Nursing Elites

1. Mark, 9 months old, is given oral rehydration solution because of diarrhea with some dehydration. In your follow-up visit, you observed that Mark's eyes become puffy. Which one of the following would you advise Mark's mother?

• A. continue giving ORS but more slowly
• B. show mother how much solution to give
• C. stop ORS and give plain water or milk
• D. reassess patient to determine how much ORS to give

Correct answer: A

Rationale: In this scenario, observing puffy eyes in a child being treated with oral rehydration solution may indicate fluid overload. Continuing to give ORS but more slowly is the correct course of action as it helps manage hydration without overloading fluids. Choice B is not the best option in this situation as the issue is not about the quantity of the solution, but the rate of administration. Choice C is incorrect because plain water or milk is not a suitable alternative for rehydration in cases of dehydration. Choice D is also incorrect as reassessing the patient does not directly address the issue of puffy eyes, which suggests a need to adjust the administration of ORS.

2. A client with asthma has low-pitched wheezes present on the final half of exhalation. One hour later the client has high-pitched wheezes extending throughout exhalation. This change in assessment indicates to the nurse that the client

• A. Has increased airway obstruction
• B. Has improved airway obstruction
• C. Needs to be suctioned
• D. Exhibits hyperventilation

Correct answer: A

Rationale: The correct answer is A: 'Has increased airway obstruction.' High-pitched wheezes extending throughout exhalation indicate a worsening airway obstruction, leading to increased resistance in the airways. Low-pitched wheezes present on the final half of exhalation may suggest some level of obstruction, but the change to high-pitched wheezes throughout exhalation indicates a progression in the obstruction. Choice B is incorrect as the change in wheeze characteristics signifies deterioration rather than improvement. Choice C is incorrect as suctioning is not indicated based on the wheeze assessment findings. Choice D is incorrect as hyperventilation does not typically present with wheezes and is not supported by the information provided.

3. What is a critical factor in determining community health?

• A. Number of hospitals
• B. Availability of healthcare services
• C. Socioeconomic status
• D. Population density

Correct answer: B

Rationale: The availability of healthcare services is a critical factor in determining community health. While the number of hospitals may contribute to healthcare accessibility, it is the overall availability of healthcare services that encompasses various factors including hospitals, clinics, healthcare providers, and resources. Socioeconomic status and population density are important determinants of health outcomes, but the direct availability of healthcare services plays a more immediate and direct role in promoting community health.

4. A community health nurse is planning a health promotion campaign. What should be the first step?

• A. Developing educational materials
• B. Assessing the needs of the community
• C. Implementing interventions
• D. Evaluating outcomes

Correct answer: B

Rationale: The correct first step in planning a health promotion campaign is to assess the needs of the community. By understanding the community's specific health needs, preferences, and resources, the nurse can tailor the campaign effectively. Developing educational materials (choice A) should come after assessing needs to ensure relevance. Implementing interventions (choice C) and evaluating outcomes (choice D) should also follow the assessment phase to measure the impact of the campaign accurately.

5. An activity designed to diagnose and treat a disease or condition in its earliest stages, before it becomes full-blown, would be classified as:

• A. primary prevention
• B. secondary prevention
• C. tertiary prevention
• D. health education

Correct answer: B

Rationale: The correct answer is B, secondary prevention. Secondary prevention focuses on early diagnosis and intervention to prevent the progression of a disease or condition. This involves detecting and treating the illness in its early stages to reduce its impact. Choice A, primary prevention, aims to prevent the development of a disease or injury before it occurs by promoting healthy behaviors. Choice C, tertiary prevention, involves managing and improving the quality of life of individuals with established conditions to prevent complications and further deterioration. Choice D, health education, refers to providing information and promoting awareness about health issues to enable individuals to make informed decisions and adopt healthy behaviors.

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