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 home health nurse knows that a 70-year-old male client who is convalescing at home following a hip replacement is at risk for developing decubitus ulcers. Which physical characteristic of aging contributes to such a risk?

• A. 16% increase in overall body fat.
• B. Reduced melanin production.
• C. Thinning of the skin with loss of elasticity.
• D. Calcium loss in the bones.

Correct answer: C

Rationale: Thinning of the skin with loss of elasticity is the physical characteristic of aging that contributes to an increased risk of developing decubitus ulcers. As individuals age, the skin becomes thinner and loses its elasticity, making it more susceptible to damage from pressure, leading to the formation of pressure ulcers. Choices A, B, and D are incorrect as they do not directly contribute to the development of decubitus ulcers in this context.

3. In formulating an objective of a community care plan, she expected results and people taking part in the activities should be clearly defined. This refers to an objective which is:

• A. time-bound
• B. specific
• C. resource-oriented
• D. measurable

Correct answer: B

Rationale: The correct answer is 'specific.' In formulating a community care plan, defining expected results and participant roles require objectives to be specific to provide clear guidance and outcomes. 'Time-bound' refers to setting deadlines, 'resource-oriented' focuses on utilizing available resources efficiently, and 'measurable' indicates the ability to quantify progress, but these aspects do not necessarily address the need for clarity and definition in defining expected results and participant roles.

4. The family health care plan includes the following listed in sequence:

• A. objective, statement of the problem, intervention, and evaluation
• B. objectives, intervention, evaluation, and statement of the problem
• C. evaluation, statement of the problems, objectives, and interventions
• D. statement of the problems, objectives, intervention, and evaluation

Correct answer: D

Rationale: In a family health care plan, the correct sequence should start with identifying the problems (statement of the problems), setting objectives, planning interventions, and then evaluating the outcomes. This sequence ensures a logical and structured approach to healthcare planning. Choices A, B, and C are incorrect as they do not follow the logical order of healthcare planning steps.

5. Which of the following is a contribution of community health nurses to the community's health?

• A. providing health education to vulnerable populations
• B. coordinating access to integrated care for the population
• C. developing comprehensive health care systems in various settings
• D. all of the above

Correct answer: D

Rationale: Community health nurses play a vital role in promoting community health by providing health education to vulnerable populations (Choice A), coordinating access to integrated care for the population (Choice B), and developing comprehensive health care systems in various settings (Choice C). These contributions work together to enhance the overall health and well-being of the community, making choice D, 'all of the above,' the correct answer. Choices A, B, and C are all essential aspects of the multifaceted approach that community health nurses take to improve the health outcomes of the community.

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