Nursing Elites

1. A school nurse is assessing a child who has frequent absences from school due to asthma. Which of the following is the priority nursing action?

• A. Teaching the child how to use an inhaler
• B. Assessing the child's asthma management plan
• C. Discussing the importance of school attendance with the parents
• D. Referring the child to a pulmonologist

Correct answer: B

Rationale: The correct answer is to assess the child's asthma management plan. This is the priority action as it allows the nurse to evaluate the current treatment regimen, identify any gaps or areas for improvement, and ensure that the plan is being effectively implemented. Teaching the child how to use an inhaler (Choice A) may be important but should come after assessing the management plan. Discussing the importance of school attendance with the parents (Choice C) is secondary to ensuring proper asthma management. Referring the child to a pulmonologist (Choice D) may be necessary but is not the priority at this stage; first, the nurse needs to evaluate the current plan in place.

2. Building a healthy community is based on the following basic principles except:

• A. concreteness and reasoning to understand and solve problems
• B. human beings do not function independently but as a group
• C. the target of change is not individual or family but community
• D. environmental factors are more basic than institutional factors

Correct answer: D

Rationale: Building a healthy community is indeed based on principles like concreteness, group dynamics, and focusing on community-level change. However, stating that environmental factors are more basic than institutional factors is incorrect. Both environmental and institutional factors play crucial roles in community health. Environmental factors like access to healthcare, clean water, and safe housing are vital, while institutional factors such as healthcare systems, education, and governance also significantly impact community health. Therefore, the correct answer is D, as environmental factors are not more basic than institutional factors.

3. An activity designed to diagnose and treat a disease or condition in its earliest stages, before it becomes full-blown, would be classified as:

• A. primary prevention
• B. secondary prevention
• C. tertiary prevention
• D. health education

Correct answer: B

Rationale: The correct answer is B, secondary prevention. Secondary prevention focuses on early diagnosis and intervention to prevent the progression of a disease or condition. This involves detecting and treating the illness in its early stages to reduce its impact. Choice A, primary prevention, aims to prevent the development of a disease or injury before it occurs by promoting healthy behaviors. Choice C, tertiary prevention, involves managing and improving the quality of life of individuals with established conditions to prevent complications and further deterioration. Choice D, health education, refers to providing information and promoting awareness about health issues to enable individuals to make informed decisions and adopt healthy behaviors.

4. The occurrence of non-communicable diseases (NCDs) is on the rise and is attributed to the changing lifestyle of Filipinos. The major NCDs are cardiovascular diseases (CVDs), cancer, chronic obstructive pulmonary disease (COPD), and diabetes mellitus (DM). The community health nurse can help address these problems. The major risk factors common to the above-mentioned four major NCDs are:

• A. Unhealthy diet, physical inactivity, and smoking
• B. Hypertension, sedentary lifestyle, and poor stress management
• C. Obesity, sedentary lifestyle, and smoking
• D. Unhealthy diet, alcoholism, and sedentary lifestyle

Correct answer: A

Rationale: The correct answer is A: 'Unhealthy diet, physical inactivity, and smoking.' These are major risk factors associated with cardiovascular diseases (CVDs), cancer, chronic obstructive pulmonary disease (COPD), and diabetes mellitus (DM). Unhealthy diet can lead to obesity and other health issues, physical inactivity contributes to various chronic conditions, and smoking is a well-known risk factor for cancer and respiratory diseases. Choice B is incorrect as hypertension is a condition that can result from these risk factors rather than being a risk factor itself. Poor stress management, although important for overall health, is not a major risk factor for the mentioned NCDs. Choice C is incorrect as although obesity is a risk factor, it is not mentioned in the question stem. Choice D is incorrect as alcoholism is not listed among the major NCDs or the common risk factors provided.

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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