Nursing Elites

1. With an alert of an internal disaster and the need for beds, the charge nurse is asked to list clients who are potential discharges within the next hour. Which client should the charge nurse select?

• A. An elderly client who has had type 2 diabetes for over 20 years, admitted with diabetic ketoacidosis 24 hours ago
• B. An adolescent admitted the prior night with Tylenol intoxication
• C. A middle-aged client with an internal automatic defibrillator and complaints of 'passing out at unknown times' admitted yesterday
• D. A school-age child diagnosed with suspected bacterial meningitis and was admitted at the change of shifts

Correct answer: A

Rationale: The correct answer is A because a client with diabetic ketoacidosis (DKA) that is being well-managed and has shown improvement within 24 hours is more stable and can be considered for discharge sooner than those with more acute or unstable conditions. Choice B is incorrect as Tylenol intoxication may require further monitoring and intervention. Choice C is incorrect as a client with an automatic defibrillator and episodes of passing out needs careful evaluation and monitoring. Choice D is incorrect as suspected bacterial meningitis is a serious condition that typically requires a longer hospital stay for treatment and observation.

2. A nurse working in the community assumes different roles. When the nurse acts as a community organizer, they perform which of the following functions?

• A. motivate and enhance community participation when planning and implementing health programs and services
• B. develop the family's capability to take care of a sick member
• C. identify needs, priorities, and problems of individuals, families, and the community
• D. participate in community development activities

Correct answer: D

Rationale: When a nurse acts as a community organizer, they participate in community development activities, which involve working with the community to address issues such as healthcare access, social services, and infrastructure. The other choices do not directly align with the role of a community organizer. Choice A is more related to community participation in health programs, choice B focuses on family care, and choice C pertains to identifying needs and priorities rather than organizing community development activities.

3. A 14-month-old had cleft palate surgical repair several days ago. The parents ask the nurse about feedings after discharge. Which lunch is the best example of an appropriate meal?

• A. Hot dog, carrot sticks, gelatin, milk
• B. Soup, blenderized soft foods, ice cream, milk
• C. Peanut butter and jelly sandwich, chips, pudding, milk
• D. Baked chicken, applesauce, cookie, milk

Correct answer: B

Rationale: Choice B, 'Soup, blenderized soft foods, ice cream, milk,' is the correct answer. After cleft palate repair, it is essential to provide soft and blenderized foods to prevent trauma to the surgical site and promote proper healing. Choices A, C, and D contain foods that may be difficult for the child to consume comfortably and safely after a cleft palate surgical repair. A hot dog, carrot sticks, chips, and hard cookies could potentially cause injury or discomfort to the surgical area. Peanut butter and jelly sandwich might be too difficult to swallow or may stick to the surgical site. Baked chicken could be too challenging to chew. Therefore, the best choice for an appropriate meal post cleft palate repair is soft, blenderized foods like soup, along with other soft options like ice cream and milk.

4. Which of these clients would the triage nurse request the healthcare provider to examine immediately?

• A. A 5-month-old infant with audible wheezing and grunting
• B. An adolescent with soot on the face and shirt
• C. A middle-aged man with second-degree burns on the right hand
• D. A toddler with singed ends of long hair extending to the waist

Correct answer: A

Rationale: The correct answer is A. Audible wheezing and grunting in an infant indicate respiratory distress, which is a critical condition requiring immediate assessment and intervention by the healthcare provider. Choices B, C, and D do not present with immediate life-threatening conditions that require urgent evaluation. Soot on the face and shirt, second-degree burns on the hand, and singed hair, while concerning, do not pose an immediate threat to life compared to respiratory distress in an infant.

5. Which of the following is an example of a positive outcome for one of the Leading Health Indicators of Healthy People 2020?

• A. A community has adopted a no smoking policy.
• B. A rural community has a public transportation system.
• C. The high school dropout rate has decreased by 15%.
• D. A county has decreased its divorce rate by 10%.

Correct answer: A

Rationale: The correct answer is A. A community adopting a no smoking policy is a positive outcome for the Leading Health Indicators of Healthy People 2020 as it promotes a healthier environment by reducing exposure to secondhand smoke and decreasing smoking-related illnesses. Choices B, C, and D do not directly align with the goals of the Leading Health Indicators. While public transportation and reduced dropout rates are beneficial for community well-being, they are not specific examples of Leading Health Indicators. Decreasing divorce rates, while potentially beneficial for family stability, is not a focus area of the Leading Health Indicators.

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