Nursing Elites

1. The increasing number of people who must learn to live with chronic illness in the community implies the need for the PHN to plan and implement a program on:

• A. communicable disease control
• B. health education
• C. child survival
• D. environmental education

Correct answer: B

Rationale: The correct answer is B: health education. Health education is crucial for individuals dealing with chronic illnesses as it helps them learn how to manage their conditions effectively. Communicable disease control (choice A) focuses on preventing the spread of infectious diseases, which is not directly related to managing chronic conditions. Child survival (choice C) pertains to initiatives aimed at reducing child mortality rates, which is not directly related to addressing chronic illnesses. Environmental education (choice D) involves raising awareness about environmental issues, which is also not directly related to helping individuals live with chronic illnesses.

2. A client with chronic renal failure is receiving erythropoietin (Epogen). The nurse should monitor the client for which of the following side effects?

• A. Hypertension
• B. Hypoglycemia
• C. Hyperkalemia
• D. Hypocalcemia

Correct answer: A

Rationale: The correct answer is A: Hypertension. Erythropoietin can lead to hypertension as a side effect due to its stimulation of red blood cell production, which can increase blood viscosity. This can result in elevated blood pressure. Choices B, C, and D are incorrect. Hypoglycemia is not a common side effect of erythropoietin. Hyperkalemia is more commonly associated with renal failure rather than erythropoietin use. Hypocalcemia is not a typical side effect of erythropoietin administration.

3. As a supervisor, you plan to conduct a seminar in response to the midwife's training need for skills in community diagnosis. Which is an appropriate method to use to enable midwives to apply the knowledge they will gain in actual practice?

• A. lecture
• B. problem-solving
• C. group discussion
• D. nominal group technique

Correct answer: B

Rationale: Problem-solving is an effective method to enable midwives to apply the knowledge gained in actual practice. By engaging in problem-solving activities during the seminar, midwives can enhance their critical thinking skills and directly apply the information to real-life scenarios they may encounter in community diagnosis. Choice A (lecture) is less effective as it primarily involves passive listening and may not provide the hands-on experience needed for practical application. Choice C (group discussion) can be helpful for sharing perspectives but may not directly translate to practical application as problem-solving would. Choice D (nominal group technique) focuses more on generating ideas and reaching consensus rather than hands-on application of knowledge.

4. As the immediate supervisor of the Rural Health Midwives, the PHN prepares a supervisory plan. Which of the following would be the PHN's activity?

• A. performing needs assessment
• B. listing supervisory activities
• C. identifying the training needs
• D. formulating objectives for supervision

Correct answer: B

Rationale: The correct answer is B: listing supervisory activities. When preparing a supervisory plan, the Public Health Nurse (PHN) needs to list the specific supervisory activities that need to be carried out. This helps in organizing and outlining the tasks that need to be accomplished to ensure effective supervision. Choices A, C, and D are incorrect because although needs assessment, identifying training needs, and formulating objectives are important aspects of supervisory planning, they are not specifically related to the act of preparing a detailed list of supervisory activities.

5. A client with chronic congestive heart failure should be instructed to contact the home health nurse if which finding occurs?

• A. Weight gain of 2 pounds or more in a 48-hour period
• B. Urinating 4 to 5 times a day
• C. A significant decrease in appetite
• D. Appearance of non-pitting ankle edema

Correct answer: A

Rationale: A rapid weight gain of 2 pounds or more in a 48-hour period may indicate fluid retention and worsening heart failure, requiring prompt medical evaluation and intervention. This finding is crucial in managing chronic congestive heart failure as it signifies a potential exacerbation of the condition. Choices B, C, and D are less concerning in this context. Urinating 4 to 5 times a day is within the normal range for most individuals and may not be directly related to heart failure. A significant decrease in appetite may be due to various factors and might not be an immediate cause for concern in heart failure patients. The appearance of non-pitting ankle edema, although related to heart failure, is a more chronic and less urgent symptom when compared to a rapid weight gain, which requires immediate attention.

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