Nursing Elites

1. A 23-year-old single client is in the 33rd week of her first pregnancy. She tells the nurse that she has everything ready for the baby and has made plans for the first weeks together at home. Which normal emotional reaction does the nurse recognize?

• A. Acceptance of the pregnancy
• B. Focus on fetal development
• C. Anticipation of the birth
• D. Ambivalence about pregnancy

Correct answer: C

Rationale: The correct answer is C: 'Anticipation of the birth.' In the third trimester, it is common for expectant mothers to feel excited and prepared for the upcoming birth of their baby. This includes making plans for the baby's arrival and the early days at home. Choice A, 'Acceptance of the pregnancy,' may occur earlier in the pregnancy and does not specifically relate to the third trimester. Choice B, 'Focus on fetal development,' is more common in the earlier stages of pregnancy when the mother may be more concerned with the baby's growth and milestones. Choice D, 'Ambivalence about pregnancy,' suggests conflicting feelings which are less likely in this scenario where the client expresses readiness and plans for the baby's arrival.

2. What title should be given to this occupational health nurse job description?

• A. manager
• B. case manager
• C. health educator
• D. nurse consultant

Correct answer: D

Rationale: The correct title for this occupational health nurse job description is 'nurse consultant.' A nurse consultant is a registered professional nurse with expertise in occupational and environmental health nursing, effective communication skills, and good administrative and consultative abilities. Choice A, 'manager,' is incorrect as the job description does not primarily focus on managerial duties. Choice B, 'case manager,' is incorrect as it does not fully cover the scope of the described role. Choice C, 'health educator,' is incorrect as it does not encompass the administrative and consultative skills mentioned in the job description.

3. 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.

4. The term 'epidemiology' is best defined as the study of:

• A. The causes of disease
• B. The distribution and determinants of health-related states in populations
• C. The treatment and prevention of disease
• D. The healthcare system and its effectiveness

Correct answer: B

Rationale: Epidemiology is the study of the distribution and determinants of health-related states in populations. Choice A is incorrect because epidemiology focuses on more than just causes but also on distribution and determinants. Choice C is incorrect as it specifically relates to public health and not just treatment and prevention. Choice D is incorrect as epidemiology is broader than just focusing on the healthcare system and its effectiveness.

5. When providing nursing care to a client receiving oxygen therapy via a nasal cannula, which of the following interventions would be appropriate?

• A. Ensure that adequate mist is supplied
• B. Inspect the nares and ears for skin breakdown
• C. Lubricate the tips of the cannula before insertion
• D. Maintain sterile technique when handling the cannula

Correct answer: B

Rationale: The correct answer is to inspect the nares and ears for skin breakdown. This is important because the nasal cannula can cause skin breakdown due to prolonged use and friction. Ensuring that the skin is intact helps prevent complications. Choice A is incorrect as oxygen therapy via a nasal cannula does not involve mist. Choice C is incorrect as lubricating the tips of the cannula is not a standard practice and may lead to complications. Choice D is incorrect because while cleanliness is important, maintaining sterile technique is not necessary for handling a nasal cannula in this context.

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