Nursing Elites

1. Which of the following measures the risk of dying from causes related to pregnancy, childbirth, and puerperium?

• A. maternal mortality
• B. neonatal death rate
• C. fetal death rate
• D. infant mortality rate

Correct answer: A

Rationale: The correct answer is A, maternal mortality. Maternal mortality specifically measures the risk of dying from pregnancy-related causes. Neonatal death rate, fetal death rate, and infant mortality rate focus on different populations and timeframes. Neonatal death rate refers to deaths within the first 28 days of life, fetal death rate measures stillbirths, and infant mortality rate includes deaths of infants under one year of age. Therefore, A is the most appropriate measure for assessing the risk of dying from causes related to pregnancy, childbirth, and puerperium.

2. The community health nurse has been following the care for an adolescent with a history of morbid obesity, asthma, hypertension, and is 22 weeks into a pregnancy. Which of these lab reports sent to the clinic needs to be called to the teen's healthcare provider within the next hour?

• A. Hemoglobin 11 g/dL and calcium 6 mg/dL
• B. Magnesium 0.8 mEq/L and creatinine 3 mg/dL
• C. Blood urea nitrogen 28 mg/dL and glucose 225 mg/dL
• D. Hematocrit 33% and platelets 200,000

Correct answer: B

Rationale: The correct answer is B. The low magnesium level and elevated creatinine suggest possible renal dysfunction, which is concerning, especially in a pregnant client with multiple risk factors such as morbid obesity, asthma, and hypertension. Immediate attention is needed to address the potential renal issues. The other choices do not indicate such urgent conditions. Hemoglobin and calcium levels in choice A are within acceptable ranges. Choice C shows elevated blood urea nitrogen and glucose levels, which may need monitoring but not immediate attention. Choice D's hematocrit and platelet levels are also within normal ranges and do not indicate an urgent issue.

3. A client with myasthenia gravis is receiving pyridostigmine (Mestinon). The nurse should monitor the client for which of the following side effects?

• A. Constipation
• B. Hypertension
• C. Muscle weakness
• D. Bradycardia

Correct answer: D

Rationale: The correct answer is D: Bradycardia. Pyridostigmine, a cholinesterase inhibitor used in myasthenia gravis, can lead to bradycardia as a side effect. Choice A, constipation, is not a common side effect of pyridostigmine. Choice B, hypertension, is unlikely as pyridostigmine is more likely to cause hypotension. Choice C, muscle weakness, is actually a symptom of myasthenia gravis itself and not a side effect of pyridostigmine.

4. During an initial clinic visit, the nurse is taking the history for a client who wants to confirm her pregnancy. The client's last child has a history of low-birth-weight (LBW). Which additional finding is most important for the nurse to consider?

• A. Cigarette smoking.
• B. African American ethnicity.
• C. Poor nutritional status.
• D. Limited maternal education.

Correct answer: A

Rationale: The correct answer is A: Cigarette smoking. Cigarette smoking is a significant risk factor for low birth weight. Smoking during pregnancy reduces the amount of oxygen available to the baby, leading to LBW. Choice B, African American ethnicity, while it may be a risk factor, is not as directly linked to LBW as cigarette smoking. Choice C, poor nutritional status, can contribute to LBW but is not as significant as cigarette smoking in this case. Choice D, limited maternal education, is an important social determinant of health but is not as directly related to LBW as cigarette smoking.

5. Community organizing is an important part of the community nursing function. Given the following elements: choosing an organizational structure, identifying and recruiting members, defining mission, vision, and goals, clarifying roles and responsibilities; at which stage do these elements belong?

• A. Program maintenance-consolidation
• B. Dissemination-Reassessment
• C. Community Analysis/diagnosis
• D. Design and initiation

Correct answer: D

Rationale: The correct answer is D: Design and initiation. These elements such as choosing an organizational structure, identifying and recruiting members, defining mission, vision, and goals, and clarifying roles and responsibilities belong to the design and initiation stage of community organizing. This stage focuses on setting up the foundation and structure of the community organization. The other choices are incorrect because: A) Program maintenance-consolidation refers to maintaining and strengthening existing programs, not establishing new ones; B) Dissemination-Reassessment involves spreading information and evaluating programs already in place; C) Community Analysis/diagnosis is about assessing community needs and identifying issues, not about setting up the initial structure.

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