Nursing Elites

1. While assessing an Rh-positive newborn whose mother is Rh-negative, the nurse recognizes the risk for hyperbilirubinemia. Which of the following should be reported immediately?

• A. Jaundice evident at 26 hours
• B. Hematocrit of 55%
• C. Serum bilirubin of 12 mg/dL
• D. Positive Coombs test

Correct answer: C

Rationale: A serum bilirubin level of 12 mg/dL in a newborn is concerning and can indicate a significant risk of hyperbilirubinemia, which requires immediate medical intervention to prevent complications like kernicterus. Jaundice at 26 hours (Choice A) is a symptom, not a laboratory result, and needs monitoring but not an immediate report. Hematocrit of 55% (Choice B) may be elevated but is not indicative of hyperbilirubinemia. A positive Coombs test (Choice D) indicates the presence of antibodies on the newborn's red blood cells but does not directly correlate with the risk of hyperbilirubinemia.

2. Epidemiology is directly concerned with which of the following?

• A. factors influencing occurrence and distribution of diseases, defects, disability, or death of groups of individuals
• B. vital health statistics
• C. environmental sanitation
• D. treatment of a communicable disease

Correct answer: A

Rationale: Corrected Rationale: Epidemiology is the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the control of health problems. It focuses on identifying and understanding the factors that influence the occurrence and distribution of diseases, defects, disability, or death of groups of individuals. Therefore, the correct answer is A. Choice B, vital health statistics, is not the primary focus of epidemiology. While vital health statistics may be used in epidemiological studies, it is not the direct concern of epidemiology. Choice C, environmental sanitation, although important for public health, is not the main focus of epidemiology. Epidemiology is more concerned with the factors influencing disease occurrence and distribution, rather than environmental sanitation. Choice D, treatment of a communicable disease, is more related to clinical medicine rather than epidemiology. Epidemiology is more focused on prevention, control, and understanding the patterns and causes of diseases rather than their treatment.

3. The nurse is teaching a client with cardiac disease about the anatomy and physiology of the heart. Which is the correct pathway of blood flow through the heart?

• A. Right ventricle, left ventricle, right atrium, left atrium
• B. Left ventricle, right ventricle, left atrium, right atrium
• C. Right atrium, right ventricle, left atrium, left ventricle
• D. Right atrium, left atrium, right ventricle, left ventricle

Correct answer: C

Rationale: The correct pathway of blood flow through the heart starts with blood entering the right atrium, moving to the right ventricle, then to the lungs for oxygenation, returning to the left atrium, and finally to the left ventricle before being pumped out to the body. Option A is incorrect as it starts with the ventricles instead of the atria. Option B is incorrect as it has the sequence of ventricles before atria reversed. Option D is incorrect as it has the atria and ventricles mixed up.

4. What title should be given to this professional role in occupational health? A registered nurse who develops researchable questions, conducts research, and communicates the findings to occupational and environmental health professionals, other peers, and the public.

• A. manager
• B. researcher
• C. clinician/practitioner
• D. health promotion specialist

Correct answer: B

Rationale: The correct answer is 'B: researcher.' In this context, the individual is primarily involved in developing research questions, conducting research, and disseminating findings, which aligns with the responsibilities of a researcher. Choice 'A: manager' is incorrect because the role described does not primarily involve managerial duties. Choice 'C: clinician/practitioner' is also incorrect as the focus is on research activities rather than direct clinical practice. Choice 'D: health promotion specialist' does not encompass the full scope of responsibilities described in the scenario.

5. The nurse is preparing an orientation class for new employees at an inner city clinic that serves a low-income population. Which information should the nurse include in the presentation to these new employees?

• A. A lack of transportation is a major barrier for the clinic's clients.
• B. Basic physiologic needs are likely to be unmet in this clinic's client population.
• C. Printed material is less effective for this population with limited reading skills.
• D. Group education classes are often poorly attended by non-compliant clients.

Correct answer: B

Rationale: The correct answer is B because addressing basic physiologic needs is crucial for low-income populations. Ensuring that basic needs such as food, shelter, and safety are met is essential for these clients to engage effectively in their healthcare. Choice A talks about transportation, which can be a barrier but may not be the major impediment. Choice C focuses on printed material and reading skills, which are important but not as fundamental as addressing basic physiologic needs. Choice D makes assumptions about client attendance based on compliance, which is not the most critical information to include in an orientation about serving a low-income population.

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