Nursing Elites

1. Which finding would be the most characteristic of an acute episode of reactive airway disease?

• A. Auditory gurgling
• B. Inspiratory laryngeal stridor
• C. Auditory expiratory wheezing
• D. Frequent dry coughing

Correct answer: C

Rationale: The correct answer is C: Auditory expiratory wheezing. Expiratory wheezing is a common sign of reactive airway disease, such as asthma, where airways are constricted, making it difficult to expel air from the lungs. Choices A, B, and D are incorrect as they are not typically associated with reactive airway disease. Auditory gurgling may suggest airway secretions or fluid accumulation, inspiratory laryngeal stridor indicates upper airway obstruction, and frequent dry coughing is more commonly seen in conditions like upper respiratory infections or postnasal drip.

2. The delivery of basic health services was decentralized to the local government units. The legal basis for this is embodied in:

• A. RA 7035
• B. EO 119
• C. RA 7160
• D. PD 999

Correct answer: C

Rationale: The correct answer is C, RA 7160. This law, also known as the Local Government Code, decentralizes health services to local government units. RA 7035 is not the legal basis for decentralizing basic health services. EO 119 and PD 999 are also not the correct legal bases for the decentralization of health services.

3. The process by which an individual gains knowledge and skills to improve their health and well-being is known as:

• A. Health literacy
• B. Health education
• C. Health promotion
• D. Health behavior

Correct answer: B

Rationale: The correct answer is B: Health education. Health education is the process through which individuals acquire knowledge and skills to enhance their health and well-being. Health literacy (choice A) refers to the ability to understand and use health information, but it is not the same as the process of gaining knowledge and skills. Health promotion (choice C) involves advocating for health and implementing interventions to improve health outcomes, rather than the individual learning process. Health behavior (choice D) pertains to the actions individuals take regarding their health, not specifically the process of gaining knowledge and skills.

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 RN is planning care at a team meeting for a 2-month-old child in bilateral leg casts for congenital clubfoot. Which of these suggestions by the PN should be considered the priority nursing goal following cast application?

• A. Infant will experience minimal pain
• B. Muscle spasms will be relieved
• C. Mobility will be managed as tolerated
• D. Tissue perfusion will be maintained

Correct answer: D

Rationale: Following cast application for congenital clubfoot in a 2-month-old child, the priority nursing goal should be to maintain tissue perfusion. This is crucial to prevent complications like compartment syndrome and ensure proper healing. While managing pain, relieving muscle spasms, and promoting mobility are important aspects of care, they are secondary to ensuring adequate tissue perfusion in this scenario.

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