Nursing Elites

1. The multidisciplinary home health care team is discussing a female client diagnosed with Parkinson's disease. The home health care nurse reports the client is getting worse, and her husband is no longer able to care for her in the home. Which action should the home health nurse implement first?

• A. Request a chaplain to counsel the couple.
• B. Assign a home health care aide to provide daily care.
• C. Discuss placing the wife in a nursing home with the husband.
• D. Contact the client's children to discuss the situation.

Correct answer: B

Rationale: In situations where a client's condition worsens and the caregiver is no longer able to provide sufficient care, the first action to implement is to assign a home health care aide to provide daily care. This ensures that the client's immediate needs are met and that they receive proper care and support. Requesting a chaplain for counseling (Choice A) may be beneficial but is not the most urgent action. Discussing placing the wife in a nursing home (Choice C) should only be considered after assessing the client's needs and exploring all other options. Contacting the client's children (Choice D) can be helpful but does not address the immediate need for daily care that the client requires.

2. When caring for a child with Reye's Syndrome, which action should the nurse give the highest priority?

• A. Monitor intake and output
• B. Provide good skin care
• C. Assess level of consciousness
• D. Assist with range of motion

Correct answer: C

Rationale: Assessing the level of consciousness is crucial when caring for a child with Reye's Syndrome. Changes in neurological status can indicate deterioration of the condition, necessitating immediate medical attention. Monitoring intake and output is important but not the highest priority compared to assessing the child's level of consciousness. Providing good skin care and assisting with range of motion are also important aspects of care but take a lower priority than assessing the child's neurological status in this critical condition.

3. The nurse is teaching a 27-year-old client with asthma about the management of their therapeutic regimen. Which statement would indicate the need for additional instruction?

• A. ''I should monitor my peak flow every day.''
• B. ''I should contact the clinic if I am using my medication more often.''
• C. ''I need to limit my exercise, especially activities such as walking and running.''
• D. ''I should learn stress reduction and relaxation techniques.''

Correct answer: C

Rationale: Exercise, especially aerobic activities, is beneficial for clients with asthma as long as it is well-managed. Limiting exercise is not generally recommended unless specifically advised by a healthcare provider, indicating a need for further instruction in this case. Monitoring peak flow, contacting the clinic for increased medication use, and learning stress reduction techniques are all appropriate self-management strategies for asthma, indicating good understanding by the client.

4. Who was the first Filipino nurse supervisor appointed in the Bureau of Health in 1919?

• A. Ms. Carmen del Rosario
• B. Mrs. Genara de Guzman
• C. Mrs. Annie Sand
• D. Mrs. Anastacio Giron-Tupas

Correct answer: D

Rationale: The correct answer is Mrs. Anastacio Giron-Tupas, who was the first Filipino nurse supervisor appointed in the Bureau of Health in 1919. Ms. Carmen del Rosario, Mrs. Genara de Guzman, and Mrs. Annie Sand were not the first Filipino nurse supervisors appointed to this position. Therefore, they are incorrect choices.

5. The nurse is assessing a client with portal hypertension. Which of the following findings would the nurse expect?

• A. Expiratory wheezes
• B. Blurred vision
• C. Ascites
• D. Dilated pupils

Correct answer: C

Rationale: Ascites is a common finding in clients with portal hypertension. Portal hypertension results in increased pressure in the portal vein, leading to the development of ascites, which is the accumulation of fluid in the abdominal cavity. Expiratory wheezes (Choice A) are associated with respiratory conditions. Blurred vision (Choice B) is more commonly linked to eye disorders or neurological issues. Dilated pupils (Choice D) can be related to neurological conditions or drug effects, but not specifically to portal hypertension.

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