Nursing Elites

1. The nurse is caring for a 75-year-old client in congestive heart failure. Which finding suggests that digitalis levels should be reviewed?

• A. Extreme fatigue
• B. Increased appetite
• C. Intense itching
• D. Constipation

Correct answer: A

Rationale: Extreme fatigue can be a sign of digitalis toxicity, especially in older adults, and warrants a review of the client's medication levels and potential adjustment. Increased appetite, intense itching, and constipation are not typically associated with digitalis toxicity and do not directly indicate a need for a review of digitalis levels.

2. As a community Health Nurse, you are a change agent. Which of the following roles must you play to succeed as a change agent?

• A. information provider
• B. information seeker
• C. motivator
• D. leader

Correct answer: B

Rationale: To succeed as a change agent, being an information seeker is crucial. While being an information provider, motivator, and leader are important roles, actively seeking information is fundamental to understanding the community's needs, concerns, and challenges before implementing effective changes. This active information seeking helps in making informed decisions and developing strategies that address the specific issues faced by the community. Therefore, the correct choice is B. Choices A, C, and D are also important roles but may not be as fundamental as actively seeking information.

3. What is the main objective of the Expanded Program on Immunization (EPI)?

• A. Provide healthcare to all individuals
• B. Reduce child mortality
• C. Eliminate vaccine-preventable diseases
• D. Promote healthy lifestyles

Correct answer: C

Rationale: The main objective of the Expanded Program on Immunization (EPI) is to eliminate vaccine-preventable diseases. While providing healthcare to all individuals and reducing child mortality are important goals, the primary focus of EPI is specifically on preventing diseases through immunization. Promoting healthy lifestyles, although beneficial, is not the primary aim of the EPI.

4. 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.

5. 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.

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