Nursing Elites

1. After 3 days, the nurse notes that James has chest indrawing and stridor. His mother returned him to the health center immediately. The nurse should:

• A. Change the antibiotic to second-line antibiotics
• B. Advise the mother to observe the child and continue giving the antibiotics
• C. Give the first dose of antibiotics and refer urgently
• D. Observe the child at the center

Correct answer: C

Rationale: Chest indrawing and stridor are signs of severe respiratory distress. In this situation, immediate referral is essential. Giving the first dose of antibiotics before referral can help initiate treatment, but urgent referral for further evaluation and management is crucial. Choice A is incorrect because simply changing the antibiotic without assessing the severity of the symptoms and providing urgent care is not appropriate. Choice B is incorrect as advising the mother to observe the child and continue antibiotics delays necessary intervention for a potentially life-threatening condition. Choice D is incorrect as observing the child at the center is not sufficient when signs of severe illness are present.

2. The nurse is caring for a 5-year-old child who has the left leg in skeletal traction. Which of the following activities would be an appropriate diversional activity?

• A. Kicking balloons with the right leg
• B. Playing 'Simon Says'
• C. Playing handheld games
• D. Throwing bean bags

Correct answer: C

Rationale: Playing handheld games is an appropriate diversional activity for a child in skeletal traction because it does not require physical movement of the affected limb. This activity can help keep the child entertained and engaged without risking any harm to the tractioned leg. Choices A, B, and D involve physical movements that could potentially interfere with the skeletal traction or cause discomfort to the child.

3. A client with hypothyroidism is receiving levothyroxine (Synthroid). The nurse should monitor the client for which of the following side effects?

• A. Tachycardia
• B. Hypotension
• C. Weight gain
• D. Bradycardia

Correct answer: A

Rationale: The correct answer is A: Tachycardia. Levothyroxine, used to treat hypothyroidism, can lead to increased metabolism, causing tachycardia as a side effect. Monitoring for tachycardia is essential to ensure the client's safety. Choices B, Hypotension, and C, Weight gain, are incorrect as levothyroxine is not typically associated with causing hypotension or weight gain. Choice D, Bradycardia, is also incorrect as levothyroxine-induced bradycardia is not a common side effect.

4. The school nurse is called to the playground for an episode of mouth trauma. The nurse finds that the front tooth of a 9-year-old child has been avulsed (knocked out). After recovering the tooth, the initial response should be to

• A. Rinse the tooth in water before placing it in the socket
• B. Place the tooth in a clean plastic bag for transport to the dentist
• C. Hold the tooth by the roots until reaching the emergency room
• D. Ask the child to replace the tooth even if the bleeding continues

Correct answer: A

Rationale: The correct immediate action after recovering an avulsed tooth is to rinse it with water and place it back in the socket. This helps preserve the tooth and increases the chances of successful re-implantation. Placing the tooth in a clean plastic bag for transport to the dentist (choice B) is not ideal as immediate re-implantation is preferred. Holding the tooth by the roots until reaching the emergency room (choice C) can further damage the tooth. Asking the child to replace the tooth even if bleeding continues (choice D) is incorrect and may lead to improper re-implantation.

5. Under which level of primary health care workers does a rural sanitary inspector fall?

• A. Village health workers
• B. Intermediate level health workers
• C. Barangay health workers
• D. All of the above

Correct answer: B

Rationale: Rural sanitary inspectors are classified as intermediate level health workers. They are not categorized under village health workers or barangay health workers. Therefore, the correct answer is B.

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