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. Occupational health nursing is concerned with the following except:

• A. educating workers about health
• B. immediate diagnosis of illness prevailing in the work field
• C. appropriate and effective ways of promoting health
• D. planning of administering health services

Correct answer: B

Rationale: Occupational health nursing focuses on educating workers about health, promoting health through appropriate and effective ways, and planning and administering health services in the workplace. Immediate diagnosis of illness prevailing in the work field is typically not the primary role of occupational health nursing, as it usually involves prevention, education, and health promotion rather than diagnosing acute conditions.

3. Which of the following characteristics apply to 2 to 3-year-old children?

• A. Prefers to feed themselves
• B. Eats very small nutritious meals a day rather than 3 large meals
• C. Can speak in longer sentences
• D. Can use a toothbrush properly

Correct answer: B

Rationale: The correct answer is B. During the age of 2 to 3 years old, children tend to eat very small, nutritious meals throughout the day rather than having three large meals. This behavior is typical for this age group as their appetites fluctuate. Choices A, C, and D are incorrect because while children of this age may start to prefer feeding themselves and begin using a toothbrush with assistance, they typically do not speak in longer sentences at this stage.

4. Which of the following best describes the goal of primary health care?

• A. Treating chronic diseases
• B. Providing specialized medical services
• C. Promoting health and preventing illness
• D. Conducting medical research

Correct answer: C

Rationale: The correct answer is C: 'Promoting health and preventing illness.' Primary health care aims to provide essential health services, promote health, prevent diseases, and manage common health problems. Choices A, B, and D are incorrect because primary health care focuses on a holistic approach to health that includes health promotion, disease prevention, treatment of common illnesses, and community participation, rather than specialized services, chronic disease treatment, or medical research.

5. A client is admitted for COPD. Which finding would require the nurse's immediate attention?

• A. Nausea and vomiting
• B. Restlessness and confusion
• C. Low-grade fever and cough
• D. Irritating cough and liquefied sputum

Correct answer: B

Rationale: Restlessness and confusion are signs of hypoxia and hypercapnia in a client with COPD, indicating that the client's condition may be deteriorating rapidly. Immediate attention is necessary to prevent further complications. Nausea and vomiting (Choice A) may be related to various factors but do not directly indicate respiratory distress. Low-grade fever and cough (Choice C) are common in COPD and may not require immediate intervention. Irritating cough and liquefied sputum (Choice D) are typical symptoms of COPD exacerbation but do not signal an immediate need for attention as restlessness and confusion.

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