Nursing Elites

1. 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.

2. In the immediate postoperative period for a cleft lip repair in a 2-month-old infant, which nursing approach should be the priority?

• A. Remove protective arm devices one at a time for short periods with supervision
• B. Initiate oral feedings when alert
• C. Introduce the parents to the suture line cleansing protocol
• D. Position the infant on the back after feedings throughout the day

Correct answer: A

Rationale: The correct nursing approach in the immediate postoperative period for a cleft lip repair in an infant is to remove protective arm devices one at a time for short periods with supervision. This approach helps prevent injury to the surgical site while ensuring the infant's comfort and safety. Choice B is incorrect as initiating oral feedings immediately after surgery may not be appropriate and could compromise the surgical site. Choice C is incorrect as introducing parents to the suture line cleansing protocol is important but not the immediate priority. Choice D is incorrect as positioning the infant on the back after feedings is not specific to the immediate postoperative period for a cleft lip repair.

3. The increasing number of people who must learn to live with chronic illness in the community implies the need for the PHN to plan and implement a program on:

• A. communicable disease control
• B. health education
• C. child survival
• D. environmental education

Correct answer: B

Rationale: The correct answer is B: health education. Health education is crucial for individuals dealing with chronic illnesses as it helps them learn how to manage their conditions effectively. Communicable disease control (choice A) focuses on preventing the spread of infectious diseases, which is not directly related to managing chronic conditions. Child survival (choice C) pertains to initiatives aimed at reducing child mortality rates, which is not directly related to addressing chronic illnesses. Environmental education (choice D) involves raising awareness about environmental issues, which is also not directly related to helping individuals live with chronic illnesses.

4. In order to facilitate the planning and implementation of an income-generating project in a barangay, which of the following actions should the Public Health Nurse NOT do?

• A. Form working groups or committees
• B. Enlist the help of technical professionals for training and guiding the people
• C. Form a core group to coordinate the various projects
• D. Give the people complete freedom to do what they want

Correct answer: D

Rationale: Giving people complete freedom without any guidance or structure can lead to disorganization, lack of focus, and ultimately project failure. In the context of implementing an income-generating project, it is crucial to provide support, direction, and coordination to ensure the project's success. Forming working groups, enlisting technical professionals for training, and establishing a core group for coordination are essential steps to enhance efficiency, productivity, and the overall success of the project.

5. The nurse should consider the following when assessing the child for chest indrawing EXCEPT:

• A. Chest indrawing should be present at all times
• B. The lower chest wall does not go in when the child breathes in
• C. The lower chest goes in when the child breathes in
• D. The child should be calm

Correct answer: A

Rationale: The correct answer is A. Chest indrawing may not always be present and can vary with the child's activity level, so it should not be expected to be present at all times. Choice B is correct because the lower chest wall should not go in when the child breathes in. Choice C is correct as the lower chest should go in when the child breathes in, indicating chest indrawing. Choice D is correct as a calm child makes it easier to assess chest indrawing, but the absence of chest indrawing does not mean the child is not calm.

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