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. Barangay Mabulaklak has poor hygienic practices and poor environmental conditions. These are contributing factors to which of the following disease conditions?

• A. influenza
• B. hepatitis B
• C. parasitism
• D. measles

Correct answer: C

Rationale: Poor hygienic practices and poor environmental conditions often create an environment conducive to the spread of parasites. Parasitism refers to the condition where parasites live on or in a host organism, potentially causing harm. In this scenario, the unsanitary conditions in Barangay Mabulaklak can lead to an increased risk of parasitic infections. The other options, influenza, hepatitis B, and measles, are not directly linked to poor hygiene and environmental conditions as parasitism is.

3. A school nurse is assessing a child who has frequent absences from school due to asthma. Which of the following is the priority nursing action?

• A. Teaching the child how to use an inhaler
• B. Assessing the child's asthma management plan
• C. Discussing the importance of school attendance with the parents
• D. Referring the child to a pulmonologist

Correct answer: B

Rationale: The correct answer is to assess the child's asthma management plan. This is the priority action as it allows the nurse to evaluate the current treatment regimen, identify any gaps or areas for improvement, and ensure that the plan is being effectively implemented. Teaching the child how to use an inhaler (Choice A) may be important but should come after assessing the management plan. Discussing the importance of school attendance with the parents (Choice C) is secondary to ensuring proper asthma management. Referring the child to a pulmonologist (Choice D) may be necessary but is not the priority at this stage; first, the nurse needs to evaluate the current plan in place.

4. The delivery of basic health services was decentralized to the local government units. The legal basis for this is embodied in:

• A. RA 7035
• B. EO 119
• C. RA 7160
• D. PD 999

Correct answer: C

Rationale: The correct answer is C, RA 7160. This law, also known as the Local Government Code, decentralizes health services to local government units. RA 7035 is not the legal basis for decentralizing basic health services. EO 119 and PD 999 are also not the correct legal bases for the decentralization of health services.

5. 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.

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