Nursing Elites

1. Which of the following is used to monitor specific groups eligible for a particular DOH program?

• A. Family treatment record
• B. Target Client list
• C. Reporting forms
• D. Output record

Correct answer: B

Rationale: The correct answer is B: Target Client list. The Target Client list is specifically designed to monitor groups that are eligible for a particular DOH program. It helps in identifying and tracking individuals or populations that qualify for the said program. Choice A, Family treatment record, is incorrect because it pertains to the medical history and treatment information of a particular family, not eligibility monitoring. Choice C, Reporting forms, is incorrect as they are used for documenting and submitting information, not for monitoring eligibility. Choice D, Output record, is also incorrect as it refers to the results or outcomes produced by a system, not for monitoring eligibility.

2. A 23-year-old single client is in the 33rd week of her first pregnancy. She tells the nurse that she has everything ready for the baby and has made plans for the first weeks together at home. Which normal emotional reaction does the nurse recognize?

• A. Acceptance of the pregnancy
• B. Focus on fetal development
• C. Anticipation of the birth
• D. Ambivalence about pregnancy

Correct answer: C

Rationale: The correct answer is C: 'Anticipation of the birth.' In the third trimester, it is common for expectant mothers to feel excited and prepared for the upcoming birth of their baby. This includes making plans for the baby's arrival and the early days at home. Choice A, 'Acceptance of the pregnancy,' may occur earlier in the pregnancy and does not specifically relate to the third trimester. Choice B, 'Focus on fetal development,' is more common in the earlier stages of pregnancy when the mother may be more concerned with the baby's growth and milestones. Choice D, 'Ambivalence about pregnancy,' suggests conflicting feelings which are less likely in this scenario where the client expresses readiness and plans for the baby's arrival.

3. The nurse is caring for a client on mechanical ventilation. When performing endotracheal suctioning, the nurse will avoid hypoxia by

• A. Inserting a fenestrated catheter with a whistle tip without suction
• B. Completing the suction pass in 30 seconds with a pressure of 150 mm Hg
• C. Hyperoxygenating with 100% O2 for 1 to 2 minutes before and after each suction pass
• D. Minimizing the suction pass to 60 seconds while slowly rotating the lubricated catheter

Correct answer: C

Rationale: Hyperoxygenating the client before and after suctioning helps prevent hypoxia by ensuring adequate oxygen levels during the procedure, which briefly interrupts the client's normal breathing pattern. Choice A is incorrect because inserting a fenestrated catheter with a whistle tip without suction would not prevent hypoxia. Choice B is incorrect as completing the suction pass in 30 seconds with a pressure of 150 mm Hg may lead to hypoxia. Choice D is incorrect as minimizing the suction pass to 60 seconds may not provide enough time for effective suctioning and could lead to hypoxia.

4. When the Public Health Nurse assesses needs and plans health interventions for a group of people in coordination with other health professionals, they are demonstrating which of the following features of community health nursing:

• A. CHN involves interdisciplinary collaboration
• B. The use of an epidemiologic approach is an essential part of nursing practice
• C. CHN is oriented towards populations
• D. CHN encourages the client's participation in determining their own health

Correct answer: A

Rationale: The correct answer is A. Interdisciplinary collaboration is a fundamental feature of community health nursing. In this scenario, the nurse works with other health professionals to assess needs and plan interventions for a group of people, emphasizing the importance of teamwork and cooperation. Choice B is incorrect because while epidemiology plays a role in community health nursing, it is not the primary focus of this particular situation. Choice C is incorrect as it describes the population-focused nature of community health nursing, which is related but not directly demonstrated in the given scenario. Choice D is incorrect because while client participation is essential in community health nursing, it is not the primary feature demonstrated in the scenario provided.

5. Which of the following patients should the home care nurse assess first?

• A. A 65-year-old male with known COPD and difficulty breathing after climbing a flight of stairs.
• B. A 78-year-old with CHF who has gained 4 lbs according to her tele-monitoring.
• C. A 50-year-old with bilateral leg swelling and difficulty walking.
• D. A 60-year-old with lower back pain.

Correct answer: A

Rationale: The correct answer is A. A patient with known COPD and difficulty breathing after physical exertion like climbing stairs requires immediate assessment by the nurse. This could indicate a potential exacerbation of COPD, which needs prompt intervention to prevent respiratory distress. Choices B, C, and D describe important patient situations that also require attention, but the urgency is higher with a COPD patient experiencing difficulty breathing.

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