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. In terms of CHN practice, how is the nurse in the community trained?

• A. nurse-midwife
• B. practice nursing
• C. generalist in nursing
• D. midwife

Correct answer: C

Rationale: In community health nursing practice, nurses are trained as generalists in nursing. They receive education that equips them to address a wide range of health concerns in the community. Choice A, nurse-midwife, is incorrect as it refers to a specific role focusing on childbirth and maternal health. Choice B, practice nursing, is vague and does not specifically describe the training of community health nurses. Choice D, midwife, is also incorrect as it refers to a specialized role in maternal and newborn care, different from the generalist training of community health nurses.

3. The nurse is caring for a 75-year-old client in congestive heart failure. Which finding suggests that digitalis levels should be reviewed?

• A. Extreme fatigue
• B. Increased appetite
• C. Intense itching
• D. Constipation

Correct answer: A

Rationale: Extreme fatigue can be a sign of digitalis toxicity, especially in older adults, and warrants a review of the client's medication levels and potential adjustment. Increased appetite, intense itching, and constipation are not typically associated with digitalis toxicity and do not directly indicate a need for a review of digitalis levels.

4. What title should be given to this occupational health nurse job description? A registered nurse who establishes a provider network, recommends treatment plans that assure quality and efficacy while controlling costs, monitors outcomes, and maintains communication among all involved.

• A. manager
• B. researcher
• C. case manager
• D. health promotion specialist

Correct answer: C

Rationale: The correct answer is C: case manager. A case manager in healthcare coordinates care, monitors outcomes, and ensures quality and cost-effectiveness. In this job description, the nurse is mainly focused on coordinating care, recommending treatment plans, monitoring outcomes, and maintaining communication among all involved, which aligns with the responsibilities of a case manager. Choices A, B, and D are incorrect because the job description does not primarily involve general management, research, or health promotion specialization.

5. 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.

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