Nursing Elites

1. Which of the following measures the frequency of new cases of the phenomenon during a given period of time?

• A. prevalence rate
• B. proportionate mortality rate
• C. case fatality rate
• D. incidence rate

Correct answer: D

Rationale: The correct answer is D, incidence rate. Incidence rate measures the frequency of new cases of a phenomenon, providing important information about the risk of developing the condition. Prevalence rate (choice A) reflects both old and new cases, proportionate mortality rate (choice B) is the proportion of deaths due to a specific cause, and case fatality rate (choice C) measures the proportion of deaths among confirmed cases, not just new cases.

2. A client with a history of hypertension is receiving enalapril (Vasotec). The nurse should monitor the client for which of the following side effects?

• A. Hyperkalemia
• B. Hypoglycemia
• C. Hypercalcemia
• D. Hypokalemia

Correct answer: A

Rationale: The correct answer is A: Hyperkalemia. Enalapril, an ACE inhibitor, can lead to hyperkalemia as a side effect. ACE inhibitors can cause potassium retention by inhibiting aldosterone secretion, which may result in elevated potassium levels. Hypoglycemia (choice B) is not typically associated with enalapril use. Hypercalcemia (choice C) is also not a common side effect of enalapril. Hypokalemia (choice D) is the opposite of what is expected with enalapril, as it tends to cause potassium retention.

3. In 1996, there were 15 cases of Acute Respiratory Infection (ARI) in Barangay B, while Barangay C had 20 cases. The total number of children who have ARI is:

• A. higher in Barangay C than in Barangay B
• B. not comparable in Barangay B and C
• C. higher in Barangay B than in Barangay C
• D. data given is insufficient

Correct answer: A

Rationale: The correct answer is A: 'higher in Barangay C than in Barangay B.' This is because Barangay C had more cases of ARI (20) compared to Barangay B (15). Therefore, the total number of children who have ARI is higher in Barangay C. Choices B and C are incorrect because the data clearly shows that Barangay C had more cases than Barangay B. Choice D is also incorrect as there is sufficient data provided to compare the number of ARI cases between the two barangays.

4. Several employees who have a 10-year or longer history of smoking ask the occupational nurse for assistance with smoking cessation. The RN develops a 2-month program that includes weekly group sessions on lifestyle changes and use of OTC products. Which measurement provides the best indication of the program's effectiveness?

• A. Encourage the employees to disclose if they have joined another smoking cessation group.
• B. Ask the employees to inform the group if they stop smoking and if they start back up again.
• C. Survey the employees about their smoking habits.
• D. Observe if the employees are smoking in the designated smoking areas.

Correct answer: C

Rationale: Surveying the employees about their smoking habits provides measurable data on program effectiveness. By collecting data directly from the employees through surveys, the occupational nurse can track changes in smoking habits, frequency, and quantity of cigarettes smoked. This direct feedback allows for a more accurate assessment of the program's impact on smoking cessation. Choices A and B rely on self-disclosure and may not provide reliable or objective data. Choice D does not directly measure changes in smoking habits but rather observes behavior in designated areas, which may not reflect overall smoking cessation progress.

5. The nurse at a health fair has taken a client's blood pressure twice, 10 minutes apart, in the same arm while the client is seated. The nurse records the two blood pressures of 172/104 mm Hg and 164/98 mm Hg. What is the appropriate nursing action in response to these readings?

• A. Refer the client to a nutritionist after providing health teaching about a low-sodium diet.
• B. Place the client in a recumbent position and call the paramedics for transport to the hospital.
• C. Talk with the client to assess whether there is stress in the client's life and refer to a counseling service.
• D. Take the client's blood pressure in the other arm and then schedule a healthcare practitioner's appointment for as soon as possible.

Correct answer: D

Rationale: The appropriate nursing action in response to significantly high blood pressure readings like 172/104 mm Hg and 164/98 mm Hg is to confirm the readings by taking the blood pressure in the other arm. This can help rule out any error or issue specific to that arm. The nurse should then schedule a healthcare practitioner's appointment for as soon as possible to further assess the client's condition and determine the appropriate intervention. Choice A is incorrect because solely referring the client to a nutritionist for a low-sodium diet without further assessment or confirmation of the blood pressure readings is premature. Choice B is incorrect as the client is already seated, and calling paramedics for immediate transport to the hospital is not warranted based solely on the blood pressure readings provided. Choice C is incorrect as stress may not be the sole reason for the high blood pressure readings, and further assessment is required before referring the client to counseling services.

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