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. Which facilities are capable of performing minor surgeries and some simple laboratory examinations?

• A. Secondary level health care
• B. Intermediate level care
• C. Tertiary level care
• D. Primary health care

Correct answer: A

Rationale: Secondary level health care facilities are equipped to perform minor surgeries and simple laboratory examinations. Intermediate level care (choice B) refers to a level of care between primary and secondary care, focusing on more complex procedures than minor surgeries. Tertiary level care (choice C) is specialized care that includes services like cardiac surgery and neurosurgery. Primary health care (choice D) is the first point of contact for individuals and is not typically equipped for minor surgeries or complex laboratory tests.

3. A client with a urinary tract infection is receiving ciprofloxacin (Cipro). The nurse should monitor the client for which of the following side effects?

• A. Hypertension
• B. Hypoglycemia
• C. Hyperkalemia
• D. Tendonitis

Correct answer: D

Rationale: Ciprofloxacin can cause tendonitis and an increased risk of tendon rupture. Monitoring for tendonitis is crucial as it can lead to significant musculoskeletal issues. Choices A, B, and C are incorrect as hypertension, hypoglycemia, and hyperkalemia are not typically associated with ciprofloxacin use.

4. Which of the following is a major focus of tertiary prevention?

• A. Preventing the onset of disease
• B. Early detection and treatment
• C. Reducing the impact of an ongoing illness
• D. Health education

Correct answer: C

Rationale: The correct answer is C, 'Reducing the impact of an ongoing illness.' Tertiary prevention aims to minimize the effects of a disease or condition that is already established. Choices A, 'Preventing the onset of disease,' and B, 'Early detection and treatment,' are aspects of primary and secondary prevention, respectively. Choice D, 'Health education,' is more related to promoting awareness and knowledge rather than specifically focusing on reducing the impact of an ongoing illness.

5. What title should be given to this occupational health nurse job description? A registered nurse with expertise in health promotion, illness and injury prevention, risk reduction, and adult learning principles.

• A. case manager
• B. health educator
• C. nurse consultant
• D. health promotion specialist

Correct answer: D

Rationale: The correct answer is 'D: health promotion specialist.' This title aligns with the described expertise in health promotion, illness and injury prevention, and risk reduction. A health promotion specialist focuses on promoting health and preventing illnesses, which directly corresponds to the skills mentioned in the job description. Choices A, B, and C are incorrect. A 'case manager' typically focuses on coordinating patient care, 'health educator' specifically emphasizes educating individuals on health topics, and a 'nurse consultant' offers expert advice and support in the nursing field but may not specialize in health promotion and risk reduction as required in this job description.

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