Nursing Elites

1. James is an 18-month-old child who has had a cough for 7 days with no general danger signs, a temperature of 37.5°C, and a respiratory rate of 41 breaths per minute. How will you classify James' breathing?

• A. Slow breathing
• B. Fast breathing
• C. Normal breathing
• D. Very fast breathing

Correct answer: C

Rationale: The correct answer is 'Normal breathing.' A respiratory rate of 41 breaths per minute is considered normal for an 18-month-old child. Choices A, B, and D are incorrect because a respiratory rate of 41 breaths per minute falls within the normal range for a child of James' age and does not indicate slow, fast, or very fast breathing.

2. When teaching a responsible family member how to perform a certain procedure for the patient, what is the best approach?

• A. Perform all these steps
• B. Arrange for the practice of the procedure
• C. Describe the procedure
• D. Demonstrate the procedure

Correct answer: D

Rationale: The best approach when teaching a responsible family member a procedure for the patient is to demonstrate the procedure. By demonstrating, the family member can visually see how it is done, making it easier for them to understand and replicate. This hands-on approach is more effective than just describing the procedure (choice C) or arranging for practice (choice B) without a visual demonstration. Performing all the steps (choice A) may not be practical or necessary when the goal is to teach someone else how to do it.

3. With an alert of an internal disaster and the need for beds, the charge nurse is asked to list clients who are potential discharges within the next hour. Which client should the charge nurse select?

• A. An elderly client who has had type 2 diabetes for over 20 years, admitted with diabetic ketoacidosis 24 hours ago
• B. An adolescent admitted the prior night with Tylenol intoxication
• C. A middle-aged client with an internal automatic defibrillator and complaints of 'passing out at unknown times' admitted yesterday
• D. A school-age child diagnosed with suspected bacterial meningitis and was admitted at the change of shifts

Correct answer: A

Rationale: The correct answer is A because a client with diabetic ketoacidosis (DKA) that is being well-managed and has shown improvement within 24 hours is more stable and can be considered for discharge sooner than those with more acute or unstable conditions. Choice B is incorrect as Tylenol intoxication may require further monitoring and intervention. Choice C is incorrect as a client with an automatic defibrillator and episodes of passing out needs careful evaluation and monitoring. Choice D is incorrect as suspected bacterial meningitis is a serious condition that typically requires a longer hospital stay for treatment and observation.

4. A school nurse is assessing a child who has frequent absences from school due to asthma. Which of the following is the priority nursing action?

• A. Teaching the child how to use an inhaler
• B. Assessing the child's asthma management plan
• C. Discussing the importance of school attendance with the parents
• D. Referring the child to a pulmonologist

Correct answer: B

Rationale: The correct answer is to assess the child's asthma management plan. This is the priority action as it allows the nurse to evaluate the current treatment regimen, identify any gaps or areas for improvement, and ensure that the plan is being effectively implemented. Teaching the child how to use an inhaler (Choice A) may be important but should come after assessing the management plan. Discussing the importance of school attendance with the parents (Choice C) is secondary to ensuring proper asthma management. Referring the child to a pulmonologist (Choice D) may be necessary but is not the priority at this stage; first, the nurse needs to evaluate the current plan in place.

5. Which of the following is a key component of community-based participatory research?

• A. Conducting research in a laboratory setting
• B. Involving community members in the research process
• C. Focusing solely on quantitative data
• D. Ignoring community input

Correct answer: B

Rationale: The correct answer is B: 'Involving community members in the research process.' Community-based participatory research emphasizes the active involvement of community members in all aspects of the research process, from identifying research questions to interpreting and disseminating results. Choice A is incorrect because community-based participatory research typically takes place in real-world settings, not in laboratories. Choice C is incorrect because community-based participatory research values a mix of quantitative and qualitative data. Choice D is incorrect because community input is essential in this research approach.

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