Nursing Elites

1. As a community organizer, the PHN facilitates the planning and implementation of program subjects in the community. In the light of the PHC approach, these programs/projects should be characterized by the following except:

• A. managed by the community leaders/members
• B. managed by non-government organizations for the people to ensure success
• C. compatible with available resources
• D. developmental in nature

Correct answer: B

Rationale: In the context of the PHC approach, programs should be characterized by being managed by community leaders/members (Choice A). This ensures community involvement and ownership. Programs should also be compatible with available resources (Choice C) to be sustainable and effective. Additionally, programs should be developmental in nature (Choice D), focusing on long-term improvements. Choice B is incorrect because programs should not be solely managed by non-government organizations; instead, they should be driven by the community to promote sustainability and empowerment.

2. Which individual has the highest risk of developing community-acquired pneumonia?

• A. A 40-year-old first-grade teacher who works with underprivileged children.
• B. A 75-year-old retired secretary with exercise-induced wheezing.
• C. A 60-year-old homeless person who is an alcoholic and smokes.
• D. A 35-year-old aerobics instructor who skips meals and eats only vegetables.

Correct answer: C

Rationale: The correct answer is the 60-year-old homeless person who is an alcoholic and smokes. This individual has the highest risk of developing community-acquired pneumonia due to factors such as homelessness, alcoholism, and smoking, which weaken the immune system and make them more susceptible to respiratory infections. Choice A is incorrect as working with underprivileged children, while potentially exposing the individual to various illnesses, does not directly increase the risk of pneumonia. Choice B is less likely as exercise-induced wheezing may suggest asthma but does not directly correlate with pneumonia risk. Choice D, an aerobics instructor who eats only vegetables and skips meals, does not have the same level of risk factors for pneumonia as the homeless person in choice C.

3. The nurse is assigned to a client with Parkinson's disease. Which findings would the nurse anticipate?

• A. Non-intention tremors and urgency with voiding
• B. Echolalia and a shuffling gait
• C. Muscle spasm and a bent-over posture
• D. Intention tremor and jerky movement of the elbows

Correct answer: B

Rationale: The correct answer is B. Echolalia (repeating others' words) and a shuffling gait are common symptoms of Parkinson's disease. These symptoms result from the degeneration of the basal ganglia in the brain that controls movement and speech. Choice A is incorrect because non-intention tremors are not typically associated with Parkinson's disease. Choice C is incorrect as muscle spasm and a bent-over posture are not classic manifestations of Parkinson's disease. Choice D is incorrect since intention tremors and jerky movement of the elbows are not characteristic of Parkinson's disease.

4. What is the main objective of the Expanded Program on Immunization (EPI)?

• A. Provide healthcare to all individuals
• B. Reduce child mortality
• C. Eliminate vaccine-preventable diseases
• D. Promote healthy lifestyles

Correct answer: C

Rationale: The main objective of the Expanded Program on Immunization (EPI) is to eliminate vaccine-preventable diseases. While providing healthcare to all individuals and reducing child mortality are important goals, the primary focus of EPI is specifically on preventing diseases through immunization. Promoting healthy lifestyles, although beneficial, is not the primary aim of the EPI.

5. A client with asthma has low-pitched wheezes present on the final half of exhalation. One hour later the client has high-pitched wheezes extending throughout exhalation. This change in assessment indicates to the nurse that the client

• A. Has increased airway obstruction
• B. Has improved airway obstruction
• C. Needs to be suctioned
• D. Exhibits hyperventilation

Correct answer: A

Rationale: The correct answer is A: 'Has increased airway obstruction.' High-pitched wheezes extending throughout exhalation indicate a worsening airway obstruction, leading to increased resistance in the airways. Low-pitched wheezes present on the final half of exhalation may suggest some level of obstruction, but the change to high-pitched wheezes throughout exhalation indicates a progression in the obstruction. Choice B is incorrect as the change in wheeze characteristics signifies deterioration rather than improvement. Choice C is incorrect as suctioning is not indicated based on the wheeze assessment findings. Choice D is incorrect as hyperventilation does not typically present with wheezes and is not supported by the information provided.

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