Nursing Elites

1. A 67-year-old client is admitted with substernal chest pain with radiation to the jaw. His admitting diagnosis is Acute Myocardial Infarction (MI). The priority nursing diagnosis for this client during the immediate 24 hours is

• A. Constipation related to immobility
• B. High risk for infection
• C. Impaired gas exchange
• D. Fluid volume deficit

Correct answer: C

Rationale: The correct answer is C: Impaired gas exchange. In a client with an acute myocardial infarction, impaired gas exchange is a priority nursing diagnosis due to compromised heart function, which affects oxygenated blood circulation. Close monitoring and interventions are crucial to ensure adequate oxygenation. Choices A, B, and D are incorrect: A) Constipation related to immobility is not the priority in this acute situation; B) High risk for infection is not the immediate concern related to the client's primary diagnosis; D) Fluid volume deficit, while important, is not the priority compared to addressing impaired gas exchange in acute MI.

2. The nurse is caring for a child who has just returned from surgery following a tonsillectomy and adenoidectomy. Which action by the nurse is appropriate?

• A. Offer ice chips every 2 hours
• B. Place the child in a semi-Fowler's position
• C. Encourage the child to drink from a cup
• D. Observe swallowing patterns

Correct answer: D

Rationale: Observing swallowing patterns is crucial post-tonsillectomy and adenoidectomy to detect signs of bleeding. Offering ice chips instead of ice cream helps prevent throat irritation. Placing the child in a semi-Fowler's position promotes airway patency and reduces the risk of aspiration. Encouraging the child to drink from a cup instead of a straw minimizes the risk of dislodging the surgical site.

3. Community organizing is an important part of the community nursing function. Given the following elements: choosing an organizational structure, identifying and recruiting members, defining mission, vision, and goals, clarifying roles and responsibilities; at which stage do these elements belong?

• A. Program maintenance-consolidation
• B. Dissemination-Reassessment
• C. Community Analysis/diagnosis
• D. Design and initiation

Correct answer: D

Rationale: The correct answer is D: Design and initiation. These elements such as choosing an organizational structure, identifying and recruiting members, defining mission, vision, and goals, and clarifying roles and responsibilities belong to the design and initiation stage of community organizing. This stage focuses on setting up the foundation and structure of the community organization. The other choices are incorrect because: A) Program maintenance-consolidation refers to maintaining and strengthening existing programs, not establishing new ones; B) Dissemination-Reassessment involves spreading information and evaluating programs already in place; C) Community Analysis/diagnosis is about assessing community needs and identifying issues, not about setting up the initial structure.

4. In order to be effective as an occupational health nurse, you should be equipped with knowledge and skills in which of the following:

• A. public health science
• B. research process
• C. interviewing and counseling
• D. oral and written communication

Correct answer: D

Rationale: To be effective as an occupational health nurse, having knowledge and skills in public health science, the research process, interviewing and counseling, and oral and written communication are all important. However, communication skills, both oral and written, are crucial for conveying information, educating employees, documenting findings, and collaborating with other healthcare professionals. While public health science, research process, interviewing, and counseling are essential, oral and written communication is fundamental for effective communication and coordination in the workplace, making it the most critical skill for an occupational health nurse.

5. As of 2002, the following data was obtained from municipality X: No. of live births - 750, No. of infant deaths - 10, No. of maternal deaths - 6, Total population - 25,000. The 2002 maternal mortality rate of municipality X is:

• A. 15/1000 live births
• B. 12.5/1000 live births
• C. 6/1000 live births
• D. 8/1000 live births

Correct answer: C

Rationale: The maternal mortality rate is calculated as 6 maternal deaths per 1000 live births. The correct answer is C because to calculate the maternal mortality rate, you divide the number of maternal deaths by the number of live births and then multiply by 1000. Choices A, B, and D are incorrect as they do not match the given data on maternal deaths and live births for municipality X.

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