Nursing Elites

1. Which individual has the highest risk of 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 the 60-year-old homeless person who is an alcoholic and smokes. This individual has the highest risk of developing community-acquired pneumonia due to factors such as homelessness, alcoholism, and smoking, which weaken the immune system and make them more susceptible to respiratory infections. Choice A is incorrect as working with underprivileged children, while potentially exposing the individual to various illnesses, does not directly increase the risk of pneumonia. Choice B is less likely as exercise-induced wheezing may suggest asthma but does not directly correlate with pneumonia risk. Choice D, an aerobics instructor who eats only vegetables and skips meals, does not have the same level of risk factors for pneumonia as the homeless person in choice C.

2. A community health nurse is conducting a home visit to assess a family's health needs. What is the first step in this process?

• A. Develop a care plan
• B. Conduct a physical examination
• C. Establish rapport with the family
• D. Provide health education

Correct answer: C

Rationale: Establishing rapport with the family is crucial in the initial stages of a home visit. It helps build trust, open communication channels, and allows the nurse to gain insight into the family's health needs and concerns. Developing a care plan (Choice A) comes after the assessment phase, where information is gathered. Conducting a physical examination (Choice B) is a part of the assessment but typically follows establishing rapport. Providing health education (Choice D) is important but usually occurs after the assessment and care planning stages.

3. Which of the following statements is correct regarding community health nursing?

• A. Evaluation of the health status of individuals and families should be done in consultation with them.
• B. The public health nurse (PHN) who works with communication for 6 can solely determine the needs of the community.
• C. Provision of PHN care is not in any way affected by policies of the agency where the nurse works.
• D. Professional growth and development of the PHN is the responsibility of the Department of Health (DOH).

Correct answer: A

Rationale: The correct statement is that evaluation of the health status of individuals and families should be done in consultation with them. This approach ensures that the assessment is accurate and takes into account the perspectives and concerns of the individuals and families involved. Choice B is incorrect because determining the needs of the community should involve input from various stakeholders, not solely the PHN. Choice C is incorrect as the provision of PHN care can be influenced by the policies of the agency or organization where the nurse works. Choice D is also incorrect as while the DOH may play a role in setting standards, the professional growth and development of a PHN is typically a personal and professional responsibility.

4. Which of the following is not classified as an essential health service?

• A. Provision of eye glasses and dentures for the elderly
• B. Maternal and child care
• C. Basic sanitation and prevention and control of locally endemic diseases
• D. Promotion of proper nutrition, adequate supply of safe water, and health education

Correct answer: A

Rationale: The provision of eyeglasses and dentures for the elderly is not classified as an essential health service. Essential health services typically focus on preventive, promotive, curative, and rehabilitative care that address the primary healthcare needs of individuals and communities. Choices B, C, and D are examples of essential health services as they directly contribute to improving and maintaining the health of populations. Maternal and child care, basic sanitation, disease prevention, nutrition promotion, safe water supply, and health education are essential components of public health initiatives.

5. At a routine health assessment, a client tells the nurse that she is planning a pregnancy in the near future. She asks about preconception diet changes. Which of the statements made by the nurse is best?

• A. Include fibers in your daily diet.
• B. Increase green leafy vegetable intake.
• C. Drink a glass of milk with each meal.
• D. Eat at least 1 serving of fish weekly.

Correct answer: B

Rationale: The correct answer is B: "Increase green leafy vegetable intake." This is the best advice because green leafy vegetables are rich in folic acid, which is essential for fetal development and helps prevent neural tube defects. Choice A is not specific enough and does not address the importance of folic acid. Choice C, drinking milk with each meal, does not provide the necessary folic acid intake. Choice D, eating fish weekly, is not as crucial for preconception diet changes as increasing folic acid intake.

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