Nursing Elites

1. A client with rheumatoid arthritis is receiving methotrexate (Rheumatrex). The nurse should monitor the client for which of the following adverse effects?

• A. Leukopenia
• B. Hyperglycemia
• C. Hypertension
• D. Hypokalemia

Correct answer: A

Rationale: The correct answer is A: Leukopenia. Methotrexate, used in the treatment of rheumatoid arthritis, can lead to bone marrow suppression, resulting in leukopenia. This condition increases the risk of infections due to decreased white blood cell count. Choices B, C, and D are incorrect because methotrexate is not known to cause hyperglycemia, hypertension, or hypokalemia as its primary adverse effects.

2. What title should be given to this occupational health nurse job description? A registered nurse with expertise in health promotion, illness and injury prevention, risk reduction, and adult learning principles.

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

Correct answer: D

Rationale: The correct answer is 'D: health promotion specialist.' This title aligns with the described expertise in health promotion, illness and injury prevention, and risk reduction. A health promotion specialist focuses on promoting health and preventing illnesses, which directly corresponds to the skills mentioned in the job description. Choices A, B, and C are incorrect. A 'case manager' typically focuses on coordinating patient care, 'health educator' specifically emphasizes educating individuals on health topics, and a 'nurse consultant' offers expert advice and support in the nursing field but may not specialize in health promotion and risk reduction as required in this job description.

3. Which of the following best describes the concept of 'health disparity'?

• A. Differences in health outcomes and their determinants between different segments of the population
• B. Providing equal healthcare services to all individuals
• C. Access to healthcare services regardless of income
• D. High-quality healthcare for everyone

Correct answer: A

Rationale: The correct answer is A: 'Differences in health outcomes and their determinants between different segments of the population.' Health disparity refers to variations in health status or health care utilization between different groups. Choice B is incorrect because providing equal healthcare services to all individuals is related to health equity, not health disparity. Choice C is also incorrect as it refers to universal access to healthcare, which is different from health disparity. Choice D is incorrect as it describes the concept of high-quality healthcare for everyone, not health disparity.

4. Which individual has the highest risk of developing community-acquired pneumonia?

• A. A 40-year-old first-grade teacher who works with underprivileged children.
• B. A 75-year-old retired secretary with exercise-induced wheezing.
• C. A 60-year-old homeless person who is an alcoholic and smokes.
• D. A 35-year-old aerobics instructor who skips meals and eats only vegetables.

Correct answer: C

Rationale: The correct answer is the 60-year-old homeless person who is an alcoholic and smokes. This individual has the highest risk of developing community-acquired pneumonia due to factors such as homelessness, alcoholism, and smoking, which weaken the immune system and make them more susceptible to respiratory infections. Choice A is incorrect as working with underprivileged children, while potentially exposing the individual to various illnesses, does not directly increase the risk of pneumonia. Choice B is less likely as exercise-induced wheezing may suggest asthma but does not directly correlate with pneumonia risk. Choice D, an aerobics instructor who eats only vegetables and skips meals, does not have the same level of risk factors for pneumonia as the homeless person in choice C.

5. Environmental sanitation is the primary problem in community Y. As a stranger to the health unit, one of the major strategies in your plan is the improvement of the environmental health conditions of the community. To indicate this, which of the following would you do?

• A. meet with youth officials and parents' group leaders
• B. meet with religious and educational leaders
• C. request mayors to create a task force to help implement your project
• D. inform local announcers to disseminate the what and why of your project

Correct answer: C

Rationale: In this scenario, requesting mayors to create a task force is the most effective strategy to improve environmental health conditions in the community. Engaging with local government officials ensures the allocation of resources, coordination of efforts, and the implementation of sustainable solutions. While meeting with youth officials, parents' group leaders, religious and educational leaders are important, involving mayors in creating a task force will lead to broader community involvement and support. Informing local announcers about the project, although helpful for awareness, is not as impactful as engaging with local authorities for tangible change.

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