Nursing Elites

1. For whom is the community health nurse primarily responsible?

• A. individuals
• B. populations
• C. families
• D. class E citizens

Correct answer: B

Rationale: Community health nurses are primarily responsible for populations. While they do provide care and support to individuals and families within the community, their focus is on the health and well-being of entire populations. Choice A is incorrect as the primary responsibility is broader than just individuals. Choice C is incorrect as families are part of the population but not the sole focus. Choice D, 'class E citizens', is too specific and not a standard term in public health, making it an incorrect choice.

2. A client with bipolar disorder is receiving lithium (Lithobid). The nurse should monitor the client for which of the following side effects?

• A. Hypernatremia
• B. Hyponatremia
• C. Hyperglycemia
• D. Hypercalcemia

Correct answer: B

Rationale: The correct answer is B: Hyponatremia. Lithium can lead to hyponatremia by affecting sodium balance in the body. Hypernatremia (Choice A) is unlikely with lithium use. Hyperglycemia (Choice C) and hypercalcemia (Choice D) are not typically associated with lithium therapy for bipolar disorder.

3. The milk code aims to ensure that:

• A. the public receives accurate information about breastmilk and breastfeeding
• B. health workers do not provide samples of infant formula to pregnant women or mothers of infants
• C. companies consistently recognize the superiority of breastmilk
• D. health workers do not accept any incentives from milk companies

Correct answer: C

Rationale: The correct answer is C because the milk code emphasizes that companies should always acknowledge the superiority of breastmilk over formula. Choice A is incorrect because the focus is not on the public receiving information, but rather on companies recognizing breastmilk's superiority. Choice B is incorrect as it addresses health workers' actions, not the companies' behavior. Choice D is incorrect as the milk code is primarily concerned with regulating companies' practices, not health workers' acceptance of incentives.

4. To be an effective educator, you should:

• A. listen to people's problems and decide on the approach to meet their needs
• B. select the best strategy for health action for people to implement
• C. direct people's efforts to implement community-based projects
• D. simply tell your clients what to do for their problems/needs

Correct answer: B

Rationale: The correct answer is to select the best strategy for health action for people to implement because it empowers the community to take ownership of their health. Listening to people's problems (Choice A) is important, but the effectiveness lies in empowering them to implement solutions. Directing people's efforts (Choice C) can be directive and may not foster community ownership. Just telling clients what to do (Choice D) does not promote active participation and empowerment.

5. The community health nurse has been following the care for an adolescent with a history of morbid obesity, asthma, hypertension, and is 22 weeks into a pregnancy. Which of these lab reports sent to the clinic needs to be called to the teen's healthcare provider within the next hour?

• A. Hemoglobin 11 g/dL and calcium 6 mg/dL
• B. Magnesium 0.8 mEq/L and creatinine 3 mg/dL
• C. Blood urea nitrogen 28 mg/dL and glucose 225 mg/dL
• D. Hematocrit 33% and platelets 200,000

Correct answer: B

Rationale: The correct answer is B. The low magnesium level and elevated creatinine suggest possible renal dysfunction, which is concerning, especially in a pregnant client with multiple risk factors such as morbid obesity, asthma, and hypertension. Immediate attention is needed to address the potential renal issues. The other choices do not indicate such urgent conditions. Hemoglobin and calcium levels in choice A are within acceptable ranges. Choice C shows elevated blood urea nitrogen and glucose levels, which may need monitoring but not immediate attention. Choice D's hematocrit and platelet levels are also within normal ranges and do not indicate an urgent issue.

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