Nursing Elites

1. Under the present system, which of the following is the local government unit responsible for?

• A. Operation and maintenance of health facilities
• B. All of these activities
• C. Implementation of health programs/projects
• D. Delivery of health services

Correct answer: B

Rationale: Under the present system, the local government unit is responsible for all the listed activities. This includes the operation and maintenance of health facilities, implementation of health programs/projects, and delivery of health services. Therefore, choice B, 'All of these activities,' is the correct answer. Choices A, C, and D are incorrect because they are all responsibilities that fall under the local government unit's jurisdiction as well.

2. A client with chronic renal failure is receiving erythropoietin (Epogen). The nurse should monitor the client for which of the following side effects?

• A. Hypertension
• B. Hypoglycemia
• C. Hyperkalemia
• D. Hypocalcemia

Correct answer: A

Rationale: The correct answer is A: Hypertension. Erythropoietin can lead to hypertension as a side effect due to its stimulation of red blood cell production, which can increase blood viscosity. This can result in elevated blood pressure. Choices B, C, and D are incorrect. Hypoglycemia is not a common side effect of erythropoietin. Hyperkalemia is more commonly associated with renal failure rather than erythropoietin use. Hypocalcemia is not a typical side effect of erythropoietin administration.

3. In the preparation of your health education plan, what is the first thing to do?

• A. Assess community needs for health education
• B. Identify the subjects for health teaching
• C. Specify your goals and objectives
• D. Identify who will provide support and the type of support to be provided

Correct answer: A

Rationale: The correct answer is A: Assess community needs for health education. This is the initial step in developing a health education plan as it helps in understanding the specific requirements of the community. Identifying subjects for teaching (choice B) comes after assessing needs. Specifying goals and objectives (choice C) is crucial but typically follows the assessment of community needs. Identifying support providers and types (choice D) is important but is not the first step in preparing a health education plan.

4. The community health nurse is planning a series of educational courses about the healthcare system and meeting healthcare needs for the community center. Which adjunct issue should the nurse address for a group of older adults?

• A. Peer concerns.
• B. Adult daycare.
• C. Retirement issues.
• D. Vocational concerns.

Correct answer: B

Rationale: When planning educational courses for older adults, addressing adult daycare is crucial as it is a relevant issue that can impact their daily lives and access to healthcare services. Peer concerns may not be directly related to healthcare needs, retirement issues are important but not as immediate in terms of healthcare access, and vocational concerns are more pertinent to working-age individuals.

5. The nurse is caring for a client admitted to the hospital with right lower lobe (RLL) pneumonia. On assessment, the nurse notes crackles over the RLL. The client has significant pleuritic pain and is unable to take in a deep breath in order to cough effectively.

• A. Impaired gas exchange related to acute infection and sputum production
• B. Ineffective airway clearance related to sputum production and ineffective cough
• C. Ineffective breathing pattern related to acute infection
• D. Anxiety related to hospitalization and role conflict

Correct answer: B

Rationale: The client's inability to effectively clear the airway due to pain and sputum production hinders the cough mechanism, making 'Ineffective airway clearance' the most appropriate nursing diagnosis. Although impaired gas exchange may occur due to the pneumonia, the immediate issue is the inability to clear the airway. 'Ineffective breathing pattern' does not address the specific issue of airway clearance. 'Anxiety' is not the priority when the focus should be on the physical complications of pneumonia.

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