Nursing Elites

1. The nurse is assessing a client with chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse expect?

• A. Decreased anteroposterior diameter
• B. Hyperresonance on percussion
• C. Increased breath sounds
• D. Prolonged expiratory phase

Correct answer: D

Rationale: The correct answer is D: Prolonged expiratory phase. In COPD, there is airflow obstruction leading to difficulty in exhaling air. This results in a prolonged expiratory phase. Choices A, B, and C are incorrect. Decreased anteroposterior diameter is associated with conditions like barrel chest in emphysema, not COPD. Hyperresonance on percussion is typical in conditions like emphysema, not necessarily in COPD. Increased breath sounds are not a typical finding in COPD; instead, diminished breath sounds may be present due to air trapping.

2. What influences health status?

• A. lifestyle choices and community resources
• B. availability of health technology like diagnostic machines
• C. presence of toxic environmental conditions
• D. all of the above

Correct answer: D

Rationale: Health status is influenced by a combination of lifestyle choices, community resources, health technology like diagnostic machines, and environmental conditions. Each of these factors plays a role in determining an individual's overall health. Choice A is correct as lifestyle choices (such as diet, exercise, and smoking habits) and access to community resources (like healthcare facilities, support groups, and recreational spaces) are important determinants of health. Choice B is correct as the availability of health technology, including diagnostic machines, can impact early detection and treatment of health conditions. Choice C is correct as exposure to toxic environmental conditions (such as pollution, contaminated water, or hazardous waste) can have adverse effects on health. Therefore, the correct answer is D because all of these factors collectively influence health status.

3. Tertiary prevention would best be described as:

• A. recovery from physical limitation and psychological regression
• B. health teaching and immunization
• C. rehabilitation of alcoholic and drug dependents
• D. preventing disability and maximum use of remaining capacity

Correct answer: D

Rationale: Tertiary prevention is the stage of prevention that aims at preventing disability and maximizing the use of remaining capacity. Choice A is more aligned with rehabilitation rather than tertiary prevention. Choice B refers to primary prevention by promoting health and preventing diseases. Choice C focuses on rehabilitation specific to alcohol and drug dependence, which is a form of secondary prevention, not tertiary prevention.

4. When assisting a family who fails to take action during a sick member despite suggestions, you will:

• A. explain the consequences of inaction
• B. identify the courses of action open to the family and the resources needed for each
• C. discuss the consequences of each course of action available
• D. influence the family to act on what you think is best for the situation

Correct answer: B

Rationale: When helping a family decide on actions to take, it is essential to identify the courses of action available to them and the resources needed for each. This empowers the family to make informed decisions based on their specific situation. Explaining the consequences of inaction (Choice A) may be necessary but does not provide a range of options. Discussing the consequences of each course of action (Choice C) is important but does not actively guide the family on the available actions. Influencing the family (Choice D) to act based on personal judgment undermines their autonomy and may not lead to the best outcome.

5. What does the infant mortality rate measure?

• A. dying for every thousand of the population
• B. dying from 0-5 years old in every thousand population
• C. dying in the first 4 weeks in every thousand children born alive that year
• D. dying before 1 year old in every thousand children born alive that year

Correct answer: D

Rationale: The infant mortality rate measures the number of deaths occurring before 1 year old per 1000 live births. This is a crucial indicator of a population's health status and access to healthcare for infants. Choices A, B, and C are incorrect because the infant mortality rate specifically focuses on deaths within the first year of life, not the entire population or different age ranges.

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