Nursing Elites

1. What percentage of term newborns have a congenital heart disease due to environmental risk factors such as maternal alcoholism or drug ingestion?

• A. 2% to 4%
• B. 10% to 20%
• C. 5% to 10%
• D. 7% to 9%

Correct answer: A

Rationale: The correct answer is A: 2% to 4%. According to research, 2% to 4% of term newborns have congenital heart disease due to environmental risk factors such as maternal alcoholism or drug ingestion. Choices B, C, and D provide percentages that are higher than the actual prevalence of congenital heart disease in newborns caused by environmental factors, making them incorrect.

2. What is the primary goal of public health?

• A. To focus on individual patient care
• B. To improve the health of populations
• C. To reduce healthcare costs
• D. To increase hospital admissions

Correct answer: B

Rationale: The primary goal of public health is to improve the health of populations by focusing on prevention, health promotion, and addressing the social determinants of health. Choice A is incorrect because public health looks at health from a population perspective rather than focusing on individual patient care. Choice C, while a potential benefit, is not the primary goal of public health. Choice D is incorrect as increasing hospital admissions is not a goal of public health; in fact, public health aims to prevent unnecessary hospitalizations through preventive measures.

3. A charge nurse on an obstetrical unit is preparing the shift assignment. Which of the following clients should be assigned to an RN who has floated from a medical-surgical unit?

• A. A client who is at 32 weeks of gestation and has premature rupture of membranes
• B. A multigravida client who has preeclampsia and is receiving misoprostol for induction of labor
• C. A primigravida client who is 1 day postoperative following a Cesarean section and has a PCA pump
• D. A client who has gestational diabetes and is receiving biweekly nonstress tests

Correct answer: C

Rationale: A nurse who floated from a medical-surgical unit would be appropriate to care for a client who is 1 day postoperative following a Cesarean section and has a PCA pump. This client requires monitoring of the postoperative incision site, pain management through the PCA pump, and assessment for any signs of complications related to the surgery. Assigning this client to an RN with experience in postoperative care aligns with providing specialized and appropriate care. Choices A, B, and D involve conditions or procedures specific to obstetrics that would be better managed by a nurse with obstetrical experience, making them incorrect choices for the floated RN.

4. Diabetes insipidus is the result of:

• A. A diet high in sugar and carbohydrates.
• B. A complicated pregnancy.
• C. A disorder of the pancreas.
• D. A disorder of the pituitary gland.

Correct answer: D

Rationale: Diabetes insipidus is caused by a disorder of the pituitary gland affecting ADH regulation. This disorder results in the decreased production or release of antidiuretic hormone (ADH), leading to the inability of the kidneys to concentrate urine properly. Choices A, B, and C are incorrect as they do not relate to the underlying cause of diabetes insipidus.

5. Which of the following is the best argument for lower patient-to-nurse ratio?

• A. The more patients a nurse has, the better the nurse will be at catching early warning signs.
• B. Greater patient-to-nurse ratios decrease patient mortality.
• C. Adequate nurse levels do not impact the prevalence of urinary tract infections.
• D. Community nursing ratios do not impact Methicillin-resistant Staphylococcus aureus (MRSA) rates.

Correct answer: B

Rationale: The best argument for lower patient-to-nurse ratios is that they decrease patient mortality. Choice A is incorrect because having more patients can lead to increased workload and decreased attention per patient. Choice C is incorrect as adequate nurse levels can indeed impact the prevalence of infections. Choice D is incorrect as community nursing ratios can impact MRSA rates due to potential transmission risks in healthcare settings.

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