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. An 82-year-old client is prescribed eye drops for the treatment of glaucoma. What assessment is needed before the nurse begins teaching proper administration of the medication?

• A. Determine the client's manual dexterity
• B. The client’s manual dexterity
• C. Proximity to health care services
• D. Ability to use visual assistive devices

Correct answer: B

Rationale: Assessing the client’s manual dexterity is crucial before teaching the administration of eye drops. Manual dexterity is essential for the proper instillation of eye drops. If the client has limited manual dexterity, alternative methods of administration may be necessary. The other choices, such as determining third-party payment plan, proximity to health care services, and ability to use visual assistive devices, are not directly related to the immediate need for assessing manual dexterity for the proper administration of eye drops.

3. Which one of the following statements, if made by the client, indicates teaching about Inderal (propranolol) has been effective?

• A. ''I may experience seizures if I stop the medication abruptly.''
• B. ''I may experience an increase in my heart rate for a few weeks.''
• C. ''I can expect to feel nervousness the first few weeks.''
• D. ''I can have a heart attack if I stop this medication suddenly.''

Correct answer: D

Rationale: The correct answer is D. Stopping Inderal (propranolol) abruptly can cause rebound hypertension, angina, and even a myocardial infarction (heart attack), so it is crucial to taper off the medication under medical supervision. Choices A, B, and C are incorrect because they do not reflect the serious consequences associated with abrupt discontinuation of propranolol.

4. When a nurse teaches a community about the importance of hand hygiene, the nurse is engaging in:

• A. Primary prevention
• B. Secondary prevention
• C. Tertiary prevention
• D. Quaternary prevention

Correct answer: A

Rationale: The correct answer is A: Primary prevention. Primary prevention aims to prevent the occurrence of a disease or injury before it happens. Teaching about hand hygiene to the community helps in preventing infections from occurring in the first place. Choice B, Secondary prevention, involves early detection and treatment to halt or slow the progress of a condition. This would involve screening or early intervention after exposure. Choice C, Tertiary prevention, focuses on managing the disease to prevent complications, recurrence, or deterioration. This would include rehabilitation and monitoring to prevent further complications. Choice D, Quaternary prevention, relates to actions taken to avoid unnecessary interventions or over-medicalization. This usually involves questioning the necessity of certain medical procedures or treatments to prevent harm to patients.

5. The term 'epidemiology' is best defined as the study of:

• A. The causes of disease
• B. The distribution and determinants of health-related states in populations
• C. The treatment and prevention of disease
• D. The healthcare system and its effectiveness

Correct answer: B

Rationale: Epidemiology is the study of the distribution and determinants of health-related states in populations. Choice A is incorrect because epidemiology focuses on more than just causes but also on distribution and determinants. Choice C is incorrect as it specifically relates to public health and not just treatment and prevention. Choice D is incorrect as epidemiology is broader than just focusing on the healthcare system and its effectiveness.

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