Nursing Elites

1. 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.

2. A public health nurse can say that she is beginning to achieve her goal of more optimal health for her community when:

• A. people learn self-care
• B. people become involved in determining health care policy
• C. all these indicators are present
• D. people assume responsibility for their own health

Correct answer: C

Rationale: Achieving optimal health for a community involves multiple factors and indicators. For a public health nurse to begin achieving this goal, it is essential that all relevant indicators are present, not just one or a few. While choices A, B, and D are important components of promoting community health, optimal health for a community encompasses a comprehensive approach where all indicators are considered and addressed. Therefore, the correct answer is C.

3. During which phase of the community organizing process are the leaders or groups given training to develop their knowledge, skills, and attitudes in managing their own programs?

• A. Sustenance and strengthening phase
• B. Pre-entry phase
• C. Organizing-building phase
• D. Entry phase

Correct answer: C

Rationale: The correct answer is C, the organizing-building phase. This phase involves providing training to leaders and groups to develop their knowledge, skills, and attitudes in managing their own programs. Choice A, the sustenance and strengthening phase, focuses more on maintaining and enhancing existing programs rather than training. Choice B, the pre-entry phase, occurs before actual organizing and training take place. Choice D, the entry phase, is about initiating the community organizing process, not specifically about training leaders and groups.

4. Which of the following is designed to help clients reduce the risk of illness and maintain the maximum level of function?

• A. illness prevention
• B. crisis intervention
• C. rehabilitation
• D. health promotion

Correct answer: D

Rationale: The correct answer is 'D: health promotion.' Health promotion strategies are aimed at helping individuals reduce the risk of illness and maintain their maximum level of function by emphasizing preventive measures, healthy behaviors, and lifestyle choices. Illness prevention (choice A) focuses on specific actions to avoid illness but may not necessarily address overall function. Crisis intervention (choice B) refers to immediate assistance during emergencies rather than long-term prevention. Rehabilitation (choice C) involves restoring function after illness or injury rather than primarily focusing on preventive measures and maintaining maximum function.

5. 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.

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