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. While assessing an Rh-positive newborn whose mother is Rh-negative, the nurse recognizes the risk for hyperbilirubinemia. Which of the following should be reported immediately?

• A. Jaundice evident at 26 hours
• B. Hematocrit of 55%
• C. Serum bilirubin of 12 mg/dL
• D. Positive Coombs test

Correct answer: C

Rationale: A serum bilirubin level of 12 mg/dL in a newborn is concerning and can indicate a significant risk of hyperbilirubinemia, which requires immediate medical intervention to prevent complications like kernicterus. Jaundice at 26 hours (Choice A) is a symptom, not a laboratory result, and needs monitoring but not an immediate report. Hematocrit of 55% (Choice B) may be elevated but is not indicative of hyperbilirubinemia. A positive Coombs test (Choice D) indicates the presence of antibodies on the newborn's red blood cells but does not directly correlate with the risk of hyperbilirubinemia.

3. Community health nurses help influence the health of communities through which of the following actions?

• A. legislating health behavior
• B. recording health status of individuals in a similar geographic region
• C. influencing health status and behavior, and engaging in health promotion
• D. none of the above

Correct answer: C

Rationale: Community health nurses play a crucial role in influencing the health of communities by engaging in health promotion activities and influencing health behaviors. Choice A is incorrect as community health nurses do not legislate health behavior but rather educate and promote healthy behaviors. Choice B is incorrect as while community health nurses may record health data, their main focus is on proactive health promotion and intervention, not just documenting health status. Choice D is incorrect because community health nurses actively work to influence health status and behaviors.

4. Which of the following is an example of a social determinant of health?

• A. Blood pressure
• B. Genetic mutations
• C. Housing conditions
• D. Age

Correct answer: C

Rationale: The correct answer is C: Housing conditions. Social determinants of health are the conditions in which people are born, grow, live, work, and age. Housing conditions directly impact health outcomes as they can affect exposure to toxins, safety, and overall well-being. Choice A, blood pressure, is a physiological measure and not a social determinant. Choice B, genetic mutations, relates to an individual's genetic makeup and is not influenced by social factors. Choice D, age, is a demographic factor and not a social determinant of health.

5. The school RN is assessing a group of middle school students for signs of scoliosis and discovers a female student with noticeable unequal symmetry of the upper and lower back. Which intervention is most important for the RN to implement?

• A. Send the student home
• B. Make a referral to have the scoliosis further evaluated.
• C. Withdraw the student from all physical activities
• D. Tell the student not to carry her backpack on her back

Correct answer: B

Rationale: Referring the student for further evaluation of scoliosis is crucial to confirm the diagnosis and determine the appropriate management plan. Sending the student home (choice A) without proper assessment and intervention is not the best course of action. Withdrawing the student from all physical activities (choice C) is not necessary and may cause unnecessary distress. Instructing the student not to carry her backpack on her back (choice D) does not address the underlying issue of scoliosis and is not the most important intervention at this point.

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