Nursing Elites

1. Occupational health nursing is concerned with the following except:

• A. educating workers about health
• B. immediate diagnosis of illness prevailing in the work field
• C. appropriate and effective ways of promoting health
• D. planning of administering health services

Correct answer: B

Rationale: Occupational health nursing focuses on educating workers about health, promoting health through appropriate and effective ways, and planning and administering health services in the workplace. Immediate diagnosis of illness prevailing in the work field is typically not the primary role of occupational health nursing, as it usually involves prevention, education, and health promotion rather than diagnosing acute conditions.

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. 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.

4. A 15-year-old client with a lengthy confining illness is at risk for altered growth and development of which task?

• A. Loss of control
• B. Insecurity
• C. Dependence
• D. Lack of trust

Correct answer: C

Rationale: A 15-year-old client with a lengthy confining illness is at risk for altered growth and development of the task of dependence. Prolonged illness and confinement can lead to the development of dependence as the individual may become reliant on others for their care and needs. Choices A, B, and D are incorrect in this context. Loss of control, insecurity, and lack of trust are important factors to consider but are not directly related to the altered growth and development task of dependence due to illness and confinement.

5. A 16-year-old female client returns to the clinic because she is pregnant for the third time by a new boyfriend. Which vaccine should the nurse plan to administer?

• A. MMR
• B. Hepatitis B
• C. Human papillomavirus
• D. Pneumococcal

Correct answer: B

Rationale: The correct answer is B, Hepatitis B. The Hepatitis B vaccine is crucial for pregnant women to prevent transmission of the virus to the baby during childbirth. Option A, MMR (Measles, Mumps, Rubella) vaccine, is not indicated during pregnancy. Option C, Human papillomavirus vaccine, is recommended for prevention of HPV infections but is not specifically indicated during pregnancy. Option D, Pneumococcal vaccine, is important for certain populations but is not the priority vaccine for a pregnant woman in this scenario.

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