Nursing Elites

1. The nurse manager has a nurse employee who is suspected of having a problem with chemical dependency. Which intervention would be the best approach by the nurse manager?

• A. Confront the nurse about the suspicions in a private meeting
• B. Schedule a staff conference, without the nurse present
• C. Consult the human resources department about the issue and needed actions
• D. Counsel the employee to resign to avoid investigation

Correct answer: C

Rationale: Consulting with human resources is the best approach in this situation. It ensures that the issue is handled according to the organization's policies and that the nurse receives the appropriate support and intervention needed for chemical dependency. Confronting the nurse directly may lead to defensiveness and hinder a constructive resolution. Scheduling a staff conference without the nurse present can create unnecessary speculation and violate the employee's privacy. Counseling the employee to resign is not appropriate and does not address the underlying problem of chemical dependency.

2. Local health boards were established at the provincial, city, and municipal levels. At the municipal level, the chairman of the board is the:

• A. rural health physician
• B. public health nurse
• C. municipal mayor
• D. chairman of the committee on health

Correct answer: C

Rationale: The correct answer is C, the municipal mayor. In the local health board structure, the municipal mayor chairs the board at the municipal level, overseeing health-related matters in that specific locality. Choices A, B, and D are incorrect because while a rural health physician or a public health nurse may be involved in health-related activities, they do not serve as the chairman of the board at the municipal level. Similarly, the chairman of the committee on health may have a role in health matters, but the municipal mayor holds the position of chairman of the local health board at the municipal level.

3. 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.

4. Epidemiology is directly concerned with which of the following?

• A. factors influencing occurrence and distribution of diseases, defects, disability, or death of groups of individuals
• B. vital health statistics
• C. environmental sanitation
• D. treatment of a communicable disease

Correct answer: A

Rationale: Corrected Rationale: Epidemiology is the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the control of health problems. It focuses on identifying and understanding the factors that influence the occurrence and distribution of diseases, defects, disability, or death of groups of individuals. Therefore, the correct answer is A. Choice B, vital health statistics, is not the primary focus of epidemiology. While vital health statistics may be used in epidemiological studies, it is not the direct concern of epidemiology. Choice C, environmental sanitation, although important for public health, is not the main focus of epidemiology. Epidemiology is more concerned with the factors influencing disease occurrence and distribution, rather than environmental sanitation. Choice D, treatment of a communicable disease, is more related to clinical medicine rather than epidemiology. Epidemiology is more focused on prevention, control, and understanding the patterns and causes of diseases rather than their treatment.

5. After 3 days, the nurse notes that James has chest indrawing and stridor. His mother returned him to the health center immediately. The nurse should:

• A. Change the antibiotic to second-line antibiotics
• B. Advise the mother to observe the child and continue giving the antibiotics
• C. Give the first dose of antibiotics and refer urgently
• D. Observe the child at the center

Correct answer: C

Rationale: Chest indrawing and stridor are signs of severe respiratory distress. In this situation, immediate referral is essential. Giving the first dose of antibiotics before referral can help initiate treatment, but urgent referral for further evaluation and management is crucial. Choice A is incorrect because simply changing the antibiotic without assessing the severity of the symptoms and providing urgent care is not appropriate. Choice B is incorrect as advising the mother to observe the child and continue antibiotics delays necessary intervention for a potentially life-threatening condition. Choice D is incorrect as observing the child at the center is not sufficient when signs of severe illness are present.

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