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. What is the term for a learning process whereby knowledge, attitudes, and practice of people are changed to improve the health status of individuals, families, or communities?

• A. Motivating
• B. Counseling
• C. Disease prevention
• D. Health education

Correct answer: D

Rationale: Health education is the correct term for the learning process that involves changing knowledge, attitudes, and practices to enhance health status. Choice A, 'Motivating,' is incorrect as it refers to inspiring action rather than the educational aspect. Choice B, 'Counseling,' focuses on providing guidance and support rather than specifically targeting knowledge and practice changes. Choice C, 'Disease prevention,' is related to strategies aimed at avoiding the occurrence of illnesses rather than the broader concept of educating for overall health improvement.

3. Which of the following is not classified as an essential health service?

• A. Provision of eye glasses and dentures for the elderly
• B. Maternal and child care
• C. Basic sanitation and prevention and control of locally endemic diseases
• D. Promotion of proper nutrition, adequate supply of safe water, and health education

Correct answer: A

Rationale: The provision of eyeglasses and dentures for the elderly is not classified as an essential health service. Essential health services typically focus on preventive, promotive, curative, and rehabilitative care that address the primary healthcare needs of individuals and communities. Choices B, C, and D are examples of essential health services as they directly contribute to improving and maintaining the health of populations. Maternal and child care, basic sanitation, disease prevention, nutrition promotion, safe water supply, and health education are essential components of public health initiatives.

4. The client with atrial fibrillation is being taught about the use of Coumadin (warfarin) at home. Which of these should be emphasized to the client to avoid?

• A. Large indoor gatherings
• B. Exposure to sunlight
• C. Active physical exercise
• D. Foods rich in vitamin K

Correct answer: D

Rationale: The correct answer is D: Foods rich in vitamin K. Foods rich in vitamin K can interfere with the effectiveness of Coumadin (warfarin) by promoting blood clotting. It is crucial for clients on this medication to maintain a consistent intake of vitamin K and avoid sudden dietary changes. Choices A, B, and C are incorrect as they are not directly related to the interaction of Coumadin (warfarin) with vitamin K. Large indoor gatherings, exposure to sunlight, and active physical exercise do not have a significant impact on the effectiveness of Coumadin (warfarin) in comparison to the interaction with foods rich in vitamin K.

5. A senior high school student, whose immunization status is current, asks the school nurse which immunizations will be included in the precollege physical. Which vaccine should the nurse tell the student to expect to receive?

• A. Hepatitis C (HepC)
• B. Influenza type B (HIB)
• C. Measles, mumps, rubella (MMR)
• D. Diphtheria, tetanus, pertussis (DTaP)

Correct answer: C

Rationale: The correct answer is C: Measles, mumps, rubella (MMR). MMR vaccine is commonly included in precollege physicals to ensure students are protected against these diseases. Choice A, Hepatitis C (HepC), is incorrect as the standard vaccine for hepatitis given in childhood is Hepatitis B. Choice B, Influenza type B (HIB), is not typically administered during precollege physicals but is recommended for younger children. Choice D, Diphtheria, tetanus, pertussis (DTaP), is usually given in early childhood and not typically repeated during precollege physicals.

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