Nursing Elites

1. The nurse is planning care for a client with pneumococcal pneumonia. Which of the following would be most effective in removing respiratory secretions?

• A. Administration of cough suppressants
• B. Increasing oral fluid intake to 3000 cc per day
• C. Maintaining bed rest with bathroom privileges
• D. Performing chest physiotherapy twice a day

Correct answer: B

Rationale: Increasing oral fluid intake to 3000 cc per day is the most effective in removing respiratory secretions in a client with pneumococcal pneumonia. Adequate hydration helps thin secretions, making them easier to expectorate. Administration of cough suppressants (Choice A) may hinder the removal of secretions by suppressing the cough reflex. Maintaining bed rest with bathroom privileges (Choice C) is important but does not directly address the removal of respiratory secretions. Performing chest physiotherapy (Choice D) is beneficial for mobilizing secretions but may not be as effective as increasing fluid intake in thinning and facilitating the removal of secretions.

2. As an important tool for planning a community health survey was conducted, the first tangible outcome of collaboration and teamwork with the Local Health Department and its Rural Health Units (RHUs) was seen. This later led to case-finding activities via collection and examination of stools from children for suspected parasitism. Which of the following community nursing diagnoses will guide the Parish Health Team for concrete action?

• A. Parasitism as a foreseeable crisis
• B. Malnutrition as a health deficit
• C. Parasitism as a health deficit
• D. Parasitism as a health threat

Correct answer: D

Rationale: The correct answer is 'Parasitism as a health threat.' This choice accurately describes the ongoing issue of parasitic infections in the community, highlighting the seriousness and urgency of the problem. Choice A ('Parasitism as a foreseeable crisis') is incorrect as it does not emphasize the immediate danger posed by parasitic infections. Choice B ('Malnutrition as a health deficit') is not the most relevant diagnosis considering the context provided. Choice C ('Parasitism as a health deficit') is also incorrect as it fails to capture the level of risk and urgency associated with parasitic infections in this scenario.

3. When caring for premature newborns in an intensive care setting, a nurse carefully monitors oxygen concentration. What is the most common complication of this therapy?

• A. Intraventricular hemorrhage
• B. Retinopathy of prematurity
• C. Bronchopulmonary dysplasia
• D. Necrotizing enterocolitis

Correct answer: B

Rationale: Retinopathy of prematurity is the most common complication in premature infants exposed to high concentrations of oxygen. This condition leads to abnormal blood vessel growth in the retina, which can potentially result in blindness if not managed promptly. Intraventricular hemorrhage, though a significant concern in premature infants, is not directly related to oxygen therapy. Bronchopulmonary dysplasia is primarily associated with mechanical ventilation and oxygen exposure over time, not specifically with oxygen concentration monitoring. Necrotizing enterocolitis is more linked to gastrointestinal issues and is not the most common complication of oxygen therapy in premature newborns.

4. Which of the following statements about CHN is wrong?

• A. CHN synthesizes public health with nursing
• B. CHN emphasizes health
• C. Promoting clients' autonomy is a responsibility of public nursing
• D. CHN makes a unique contribution to health care not by the nature of its practice but where it is practiced

Correct answer: D

Rationale: The statement in option D is incorrect. The unique contribution of Community Health Nursing (CHN) is not only where it is practiced but also by the nature of its practice. CHN's distinct value lies in its approach to care delivery, focusing on preventive care, health promotion, and addressing the needs of specific communities. Options A and B are correct as CHN involves synthesizing public health principles with nursing practice and emphasizes holistic health. Option C is incorrect as promoting clients' autonomy is a fundamental aspect of community health nursing, respecting individuals' rights to make decisions about their health.

5. 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.

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