Nursing Elites

1. During the care of a client with Legionnaire's disease, which finding would require the nurse's immediate attention?

• A. Pleuritic pain on inspiration
• B. Dry mucus membranes in the mouth
• C. A decrease in respiratory rate from 34 to 24
• D. Decrease in chest wall expansion

Correct answer: D

Rationale: A decrease in chest wall expansion suggests that the client may be experiencing a serious complication, such as worsening pneumonia or respiratory failure, requiring immediate medical attention. This finding indicates a potential decrease in lung function, which could lead to respiratory distress. Pleuritic pain on inspiration may be related to the disease process but does not indicate an immediate need for intervention. Dry mucus membranes in the mouth may require attention but are not as critical as a decrease in chest wall expansion. A decrease in respiratory rate could be concerning but is not as urgent as a decrease in chest wall expansion, which directly impacts respiratory function.

2. What does the term 'vital statistics' refer to?

• A. The systematic study of vital events such as births, illnesses, marriages, divorce, separation, and deaths
• B. Morbidity
• C. Statistics
• D. Mortality

Correct answer: A

Rationale: The term 'vital statistics' specifically refers to the systematic study of vital events, including births, illnesses, marriages, divorces, separations, and deaths. This field focuses on quantifying and analyzing these essential life events within a population. Choices B, C, and D are incorrect because while they may be related to data collection and analysis, they do not encompass the broad spectrum of vital events covered under the term 'vital statistics.' Morbidity refers to the prevalence of a specific illness or disease within a population, statistics is a more general term for numerical data analysis, and mortality specifically pertains to deaths within a population.

3. As a supervisor, you plan to conduct a seminar in response to the midwife's training need for skills in community diagnosis. Which is an appropriate method to use to enable midwives to apply the knowledge they will gain in actual practice?

• A. lecture
• B. problem-solving
• C. group discussion
• D. nominal group technique

Correct answer: B

Rationale: Problem-solving is an effective method to enable midwives to apply the knowledge gained in actual practice. By engaging in problem-solving activities during the seminar, midwives can enhance their critical thinking skills and directly apply the information to real-life scenarios they may encounter in community diagnosis. Choice A (lecture) is less effective as it primarily involves passive listening and may not provide the hands-on experience needed for practical application. Choice C (group discussion) can be helpful for sharing perspectives but may not directly translate to practical application as problem-solving would. Choice D (nominal group technique) focuses more on generating ideas and reaching consensus rather than hands-on application of knowledge.

4. When assessing a newborn infant with low set ears, short palpebral fissures, flat nasal bridge, and an indistinct philtrum, a priority maternal assessment by the nurse should be to ask about

• A. Alcohol use during pregnancy
• B. Usual nutritional intake
• C. Family genetic disorders
• D. Maternal and paternal ages

Correct answer: A

Rationale: The correct answer is A: Alcohol use during pregnancy. The physical features mentioned are indicative of fetal alcohol syndrome, a condition caused by maternal alcohol consumption during pregnancy. It is crucial for the nurse to inquire about alcohol use as it can help in diagnosing and managing the infant's condition. Choices B, C, and D are incorrect as they are not directly associated with the physical findings described in the newborn, which specifically point towards a potential history of alcohol exposure during pregnancy.

5. A health program that aims to reduce the incidence of chronic diseases through lifestyle modifications is an example of:

• A. Primary prevention
• B. Secondary prevention
• C. Tertiary prevention
• D. Quaternary prevention

Correct answer: A

Rationale: The correct answer is A: Primary prevention. Primary prevention focuses on preventing the development of diseases or injuries before they occur by promoting healthy behaviors and lifestyles. In this scenario, the health program targeting lifestyle modifications to reduce chronic diseases aligns with primary prevention efforts. Choice B, secondary prevention, involves early detection and treatment to prevent the progression of disease. Choice C, tertiary prevention, focuses on managing and treating existing diseases to prevent complications. Choice D, quaternary prevention, relates to actions taken to mitigate or avoid the consequences of unnecessary or excessive interventions in healthcare.

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