Nursing Elites

1. While assessing an Rh-positive newborn whose mother is Rh-negative, the nurse recognizes the risk for hyperbilirubinemia. Which of the following should be reported immediately?

• A. Jaundice evident at 26 hours
• B. Hematocrit of 55%
• C. Serum bilirubin of 12 mg/dL
• D. Positive Coombs test

Correct answer: C

Rationale: A serum bilirubin level of 12 mg/dL in a newborn is concerning and can indicate a significant risk of hyperbilirubinemia, which requires immediate medical intervention to prevent complications like kernicterus. Jaundice at 26 hours (Choice A) is a symptom, not a laboratory result, and needs monitoring but not an immediate report. Hematocrit of 55% (Choice B) may be elevated but is not indicative of hyperbilirubinemia. A positive Coombs test (Choice D) indicates the presence of antibodies on the newborn's red blood cells but does not directly correlate with the risk of hyperbilirubinemia.

2. Which of the following health behavior choices are essential to promoting health and preventing diseases?

• A. Getting the right kind of food, adequate sleep, physical activity, and effectively handling stress
• B. Stopping smoking and taking vacations
• C. Making sure that all prescription medications are taken properly and at the right time
• D. Avoiding crowds during flu season

Correct answer: A

Rationale: The correct answer is A. Proper nutrition, adequate sleep, engaging in physical activity, and effective stress management are crucial for promoting health and preventing diseases. Choices B, C, and D do not encompass the comprehensive approach needed for overall health and disease prevention. Stopping smoking is important for health but is not the only factor to consider. Taking vacations can contribute to well-being but is not a core health behavior choice. Ensuring proper medication intake is essential for managing specific health conditions but does not cover all aspects of health promotion. Avoiding crowds during flu season is a preventive measure for infectious diseases but is not a fundamental health behavior choice for overall well-being.

3. Care provided by specialists in health facilities such as medical centers, regional, and provincial hospitals falls under which level of care?

• A. Secondary level care
• B. Primary care
• C. Tertiary care
• D. Intermediate care

Correct answer: C

Rationale: Tertiary care is the correct answer because it involves specialized care provided by medical centers and regional or provincial hospitals. Primary care (Choice B) refers to basic healthcare services usually delivered by general practitioners, nurses, and other healthcare professionals. Secondary care (Choice A) involves specialized services provided by medical specialists and other health professionals who generally do not have first contact with patients. Intermediate care (Choice D) is not a recognized level of care in the typical healthcare system hierarchy; it may cause confusion as it's not a standard term used to describe levels of care.

4. The nurse is conducting a process evaluation of a prevention education program for older adults who are at risk for substance abuse. Which data source provides the information the nurse needs to conduct this process evaluation?

• A. client's score on an alcohol screening instrument
• B. results of a urine drug and alcohol screen
• C. most recent community census data
• D. documentation of client education in the nursing record

Correct answer: D

Rationale: Correct! Documentation of client education in the nursing record is the most appropriate data source for conducting a process evaluation of a prevention education program. This documentation provides insight into the educational process, its implementation, and the quality of education delivered. Choices A and B focus on assessing the clients directly for substance abuse, which is different from evaluating the educational process. Choice C, the most recent community census data, is not directly related to evaluating the specific prevention education program for older adults at risk for substance abuse.

5. Iwa, two years old, was brought to the health center because of diarrhea for 4 days. Assessment revealed that Iwa has under-nutrition. Which of the following actions will you take?

• A. Advise the mother to give milk and juices between meals at home
• B. Give nutritious food available at home
• C. Refer to the hospital for proper management
• D. Provide mother with ORS solution and show her how to give the solution

Correct answer: A

Rationale: In the case of a child with under-nutrition and diarrhea, advising the mother to give milk and juices between meals at home is the appropriate action. This helps address the nutritional needs of the child while also providing hydration. Option B, giving nutritious food available at home, may not be sufficient in addressing immediate needs such as dehydration. Option C, referring to the hospital, may be necessary in severe cases but is not the first-line action. Option D, providing ORS solution, is important but does not directly address the under-nutrition concern.

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