Nursing Elites

1. From January 1 to 15, 1996, there were 8 cases of Tetanus neonatorum in San Lazaro Hospital. There were two deaths. What is the case fatality ratio of this disease?

• A. 20%
• B. 30%
• C. 28%
• D. 25%

Correct answer: D

Rationale: The case fatality ratio is calculated as (deaths/cases) * 100. In this case, there were 2 deaths out of 8 cases. Therefore, the calculation is (2/8) * 100 = 25%. Choices A, B, and C are incorrect as they do not match the correct calculation.

2. Local health boards were established at the provincial, city, and municipal levels. At the municipal level, the chairman of the board is the:

• A. rural health physician
• B. public health nurse
• C. municipal mayor
• D. chairman of the committee on health

Correct answer: C

Rationale: The correct answer is C, the municipal mayor. In the local health board structure, the municipal mayor chairs the board at the municipal level, overseeing health-related matters in that specific locality. Choices A, B, and D are incorrect because while a rural health physician or a public health nurse may be involved in health-related activities, they do not serve as the chairman of the board at the municipal level. Similarly, the chairman of the committee on health may have a role in health matters, but the municipal mayor holds the position of chairman of the local health board at the municipal level.

3. A community health RN believes that immunization rates in a lower socioeconomic section of the city are probably below the target set by the state health department. What action should the RN take FIRST to intervene with this health problem?

• A. Take a health history of the members of the community
• B. Initiate an immunization program for the community
• C. Review current epidemiological population data that might document a low immunization rate
• D. Refer all clients to the local health department

Correct answer: C

Rationale: The correct first action for the community health RN to take in this situation is to review current epidemiological population data that might document a low immunization rate. By doing so, the RN can gather evidence to support further intervention strategies. Option A is incorrect because taking a health history would not provide immediate data on immunization rates in the community. Option B is incorrect as initiating an immunization program without confirming the actual immunization rates may not address the specific needs of the community. Option D is incorrect as a blanket referral without assessing the situation may not be the most effective first step.

4. During an initial clinic visit, the nurse is taking the history for a client who wants to confirm her pregnancy. The client's last child has a history of low-birth-weight (LBW). Which additional finding is most important for the nurse to consider?

• A. Cigarette smoking.
• B. African American ethnicity.
• C. Poor nutritional status.
• D. Limited maternal education.

Correct answer: A

Rationale: The correct answer is A: Cigarette smoking. Cigarette smoking is a significant risk factor for low birth weight. Smoking during pregnancy reduces the amount of oxygen available to the baby, leading to LBW. Choice B, African American ethnicity, while it may be a risk factor, is not as directly linked to LBW as cigarette smoking. Choice C, poor nutritional status, can contribute to LBW but is not as significant as cigarette smoking in this case. Choice D, limited maternal education, is an important social determinant of health but is not as directly related to LBW as cigarette smoking.

5. The nurse is teaching a client about the healthy use of ego defense mechanisms. An appropriate goal for this client would be

• A. Reduce fear and protect self-esteem
• B. Minimize anxiety and delay apprehension
• C. Avoid conflict and leave unpleasant situations
• D. Increase independence and communicate more effectively

Correct answer: A

Rationale: The correct answer is A: 'Reduce fear and protect self-esteem.' When teaching a client about the healthy use of ego defense mechanisms, the goal is to help the individual manage emotions effectively without denying reality. Using defense mechanisms in a healthy way aims to reduce fear and protect self-esteem while still addressing underlying issues. Choices B, C, and D are incorrect because they do not focus on the core principles of using defense mechanisms in a healthy manner. Minimizing anxiety and delaying apprehension, avoiding conflict and leaving unpleasant situations, and increasing independence and communicating more effectively do not directly align with the goal of utilizing ego defense mechanisms in a constructive way.

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