Nursing Elites

1. When a nurse from the surgical department is reassigned to the pediatric unit, the charge nurse should recognize that the child at highest risk for cardiac arrest and is the least likely to be assigned to this nurse is which child?

• A. Congenital cardiac defects
• B. An acute febrile illness
• C. Prolonged hypoxemia
• D. Severe multiple trauma

Correct answer: C

Rationale: The correct answer is C, 'Prolonged hypoxemia.' Prolonged hypoxemia is a critical condition that requires specialized pediatric care due to the high risk of cardiac arrest. The other choices, such as congenital cardiac defects, acute febrile illness, and severe multiple trauma, may also require attention, but prolonged hypoxemia poses the highest risk for cardiac arrest and demands specialized expertise in managing pediatric patients with this condition.

2. Local health boards were established at the provincial, city, and municipal levels. At the municipal level, the chairman of the board is the:

• A. rural health physician
• B. public health nurse
• C. municipal mayor
• D. chairman of the committee on health

Correct answer: C

Rationale: The correct answer is C, the municipal mayor. In the local health board structure, the municipal mayor chairs the board at the municipal level, overseeing health-related matters in that specific locality. Choices A, B, and D are incorrect because while a rural health physician or a public health nurse may be involved in health-related activities, they do not serve as the chairman of the board at the municipal level. Similarly, the chairman of the committee on health may have a role in health matters, but the municipal mayor holds the position of chairman of the local health board at the municipal level.

3. A client with chronic renal failure is receiving peritoneal dialysis. The nurse should assess the client for which of the following complications?

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

Correct answer: B

Rationale: The correct answer is B: Hyperglycemia. In peritoneal dialysis, hyperglycemia can occur due to the glucose content of the dialysate solution. This high glucose concentration can lead to increased blood sugar levels in the client. Option A, Hypertension, is a common complication in chronic renal failure but is not directly related to peritoneal dialysis. Option C, Hypokalemia, is more commonly associated with loop diuretics or inadequate potassium intake. Option D, Hypernatremia, is more often seen in conditions of excessive sodium intake or water loss, rather than in peritoneal dialysis.

4. The RN is serving on a medical center committee to update goals and protocols based on the national standards. Which goal most directly addresses the Healthy People 2020 initiative?

• A. Reduce ED wait time for indigent clients
• B. Providing transportation for medically challenged clients
• C. Provide access to health services
• D. Refer clients to local health department for medical services

Correct answer: C

Rationale: The correct answer is C: 'Provide access to health services.' This goal most directly addresses the Healthy People 2020 initiative, which aims to improve health care access for all individuals. Option A, 'Reduce ED wait time for indigent clients,' focuses on efficiency rather than access. Option B, 'Providing transportation for medically challenged clients,' addresses a specific need but does not cover overall health service access. Option D, 'Refer clients to local health department for medical services,' involves referral rather than direct access to services.

5. A client with a history of deep vein thrombosis (DVT) is receiving warfarin (Coumadin). The nurse should monitor the client for which of the following laboratory values?

• A. Prothrombin time (PT)
• B. Serum potassium
• C. Blood urea nitrogen (BUN)
• D. White blood cell count (WBC)

Correct answer: A

Rationale: The correct answer is A: Prothrombin time (PT). Prothrombin time is monitored to assess the effectiveness of warfarin therapy. Warfarin is an anticoagulant medication that works by inhibiting the synthesis of vitamin K-dependent clotting factors, including factors II, VII, IX, and X. Monitoring the PT helps ensure that the client's blood is clotting within the desired therapeutic range to prevent complications such as recurrent DVT or excessive bleeding. Choices B, C, and D are incorrect because serum potassium, blood urea nitrogen, and white blood cell count are not directly related to monitoring warfarin therapy in a client with a history of DVT.

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