Nursing Elites

1. Under the present system, which of the following is the local government unit responsible for?

• A. Operation and maintenance of health facilities
• B. All of these activities
• C. Implementation of health programs/projects
• D. Delivery of health services

Correct answer: B

Rationale: Under the present system, the local government unit is responsible for all the listed activities. This includes the operation and maintenance of health facilities, implementation of health programs/projects, and delivery of health services. Therefore, choice B, 'All of these activities,' is the correct answer. Choices A, C, and D are incorrect because they are all responsibilities that fall under the local government unit's jurisdiction as well.

2. A public health nurse can say that she is beginning to achieve her goal of more optimal health for her community when:

• A. people learn self-care
• B. people become involved in determining health care policy
• C. all these indicators are present
• D. people assume responsibility for their own health

Correct answer: C

Rationale: Achieving optimal health for a community involves multiple factors and indicators. For a public health nurse to begin achieving this goal, it is essential that all relevant indicators are present, not just one or a few. While choices A, B, and D are important components of promoting community health, optimal health for a community encompasses a comprehensive approach where all indicators are considered and addressed. Therefore, the correct answer is C.

3. Which client has the highest risk for developing community-acquired pneumonia?

• A. a 40-year-old first-grade teacher who works with underprivileged children
• B. a 75-year-old retired secretary with exercise-induced wheezing
• C. a 60-year-old homeless person who is an alcoholic and smokes
• D. a 35-year-old aerobics instructor who skips meals and eats only vegetables

Correct answer: C

Rationale: The correct answer is C because homeless individuals who are alcoholics and smoke have a higher risk of developing community-acquired pneumonia due to factors like poor living conditions, compromised immune systems, and increased exposure to infections. Choice A is less likely as the teacher's profession, while involving contact with children, may not pose as high a risk as the factors in choice C. Choice B may have respiratory issues but does not have the same risk factors as choice C. Choice D, the aerobics instructor, may have a healthy lifestyle but skipping meals and a restrictive diet do not directly correlate with a higher risk of pneumonia compared to the risk factors in choice C.

4. On admission to the psychiatric unit, the client is trembling and appears fearful. The nurse’s initial response should be to

• A. Give the client orientation materials and review the unit rules and regulations
• B. Introduce oneself and accompany the client to their room
• C. Take the client to the day room and introduce them to the other clients
• D. Ask the nursing assistant to get the client’s vital signs and complete the admission search

Correct answer: B

Rationale: In situations where a client is trembling and fearful upon admission to a psychiatric unit, it is essential to prioritize building trust and reducing anxiety. By introducing oneself and accompanying the client to their room, the nurse can establish a therapeutic relationship, provide a sense of security, and address the client's immediate emotional needs. Choices A, C, and D are not the most appropriate initial responses as they do not directly address the client's emotional state or focus on establishing a supportive relationship.

5. In a long term rehabilitation care unit a client with spinal cord injury complains of a pounding headache. The client is sitting in a wheelchair watching television in the assigned room. Further assessment by the nurse reveals excessive sweating, a splotchy rash, pilomotor erection, facial flushing, congested nasal passages and a heart rate of 50. The nurse should do which action next?

• A. Take the client's respirations, blood pressure (BP), temperature and then pupillary responses
• B. Place the client into the bed and administer the ordered PRN analgesic
• C. Check the client for bladder distention and the client's urinary catheter for kinks
• D. Turn the television off and then assist client to use relaxation techniques

Correct answer: C

Rationale: These symptoms suggest autonomic dysreflexia, often triggered by bladder distention.

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