Nursing Elites

1. A client has just returned to the medical-surgical unit following a segmental lung resection. After assessing the client, the first nursing action would be to:

• A. Administer pain medication
• B. Suction excessive tracheobronchial secretions
• C. Assist the client to turn, deep breathe, and cough
• D. Monitor oxygen saturation

Correct answer: B

Rationale: After a segmental lung resection, the priority nursing action should be to suction excessive tracheobronchial secretions. This helps in preventing airway obstruction from secretions, ensuring the patency of the airway and optimizing respiratory function. Administering pain medication can be important but addressing airway clearance takes precedence. Assisting the client to turn, deep breathe, and cough is essential for respiratory hygiene but not the first action immediately post-op. Monitoring oxygen saturation is crucial, but ensuring airway clearance is the priority to prevent complications.

2. 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.

3. You assisted the midwife in formulating the objectives of the plan of care for Barangay Mabulaklak. Which of the following is a well-stated objective?

• A. to reduce the number of children with ascariasis by the end of two years
• B. to protect the water sources from pollution
• C. to conduct health teachings on proper nutrition
• D. to reduce the number of underweight children by 10%

Correct answer: D

Rationale: A specific, measurable objective like reducing the number of underweight children by 10% is well-stated. This objective is clear, quantifiable, and time-bound, making it easier to track progress and evaluate the effectiveness of the plan. Choices A, B, and C are not as well-stated as they lack specificity, measurability, and a quantifiable target.

4. What title should be given to this role in occupational health? An advanced practice nurse who provides workers with primary care services with an emphasis on the diagnosis and management of common acute illnesses/injuries and stable chronic diseases.

• A. case manager
• B. nurse consultant
• C. clinician nurse practitioner
• D. health promotion specialist

Correct answer: C

Rationale: The correct title for this role is a clinician nurse practitioner as they provide primary care services, including diagnosing and managing illnesses. Choice A, case manager, typically focuses on coordinating care and services for patients. Choice B, nurse consultant, involves providing expert advice and guidance. Choice D, health promotion specialist, concentrates on promoting health and preventing diseases rather than diagnosing and treating illnesses.

5. Which of the following health behavior choices are essential to promoting health and preventing diseases?

• A. Getting the right kind of food, adequate sleep, physical activity, and effectively handling stress
• B. Stopping smoking and taking vacations
• C. Making sure that all prescription medications are taken properly and at the right time
• D. Avoiding crowds during flu season

Correct answer: A

Rationale: The correct answer is A. Proper nutrition, adequate sleep, engaging in physical activity, and effective stress management are crucial for promoting health and preventing diseases. Choices B, C, and D do not encompass the comprehensive approach needed for overall health and disease prevention. Stopping smoking is important for health but is not the only factor to consider. Taking vacations can contribute to well-being but is not a core health behavior choice. Ensuring proper medication intake is essential for managing specific health conditions but does not cover all aspects of health promotion. Avoiding crowds during flu season is a preventive measure for infectious diseases but is not a fundamental health behavior choice for overall well-being.

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