Nursing Elites

1. When the Public Health Nurse assesses needs and plans health interventions for a group of people in coordination with other health professionals, they are demonstrating which of the following features of community health nursing:

• A. CHN involves interdisciplinary collaboration
• B. The use of an epidemiologic approach is an essential part of nursing practice
• C. CHN is oriented towards populations
• D. CHN encourages the client's participation in determining their own health

Correct answer: A

Rationale: The correct answer is A. Interdisciplinary collaboration is a fundamental feature of community health nursing. In this scenario, the nurse works with other health professionals to assess needs and plan interventions for a group of people, emphasizing the importance of teamwork and cooperation. Choice B is incorrect because while epidemiology plays a role in community health nursing, it is not the primary focus of this particular situation. Choice C is incorrect as it describes the population-focused nature of community health nursing, which is related but not directly demonstrated in the given scenario. Choice D is incorrect because while client participation is essential in community health nursing, it is not the primary feature demonstrated in the scenario provided.

2. The milk code aims to ensure that:

• A. the public receives accurate information about breastmilk and breastfeeding
• B. health workers do not provide samples of infant formula to pregnant women or mothers of infants
• C. companies consistently recognize the superiority of breastmilk
• D. health workers do not accept any incentives from milk companies

Correct answer: C

Rationale: The correct answer is C because the milk code emphasizes that companies should always acknowledge the superiority of breastmilk over formula. Choice A is incorrect because the focus is not on the public receiving information, but rather on companies recognizing breastmilk's superiority. Choice B is incorrect as it addresses health workers' actions, not the companies' behavior. Choice D is incorrect as the milk code is primarily concerned with regulating companies' practices, not health workers' acceptance of incentives.

3. During the care of a client with Legionnaire's disease, which finding would require the nurse's immediate attention?

• A. Pleuritic pain on inspiration
• B. Dry mucus membranes in the mouth
• C. A decrease in respiratory rate from 34 to 24
• D. Decrease in chest wall expansion

Correct answer: D

Rationale: A decrease in chest wall expansion suggests that the client may be experiencing a serious complication, such as worsening pneumonia or respiratory failure, requiring immediate medical attention. This finding indicates a potential decrease in lung function, which could lead to respiratory distress. Pleuritic pain on inspiration may be related to the disease process but does not indicate an immediate need for intervention. Dry mucus membranes in the mouth may require attention but are not as critical as a decrease in chest wall expansion. A decrease in respiratory rate could be concerning but is not as urgent as a decrease in chest wall expansion, which directly impacts respiratory function.

4. A client with asthma has low-pitched wheezes present on the final half of exhalation. One hour later the client has high-pitched wheezes extending throughout exhalation. This change in assessment indicates to the nurse that the client

• A. Has increased airway obstruction
• B. Has improved airway obstruction
• C. Needs to be suctioned
• D. Exhibits hyperventilation

Correct answer: A

Rationale: The correct answer is A: 'Has increased airway obstruction.' High-pitched wheezes extending throughout exhalation indicate a worsening airway obstruction, leading to increased resistance in the airways. Low-pitched wheezes present on the final half of exhalation may suggest some level of obstruction, but the change to high-pitched wheezes throughout exhalation indicates a progression in the obstruction. Choice B is incorrect as the change in wheeze characteristics signifies deterioration rather than improvement. Choice C is incorrect as suctioning is not indicated based on the wheeze assessment findings. Choice D is incorrect as hyperventilation does not typically present with wheezes and is not supported by the information provided.

5. The nurse understands that the primary goal of the occupational health program is:

• A. curative care of workers/employees
• B. birth and death rates
• C. disease trends
• D. social environmental conditions

Correct answer: A

Rationale: The primary goal of an occupational health program is to provide curative care to workers/employees. This includes preventing and treating work-related illnesses and injuries, promoting workplace safety, and ensuring the well-being of employees in their work environment. Choice B, birth and death rates, is not directly related to the primary goal of an occupational health program. Choice C, disease trends, may be a focus of public health programs but is not the primary goal of an occupational health program. Choice D, social environmental conditions, while important for overall health, is not the primary goal of an occupational health program which is more focused on the health and safety of workers in their work settings.

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