Nursing Elites

1. What action is best for the community health nurse to take if the nurse suspects that an infant is being physically abused?

• A. Follow agency protocols to report suspected abuse.
• B. Report suspicions to the local child abuse reporting hotline.
• C. Educate the child's caregivers about growth and development issues.
• D. Call the police department to have the child removed from the home.

Correct answer: A

Rationale: When a community health nurse suspects that an infant is being physically abused, the best course of action is to follow agency protocols to report the suspected abuse. This is essential to ensure that the appropriate authorities are informed, and proper interventions can be initiated. Reporting suspicions to the local child abuse reporting hotline (Choice B) can be a part of the agency protocols but may not cover all necessary steps. Educating the child's caregivers about growth and development (Choice C) is not appropriate in cases of suspected abuse, as the immediate focus should be on the safety and well-being of the infant. Calling the police department to have the child removed from the home (Choice D) is not the primary role of the nurse; the proper authorities should handle the removal process after an investigation.

2. The Philippine Family Program seeks to improve and maintain which of the following life-saving measures?

• A. proper spacing of pregnancies
• B. proper timing of pregnancies
• C. fewer pregnancies
• D. all of the above

Correct answer: D

Rationale: The correct answer is D, all of the above. The Philippine Family Program aims to enhance and sustain proper spacing of pregnancies, proper timing of pregnancies, and reducing the number of pregnancies. These measures are essential for promoting maternal and child health, preventing complications, and ensuring better outcomes. Choices A, B, and C are all part of the comprehensive approach taken by the program to safeguard the well-being of families and contribute to overall public health.

3. The nurse is administering the measles, mumps, rubella (MMR) vaccine to a 12-month-old child during the well-baby visit. Which age range should the nurse advise the parents to plan for their child to receive the MMR booster based on the current recommendations and guidelines by the Center for Disease Control (CDC)?

• A. 13 to 18 years of age.
• B. 11 to 12 years of age.
• C. 18 to 24 months of age.
• D. 4 to 6 years of age.

Correct answer: D

Rationale: The correct answer is D: 4 to 6 years of age. The CDC recommends the MMR booster for children in this age group. Choice A (13 to 18 years of age) is incorrect as it is not the recommended age range for the MMR booster. Choice B (11 to 12 years of age) is also incorrect as it does not align with the CDC guidelines for the MMR booster. Choice C (18 to 24 months of age) is not the correct age range for the MMR booster according to CDC recommendations.

4. A pre-term baby develops nasal flaring, cyanosis, and diminished breath sounds on one side. The provider's diagnosis is spontaneous pneumothorax. Which procedure should the nurse prepare for first?

• A. Cardiopulmonary resuscitation
• B. Insertion of a chest tube
• C. Oxygen therapy
• D. Assisted ventilation

Correct answer: B

Rationale: The correct answer is B: Insertion of a chest tube. In a case of spontaneous pneumothorax, the primary intervention is to insert a chest tube. This procedure allows the trapped air to escape from the pleural space, relieving pressure and enabling the lung to re-expand. Choices A, C, and D are not the initial interventions for spontaneous pneumothorax. Cardiopulmonary resuscitation is indicated for cardiac arrest, oxygen therapy may provide supportive care but does not address the underlying issue of trapped air in the pleural space, and assisted ventilation may be needed later but is not the first-line treatment for a pneumothorax.

5. In planning for the nursing care of the sick person in the home, the major point that the nurse must keep in mind is:

• A. who will be responsible for the patient during the nurse's absence from the home
• B. economic level of the family
• C. the availability of the nearest hospital
• D. whether or not the patient is under a private physician

Correct answer: A

Rationale: The correct answer is A because ensuring someone is responsible for the patient is crucial for continuous care. The presence of a caregiver during the nurse's absence ensures the patient's safety and well-being. Choice B, economic level of the family, is important but not the major point when planning nursing care in the home. Choice C, the availability of the nearest hospital, is significant but doesn't address the day-to-day care in the home. Choice D, whether or not the patient is under a private physician, is relevant but not as critical as ensuring someone is available to care for the patient at all times.

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