Nursing Elites

1. While caring for a client with infective endocarditis, the nurse must be alert for signs of pulmonary embolism. Which of the following assessment findings suggests this complication?

• A. Positive Homan's sign
• B. Fever and chills
• C. Dyspnea and cough
• D. Sensory impairment

Correct answer: C

Rationale: The correct answer is C: 'Dyspnea and cough.' Pulmonary embolism often presents with a sudden onset of dyspnea (difficulty breathing) and cough, which are due to the obstruction of blood flow in the pulmonary arteries. Choices A, B, and D are incorrect. Positive Homan's sign is associated with deep vein thrombosis, fever and chills are nonspecific symptoms commonly seen in infective endocarditis, and sensory impairment is not typically indicative of pulmonary embolism.

2. A nurse manager is using the technique of brainstorming to help solve a problem. One nurse criticizes another nurse’s contribution and begins to find objections to the suggestion. The nurse manager's best response is to

• A. Let’s move on to a new action that deals with the problem.
• B. I think you need to reserve judgment until after all suggestions are offered.
• C. Very well thought out. Your analytic skills and interest are incredible.
• D. Let’s move to the ‘what if…’ as related to these objections for an exploration of spin-off ideas.

Correct answer: D

Rationale: Encouraging the group to explore 'what if' scenarios based on the objections helps to maintain a positive and creative brainstorming atmosphere, while also validating the concerns raised by the nurse. Choice A is dismissive and does not address the issue at hand. Choice B suggests postponing judgment, which may not resolve the tension caused by the criticism. Choice C is complimentary but does not address the critical feedback provided by the nurse, missing an opportunity to turn objections into opportunities for further exploration.

3. On admission to the psychiatric unit, the client is trembling and appears fearful. The nurse’s initial response should be to

• A. Give the client orientation materials and review the unit rules and regulations
• B. Introduce oneself and accompany the client to their room
• C. Take the client to the day room and introduce them to the other clients
• D. Ask the nursing assistant to get the client’s vital signs and complete the admission search

Correct answer: B

Rationale: In situations where a client is trembling and fearful upon admission to a psychiatric unit, it is essential to prioritize building trust and reducing anxiety. By introducing oneself and accompanying the client to their room, the nurse can establish a therapeutic relationship, provide a sense of security, and address the client's immediate emotional needs. Choices A, C, and D are not the most appropriate initial responses as they do not directly address the client's emotional state or focus on establishing a supportive relationship.

4. The nurse is planning care for a client with pneumococcal pneumonia. Which of the following would be most effective in removing respiratory secretions?

• A. Administration of cough suppressants
• B. Increasing oral fluid intake to 3000 cc per day
• C. Maintaining bed rest with bathroom privileges
• D. Performing chest physiotherapy twice a day

Correct answer: B

Rationale: Increasing oral fluid intake to 3000 cc per day is the most effective in removing respiratory secretions in a client with pneumococcal pneumonia. Adequate hydration helps thin secretions, making them easier to expectorate. Administration of cough suppressants (Choice A) may hinder the removal of secretions by suppressing the cough reflex. Maintaining bed rest with bathroom privileges (Choice C) is important but does not directly address the removal of respiratory secretions. Performing chest physiotherapy (Choice D) is beneficial for mobilizing secretions but may not be as effective as increasing fluid intake in thinning and facilitating the removal of secretions.

5. Who was the first Filipino nurse supervisor appointed in the Bureau of Health in 1919?

• A. Ms. Carmen del Rosario
• B. Mrs. Genara de Guzman
• C. Mrs. Annie Sand
• D. Mrs. Anastacio Giron-Tupas

Correct answer: D

Rationale: The correct answer is Mrs. Anastacio Giron-Tupas, who was the first Filipino nurse supervisor appointed in the Bureau of Health in 1919. Ms. Carmen del Rosario, Mrs. Genara de Guzman, and Mrs. Annie Sand were not the first Filipino nurse supervisors appointed to this position. Therefore, they are incorrect choices.

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