Nursing Elites

1. To succeed in her health education program, the PHN needs to be adept in:

• A. teaching-learning strategies
• B. providing accurate information
• C. communicating ideas effectively
• D. all of these

Correct answer: D

Rationale: To excel in a health education program, a Public Health Nurse (PHN) must possess a combination of teaching-learning strategies to effectively impart knowledge, provide accurate information to ensure credibility, and communicate ideas effectively to engage and interact with the audience. Therefore, all of these skills are essential for a PHN to succeed in her health education program. Choices A, B, and C are integral components of a successful health education program, making option D the correct answer.

2. As the immediate supervisor of the Rural Health Midwives, the PHN prepares a supervisory plan. Which of the following would be the PHN's activity?

• A. performing needs assessment
• B. listing supervisory activities
• C. identifying the training needs
• D. formulating objectives for supervision

Correct answer: B

Rationale: The correct answer is B: listing supervisory activities. When preparing a supervisory plan, the Public Health Nurse (PHN) needs to list the specific supervisory activities that need to be carried out. This helps in organizing and outlining the tasks that need to be accomplished to ensure effective supervision. Choices A, C, and D are incorrect because although needs assessment, identifying training needs, and formulating objectives are important aspects of supervisory planning, they are not specifically related to the act of preparing a detailed list of supervisory activities.

3. A client with chronic renal failure is receiving erythropoietin (Epogen). The nurse should monitor the client for which of the following side effects?

• A. Hypertension
• B. Hypoglycemia
• C. Hyperkalemia
• D. Hypocalcemia

Correct answer: A

Rationale: The correct answer is A: Hypertension. Erythropoietin can lead to hypertension as a side effect due to its stimulation of red blood cell production, which can increase blood viscosity. This can result in elevated blood pressure. Choices B, C, and D are incorrect. Hypoglycemia is not a common side effect of erythropoietin. Hyperkalemia is more commonly associated with renal failure rather than erythropoietin use. Hypocalcemia is not a typical side effect of erythropoietin administration.

4. A community health RN believes that immunization rates in a lower socioeconomic section of the city are probably below the target set by the state health department. What action should the RN take FIRST to intervene with this health problem?

• A. Take a health history of the members of the community
• B. Initiate an immunization program for the community
• C. Review current epidemiological population data that might document a low immunization rate
• D. Refer all clients to the local health department

Correct answer: C

Rationale: The correct first action for the community health RN to take in this situation is to review current epidemiological population data that might document a low immunization rate. By doing so, the RN can gather evidence to support further intervention strategies. Option A is incorrect because taking a health history would not provide immediate data on immunization rates in the community. Option B is incorrect as initiating an immunization program without confirming the actual immunization rates may not address the specific needs of the community. Option D is incorrect as a blanket referral without assessing the situation may not be the most effective first step.

5. The appropriate order of steps in active management of the third stage of labor includes:

• A. Cord clamping and cutting, controlled cord traction, ergometrine administration, and inspection to ensure the placenta is intact.
• B. Intravenous oxytocin, cord clamping and cutting, and fundal massage.
• C. Intramuscular injection of oxytocin, controlled cord traction with counter traction to the uterus, and uterine massage.
• D. Controlled cord traction, fundal massage, and oxytocin.

Correct answer: C

Rationale: The correct sequence of steps in active management of the third stage of labor includes intramuscular injection of oxytocin to prevent postpartum hemorrhage, controlled cord traction with counter traction to the uterus to facilitate placental delivery, and uterine massage to aid in uterine contraction and prevent excessive bleeding. Choice A is incorrect because ergometrine administration is not routinely recommended in active management. Choice B is incorrect as intravenous oxytocin is not the preferred route of administration. Choice D is incorrect as the order of steps is not accurate.

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