emphasizes holistic health. Option C is incorrect as promoting clients' autonomy is a fundamental aspect of community health nursing, respecting individuals' rights to make decisions about their health.

5. An infant weighed 7 pounds 8 ounces at birth. If growth occurs at a normal rate, what would be the expected weight at 6 months of age?

• A. Double the birth weight
• B. Triple the birth weight
• C. Gain 6 ounces each week
• D. Add 2 pounds each month

Correct answer: A

Rationale: The correct answer is A: 'Double the birth weight.' Infants typically double their birth weight by 6 months of age. This is a common milestone in healthy infant growth and development. Choice B is incorrect because tripling the birth weight would be excessive and not in line with normal growth patterns. Choice C, 'Gain 6 ounces each week,' is not accurate as infant growth is not linear each week. Choice D, 'Add 2 pounds each month,' is also incorrect as this rate of growth would be too rapid and unrealistic for healthy infant development.

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