Nursing Elites

1. A young child is admitted for treatment of lead poisoning. The nurse recognizes that the most serious effect of chronic lead poisoning is

• A. Central nervous system damage
• B. Moderate anemia
• C. Renal tubule damage
• D. Growth impairment

Correct answer: A

Rationale: Corrected Rationale: Chronic lead poisoning can lead to severe and irreversible damage to the central nervous system, including cognitive and developmental delays. Central nervous system damage is the most serious effect of chronic lead poisoning because it can have long-lasting consequences on a child's cognitive function and overall development. Moderate anemia (Choice B), renal tubule damage (Choice C), and growth impairment (Choice D) can also occur due to lead poisoning, but they are not as severe or potentially irreversible as the damage to the central nervous system.

2. The home health nursing director is conducting an educational program for registered nurses and practical nurses about Medicare reimbursement. To obtain payment for Medicare services, what must be included in the client's record?

• A. A prescription from the healthcare provider for each visit made.
• B. Documentation of a skilled care service provided during the visit.
• C. A copy of the client's health history and social security card.
• D. A record of the preventative healthcare services provided during the visit.

Correct answer: B

Rationale: The correct answer is B: Documentation of skilled care services is required for Medicare reimbursement. Medicare reimbursement is based on the provision of skilled care services, not on prescriptions or preventative healthcare services. Including a copy of the client's health history and social security card is not a requirement for Medicare reimbursement.

3. Which of the following qualifications is not required for a Nurse Supervisor at the provincial level?

• A. BSN, RN
• B. at least 3 years experience
• C. Master's in public health
• D. at least 5 years experience in public health

Correct answer: B

Rationale: The correct answer is B because the qualifications for a Nurse Supervisor at the provincial level include a BSN, RN, and a Master's in public health, along with a minimum of 5 years of experience in public health. Choice B, which states 'at least 3 years experience,' is incorrect as the requirement is for at least 5 years of experience in public health. Choices A, C, and D are necessary qualifications for a Nurse Supervisor at the provincial level based on the provided information.

4. The increasing number of people who must learn to live with chronic illness in the community implies the need for the PHN to plan and implement a program on:

• A. communicable disease control
• B. health education
• C. child survival
• D. environmental education

Correct answer: B

Rationale: The correct answer is B: health education. Health education is crucial for individuals dealing with chronic illnesses as it helps them learn how to manage their conditions effectively. Communicable disease control (choice A) focuses on preventing the spread of infectious diseases, which is not directly related to managing chronic conditions. Child survival (choice C) pertains to initiatives aimed at reducing child mortality rates, which is not directly related to addressing chronic illnesses. Environmental education (choice D) involves raising awareness about environmental issues, which is also not directly related to helping individuals live with chronic illnesses.

5. When providing nursing care to a client receiving oxygen therapy via a nasal cannula, which of the following interventions would be appropriate?

• A. Ensure that adequate mist is supplied
• B. Inspect the nares and ears for skin breakdown
• C. Lubricate the tips of the cannula before insertion
• D. Maintain sterile technique when handling the cannula

Correct answer: B

Rationale: The correct answer is to inspect the nares and ears for skin breakdown. This is important because the nasal cannula can cause skin breakdown due to prolonged use and friction. Ensuring that the skin is intact helps prevent complications. Choice A is incorrect as oxygen therapy via a nasal cannula does not involve mist. Choice C is incorrect as lubricating the tips of the cannula is not a standard practice and may lead to complications. Choice D is incorrect because while cleanliness is important, maintaining sterile technique is not necessary for handling a nasal cannula in this context.

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