Nursing Elites

1. A client comes into the community health center upset and crying stating, “I will die of cancer now that I have this disease.” And then the client hands the nurse a paper with one word written on it: 'Pheochromocytoma.' Which response should the nurse state initially?

• A. 'Pheochromocytomas usually aren't cancerous (malignant). But they may be associated with cancerous tumors in other endocrine glands such as the thyroid (medullary carcinoma of the thyroid).'
• B. 'This problem is diagnosed by blood and urine tests that reveal elevated levels of adrenaline and noradrenaline.'
• C. 'Computerized tomography (CT) or magnetic resonance imaging (MRI) are used to detect an adrenal tumor.'
• D. 'You probably have had episodes of sweating, heart pounding, and headaches.'

Correct answer: A

Rationale: The correct initial response for the nurse to provide in this situation is to offer reassurance. Stating that 'Pheochromocytomas usually aren't cancerous (malignant)' helps to alleviate the client's anxiety and fear of having cancer. This response also establishes a foundation for further discussion about the condition, allowing the nurse to address the client's concerns and provide accurate information. Choice B is incorrect as it focuses solely on the diagnostic tests for pheochromocytoma but does not address the client's emotional distress. Choice C is incorrect as it discusses imaging modalities without directly addressing the client's concerns. Choice D is also incorrect as it assumes symptoms without first addressing the client's emotional state and fear of cancer.

2. Which of the following patients should the home care nurse assess first?

• A. A 65-year-old male with known COPD and difficulty breathing after climbing a flight of stairs.
• B. A 78-year-old with CHF who has gained 4 lbs according to her tele-monitoring.
• C. A 50-year-old with bilateral leg swelling and difficulty walking.
• D. A 60-year-old with lower back pain.

Correct answer: A

Rationale: The correct answer is A. A patient with known COPD and difficulty breathing after physical exertion like climbing stairs requires immediate assessment by the nurse. This could indicate a potential exacerbation of COPD, which needs prompt intervention to prevent respiratory distress. Choices B, C, and D describe important patient situations that also require attention, but the urgency is higher with a COPD patient experiencing difficulty breathing.

3. During the care of a client with Legionnaire's disease, which finding would require the nurse's immediate attention?

• A. Pleuritic pain on inspiration
• B. Dry mucus membranes in the mouth
• C. A decrease in respiratory rate from 34 to 24
• D. Decrease in chest wall expansion

Correct answer: D

Rationale: A decrease in chest wall expansion suggests that the client may be experiencing a serious complication, such as worsening pneumonia or respiratory failure, requiring immediate medical attention. This finding indicates a potential decrease in lung function, which could lead to respiratory distress. Pleuritic pain on inspiration may be related to the disease process but does not indicate an immediate need for intervention. Dry mucus membranes in the mouth may require attention but are not as critical as a decrease in chest wall expansion. A decrease in respiratory rate could be concerning but is not as urgent as a decrease in chest wall expansion, which directly impacts respiratory function.

4. What are the requirements and qualifications for a regional nurse supervisor?

• A. BSN, RN
• B. at least 5 years of experience in public health
• C. Master's in public health
• D. all of the above

Correct answer: D

Rationale: To become a regional nurse supervisor, one must possess a BSN and RN credentials to ensure clinical competency. Additionally, a minimum of 5 years of experience in public health is required to demonstrate a solid understanding of the field. Lastly, holding a Master's degree in public health is essential for leadership and decision-making roles. Therefore, all the choices (BSN, RN; at least 5 years of experience in public health; Master's in public health) are necessary qualifications for a regional nurse supervisor.

5. In this municipality, what should the nursing health care plan focus on?

• A. Rehabilitative services
• B. All of these services
• C. Health promotion and disease prevention
• D. Curative services

Correct answer: C

Rationale: In this municipality, the nursing health care plan should primarily focus on health promotion and disease prevention. This approach addresses the underlying causes of health problems, promotes overall well-being, and helps prevent illnesses before they occur. While rehabilitative and curative services are important, health promotion and disease prevention are crucial for fostering a healthier community in the long term. Therefore, choices A, B, and D are not the best options as they do not prioritize preventing health issues at the root cause.

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