Nursing Elites

1. The nurse is teaching childbirth preparation classes. One woman asks about her rights to develop a birthing plan. Which response made by the nurse would be best?

• A. "What is your reason for wanting such a plan?"
• B. "Have you talked with your health care provider about this?"
• C. "Let us discuss your rights as a couple."
• D. "Write your ideal plan for the next class."

Correct answer: C

Rationale: Discussing the rights as a couple allows for open communication and helps ensure that the birthing plan aligns with the couple's preferences and medical advice.

2. What does the infant mortality rate measure?

• A. dying for every thousand of the population
• B. dying from 0-5 years old in every thousand population
• C. dying in the first 4 weeks in every thousand children born alive that year
• D. dying before 1 year old in every thousand children born alive that year

Correct answer: D

Rationale: The infant mortality rate measures the number of deaths occurring before 1 year old per 1000 live births. This is a crucial indicator of a population's health status and access to healthcare for infants. Choices A, B, and C are incorrect because the infant mortality rate specifically focuses on deaths within the first year of life, not the entire population or different age ranges.

3. Which of the following statements is correct regarding community health nursing?

• A. Evaluation of the health status of individuals and families should be done in consultation with them.
• B. The public health nurse (PHN) who works with communication for 6 can solely determine the needs of the community.
• C. Provision of PHN care is not in any way affected by policies of the agency where the nurse works.
• D. Professional growth and development of the PHN is the responsibility of the Department of Health (DOH).

Correct answer: A

Rationale: The correct statement is that evaluation of the health status of individuals and families should be done in consultation with them. This approach ensures that the assessment is accurate and takes into account the perspectives and concerns of the individuals and families involved. Choice B is incorrect because determining the needs of the community should involve input from various stakeholders, not solely the PHN. Choice C is incorrect as the provision of PHN care can be influenced by the policies of the agency or organization where the nurse works. Choice D is also incorrect as while the DOH may play a role in setting standards, the professional growth and development of a PHN is typically a personal and professional responsibility.

4. At a routine health assessment, a client tells the nurse that she is planning a pregnancy in the near future. She asks about preconception diet changes. Which of the statements made by the nurse is best?

• A. Include fibers in your daily diet.
• B. Increase green leafy vegetable intake.
• C. Drink a glass of milk with each meal.
• D. Eat at least 1 serving of fish weekly.

Correct answer: B

Rationale: The correct answer is B: "Increase green leafy vegetable intake." This is the best advice because green leafy vegetables are rich in folic acid, which is essential for fetal development and helps prevent neural tube defects. Choice A is not specific enough and does not address the importance of folic acid. Choice C, drinking milk with each meal, does not provide the necessary folic acid intake. Choice D, eating fish weekly, is not as crucial for preconception diet changes as increasing folic acid intake.

5. During the beginning shift assessment of a client with asthma who is receiving oxygen via nasal cannula at 2 liters per minute, the nurse would be most concerned about which unreported finding?

• A. Pulse oximetry reading of 89%
• B. Crackles at the base of the lungs on auscultation
• C. Rapid shallow respirations with intermittent wheezes
• D. Excessive thirst with a dry cracked tongue

Correct answer: C

Rationale: Rapid, shallow respirations with intermittent wheezes are concerning as they indicate a potential worsening of the client's asthma. This finding suggests airway narrowing, which can lead to respiratory failure. Immediate intervention is required to address this respiratory distress. A pulse oximetry reading of 89% is low and indicates hypoxemia, but the respiratory pattern described in option C takes priority as it directly reflects the client's respiratory status. Crackles at the base of the lungs suggest fluid accumulation, which is important but not as immediately critical as the respiratory distress in asthma. Excessive thirst and a dry cracked tongue may indicate dehydration, which is relevant but not as urgent as the respiratory compromise presented in option C.

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