Nursing Elites

1. The community health nurse has been following the care for an adolescent with a history of morbid obesity, asthma, hypertension, and is 22 weeks into a pregnancy. Which of these lab reports sent to the clinic needs to be called to the teen's healthcare provider within the next hour?

• A. Hemoglobin 11 g/dL and calcium 6 mg/dL
• B. Magnesium 0.8 mEq/L and creatinine 3 mg/dL
• C. Blood urea nitrogen 28 mg/dL and glucose 225 mg/dL
• D. Hematocrit 33% and platelets 200,000

Correct answer: B

Rationale: The correct answer is B. The low magnesium level and elevated creatinine suggest possible renal dysfunction, which is concerning, especially in a pregnant client with multiple risk factors such as morbid obesity, asthma, and hypertension. Immediate attention is needed to address the potential renal issues. The other choices do not indicate such urgent conditions. Hemoglobin and calcium levels in choice A are within acceptable ranges. Choice C shows elevated blood urea nitrogen and glucose levels, which may need monitoring but not immediate attention. Choice D's hematocrit and platelet levels are also within normal ranges and do not indicate an urgent issue.

2. Refers to the nurses in the local/national health departments or public schools:

• A. Public health nursing
• B. Public health nurse
• C. Registered midwives
• D. Registered nurses

Correct answer: B

Rationale: The correct term for nurses working in local/national health departments or public schools is 'public health nurse.' This term specifically refers to individual nurses in those settings. Choice A, 'Public health nursing,' is a broader term that refers to the field of nursing focused on improving community health. Choices C and D, 'Registered midwives' and 'Registered nurses,' do not specifically indicate the nurses working in local/national health departments or public schools, making them incorrect.

3. Which of the following statements is correct regarding community health nursing?

• A. Evaluation of the health status of individuals and families should be done in consultation with them.
• B. The public health nurse (PHN) who works with communication for 6 can solely determine the needs of the community.
• C. Provision of PHN care is not in any way affected by policies of the agency where the nurse works.
• D. Professional growth and development of the PHN is the responsibility of the Department of Health (DOH).

Correct answer: A

Rationale: The correct statement is that evaluation of the health status of individuals and families should be done in consultation with them. This approach ensures that the assessment is accurate and takes into account the perspectives and concerns of the individuals and families involved. Choice B is incorrect because determining the needs of the community should involve input from various stakeholders, not solely the PHN. Choice C is incorrect as the provision of PHN care can be influenced by the policies of the agency or organization where the nurse works. Choice D is also incorrect as while the DOH may play a role in setting standards, the professional growth and development of a PHN is typically a personal and professional responsibility.

4. The occurrence of non-communicable diseases (NCDs) is on the rise and is attributed to the changing lifestyle of Filipinos. The major NCDs are cardiovascular diseases (CVDs), cancer, chronic obstructive pulmonary disease (COPD), and diabetes mellitus (DM). The community health nurse can help address these problems. The major risk factors common to the above-mentioned four major NCDs are:

• A. Unhealthy diet, physical inactivity, and smoking
• B. Hypertension, sedentary lifestyle, and poor stress management
• C. Obesity, sedentary lifestyle, and smoking
• D. Unhealthy diet, alcoholism, and sedentary lifestyle

Correct answer: A

Rationale: The correct answer is A: 'Unhealthy diet, physical inactivity, and smoking.' These are major risk factors associated with cardiovascular diseases (CVDs), cancer, chronic obstructive pulmonary disease (COPD), and diabetes mellitus (DM). Unhealthy diet can lead to obesity and other health issues, physical inactivity contributes to various chronic conditions, and smoking is a well-known risk factor for cancer and respiratory diseases. Choice B is incorrect as hypertension is a condition that can result from these risk factors rather than being a risk factor itself. Poor stress management, although important for overall health, is not a major risk factor for the mentioned NCDs. Choice C is incorrect as although obesity is a risk factor, it is not mentioned in the question stem. Choice D is incorrect as alcoholism is not listed among the major NCDs or the common risk factors provided.

5. When discussing hypothyroidism and treatment with the family of a newborn, the nurse should emphasize

• A. Expecting mental retardation in the child is likely
• B. Administering thyroid hormone can prevent problems
• C. This rare problem is always hereditary
• D. Physical growth/development will be delayed

Correct answer: B

Rationale: The correct answer is B. Administering thyroid hormone to a newborn diagnosed with hypothyroidism can prevent developmental delays and mental retardation. This treatment is crucial to ensure optimal growth and development. Choice A is incorrect because with prompt treatment, mental retardation can be prevented. Choice C is incorrect as hypothyroidism can also be acquired and not only hereditary. Choice D is incorrect as physical growth and development can be supported through timely administration of thyroid hormone.

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