Nursing Elites

1. The nurse is preparing to discharge an elderly, recently widowed female client following a mild stroke. At this time she is able to walk with the aid of a walker. As part of the discharge planning, what referral is most important for the nurse to make?

• A. Pastoral care.
• B. Meals-on-Wheels.
• C. Grief support group.
• D. Physical therapy.

Correct answer: B

Rationale: The most important referral for the nurse to make for the elderly, recently widowed female client who had a mild stroke and limited mobility is Meals-on-Wheels. This service will ensure she receives proper nutrition and support given her circumstances. Pastoral care may provide emotional and spiritual support but is not as essential in this scenario. Grief support group could be beneficial but addressing her nutritional needs takes precedence. Physical therapy may be important for rehabilitation but ensuring proper nutrition is more critical at this time.

2. In reviewing the assessment data of a client suspected of having diabetes insipidus, the nurse expects which of the following after a water deprivation test?

• A. Increased edema and weight gain
• B. Unchanged urine specific gravity
• C. Rapid protein excretion
• D. Decreased blood potassium

Correct answer: B

Rationale: After a water deprivation test in a client suspected of having diabetes insipidus, the nurse would expect the urine specific gravity to remain unchanged. This occurs because in diabetes insipidus, the kidneys are unable to concentrate urine, leading to a low urine specific gravity even after water deprivation. Choices A, C, and D are incorrect. Increased edema and weight gain are not typical findings in diabetes insipidus. Rapid protein excretion is not directly related to the condition, and decreased blood potassium is not a common outcome of a water deprivation test for diabetes insipidus.

3. In order to determine what specific health teaching should be appropriate for the people of this municipality, which of the following is the best method to use?

• A. interviewing midwives
• B. reviewing records and reports
• C. studying knowledge, attitudes, and practices of the people
• D. reviewing health statistics

Correct answer: C

Rationale: Studying knowledge, attitudes, and practices of the people is the best method to determine appropriate health teaching for a community. This approach provides valuable insights into the specific needs, beliefs, and behaviors of the population, allowing for tailored and effective health education interventions. Interviewing midwives may offer some insights, but focusing on the broader community is more comprehensive. Reviewing records and reports can provide historical data but may not capture current community needs as effectively as studying current knowledge, attitudes, and practices. Reviewing health statistics is important but may not provide the detailed understanding of community perceptions and behaviors that directly impact health education planning.

4. Which of the following is an example of a modifiable risk factor for chronic diseases?

• A. Age
• B. Gender
• C. Genetic predisposition
• D. Physical inactivity

Correct answer: D

Rationale: Physical inactivity is a modifiable risk factor for chronic diseases because individuals have control over their level of physical activity. By increasing physical activity, the risk of chronic diseases can be reduced. Choices A, B, and C are not modifiable risk factors: Age is a non-modifiable factor, gender is a biological characteristic, and genetic predisposition is inherent and cannot be altered.

5. After 3 days, the nurse notes that James has chest indrawing and stridor. His mother returned him to the health center immediately. The nurse should:

• A. Change the antibiotic to second-line antibiotics
• B. Advise the mother to observe the child and continue giving the antibiotics
• C. Give the first dose of antibiotics and refer urgently
• D. Observe the child at the center

Correct answer: C

Rationale: Chest indrawing and stridor are signs of severe respiratory distress. In this situation, immediate referral is essential. Giving the first dose of antibiotics before referral can help initiate treatment, but urgent referral for further evaluation and management is crucial. Choice A is incorrect because simply changing the antibiotic without assessing the severity of the symptoms and providing urgent care is not appropriate. Choice B is incorrect as advising the mother to observe the child and continue antibiotics delays necessary intervention for a potentially life-threatening condition. Choice D is incorrect as observing the child at the center is not sufficient when signs of severe illness are present.

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