Nursing Elites

1. A client with terminal cancer is experiencing severe pain. The nurse plans to implement which of the following pain management strategies?

• A. Administer analgesics on a fixed schedule
• B. Administer analgesics only when the client requests
• C. Use non-pharmacological methods only
• D. Increase the dose of analgesics when the client complains of pain

Correct answer: A

Rationale: Administering analgesics on a fixed schedule is the most appropriate pain management strategy for a client with terminal cancer experiencing severe pain. This approach ensures consistent pain control and helps prevent breakthrough pain. Administering analgesics only when the client requests (Choice B) may lead to uncontrolled pain as the client may delay requesting medication until the pain becomes unbearable. Using non-pharmacological methods only (Choice C) may not provide adequate pain relief for a client experiencing severe pain. Increasing the dose of analgesics when the client complains of pain (Choice D) may result in inconsistent pain control and could lead to potential overdose or adverse effects.

2. The following are functions of the Provincial Nurse Supervisor except:

• A. interpreting policies, guidelines, and SDP to nursing and midwifery staff of the province
• B. assessing training needs and planning staff development programs for nursing and midwifery staff
• C. participating in planning, developing, and evaluating OJT for nurses and midwives conducted by the department
• D. collecting, consolidating, analyzing, and interpreting health records and reports and making recommendations as needed

Correct answer: D

Rationale: The correct answer is D. Collecting, consolidating, analyzing, and interpreting health records is not a primary function of a Provincial Nurse Supervisor. The primary functions of a Provincial Nurse Supervisor include interpreting policies, guidelines, and SDP to nursing and midwifery staff, assessing training needs, planning staff development programs, and participating in planning, developing, and evaluating OJT for nurses and midwives. While health records may be accessed for specific purposes, the core responsibilities of a Provincial Nurse Supervisor focus on staff management and development rather than direct involvement in health record analysis.

3. The major target of the Philippine Family Program are women belonging to the high-risk group which includes:

• A. Women under 20 or over 35 years old
• B. Women suffering from certain medical conditions that contradict pregnancy
• C. All these groups
• D. Women who have had at least 4 deliveries

Correct answer: C

Rationale: The correct answer is C, 'All these groups.' The Philippine Family Program targets women under 20 years old, over 35 years old, those with certain medical conditions that contradict pregnancy, and women who have had at least 4 deliveries. Therefore, choice C is the correct answer because it encompasses all the high-risk groups identified by the program. Choices A, B, and D are incorrect because they do not cover all the specified high-risk groups targeted by the program.

4. The community health nurse has been following the care for an adolescent with a history of morbid obesity, asthma, hypertension, and is 22 weeks into a pregnancy. Which of these lab reports sent to the clinic needs to be called to the teen's healthcare provider within the next hour?

• A. Hemoglobin 11 g/dL and calcium 6 mg/dL
• B. Magnesium 0.8 mEq/L and creatinine 3 mg/dL
• C. Blood urea nitrogen 28 mg/dL and glucose 225 mg/dL
• D. Hematocrit 33% and platelets 200,000

Correct answer: B

Rationale: The correct answer is B. The low magnesium level and elevated creatinine suggest possible renal dysfunction, which is concerning, especially in a pregnant client with multiple risk factors such as morbid obesity, asthma, and hypertension. Immediate attention is needed to address the potential renal issues. The other choices do not indicate such urgent conditions. Hemoglobin and calcium levels in choice A are within acceptable ranges. Choice C shows elevated blood urea nitrogen and glucose levels, which may need monitoring but not immediate attention. Choice D's hematocrit and platelet levels are also within normal ranges and do not indicate an urgent issue.

5. For Barangay Mabulaklak, you intend to conduct health education sessions for a group of mothers. Which of the following topics for discussion will be given least priority:

• A. proper selection and preparation of food
• B. handwashing before preparing food
• C. cutting children's fingernails short
• D. overcrowding and its effect

Correct answer: D

Rationale: The correct answer is D - 'overcrowding and its effect.' While overcrowding is an important topic, it will be given least priority compared to the other choices when conducting health education sessions for a group of mothers. Proper selection and preparation of food (Choice A) is crucial for ensuring adequate nutrition, handwashing before preparing food (Choice B) is essential for preventing foodborne illnesses, and cutting children's fingernails short (Choice C) is important for maintaining good hygiene. Overcrowding, although significant in the context of public health, might be considered less immediately relevant for a group of mothers in a health education session focused on more direct and practical aspects of family health and hygiene.

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