Nursing Elites

1. A client with bipolar disorder is receiving lithium (Lithobid). The nurse should monitor the client for which of the following side effects?

• A. Hypernatremia
• B. Hyponatremia
• C. Hyperglycemia
• D. Hypercalcemia

Correct answer: B

Rationale: The correct answer is B: Hyponatremia. Lithium can lead to hyponatremia by affecting sodium balance in the body. Hypernatremia (Choice A) is unlikely with lithium use. Hyperglycemia (Choice C) and hypercalcemia (Choice D) are not typically associated with lithium therapy for bipolar disorder.

2. The appropriate order of steps in active management of the third stage of labor includes:

• A. Cord clamping and cutting, controlled cord traction, ergometrine administration, and inspection to ensure the placenta is intact.
• B. Intravenous oxytocin, cord clamping and cutting, and fundal massage.
• C. Intramuscular injection of oxytocin, controlled cord traction with counter traction to the uterus, and uterine massage.
• D. Controlled cord traction, fundal massage, and oxytocin.

Correct answer: C

Rationale: The correct sequence of steps in active management of the third stage of labor includes intramuscular injection of oxytocin to prevent postpartum hemorrhage, controlled cord traction with counter traction to the uterus to facilitate placental delivery, and uterine massage to aid in uterine contraction and prevent excessive bleeding. Choice A is incorrect because ergometrine administration is not routinely recommended in active management. Choice B is incorrect as intravenous oxytocin is not the preferred route of administration. Choice D is incorrect as the order of steps is not accurate.

3. In terms of CHN practice, how is the nurse in the community trained?

• A. nurse-midwife
• B. practice nursing
• C. generalist in nursing
• D. midwife

Correct answer: C

Rationale: In community health nursing practice, nurses are trained as generalists in nursing. They receive education that equips them to address a wide range of health concerns in the community. Choice A, nurse-midwife, is incorrect as it refers to a specific role focusing on childbirth and maternal health. Choice B, practice nursing, is vague and does not specifically describe the training of community health nurses. Choice D, midwife, is also incorrect as it refers to a specialized role in maternal and newborn care, different from the generalist training of community health nurses.

4. At a nursing staff meeting, there is a discussion of perceived inequities in weekend staff assignments. As a follow-up, what should the nurse manager do initially?

• A. Allow the staff to change assignments
• B. Clarify reasons for current assignments
• C. Help staff see the complexity of issues
• D. Facilitate creative thinking on staffing

Correct answer: D

Rationale: Facilitating creative thinking on staffing is the most appropriate initial action for the nurse manager in addressing perceived inequities in weekend staff assignments. By encouraging creative thinking, the manager promotes innovative solutions and fosters a sense of ownership and collaboration among staff members. Choices A, B, and C are not the best initial steps in this situation. Allowing staff to change assignments may not address the underlying issues, clarifying reasons for current assignments may not resolve perceived inequities, and helping staff see the complexity of issues may not lead to actionable solutions.

5. A nurse is practicing community health nursing when:

• A. leading a support group for obese adolescents
• B. visiting an old woman in her condominium to change her postsurgical dressing
• C. being in a clinic instructing a couple about newborn care
• D. performing any of these activities

Correct answer: D

Rationale: Correct! Community health nursing involves a broad scope of activities that focus on promoting and preserving the health of populations rather than individuals. This includes leading support groups, providing home care, and educating communities. The other options represent different aspects of nursing care such as home health nursing, wound care, and maternal-child health - which are not exclusive to community health nursing.

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