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. When designing a community health project based on a report provided by the World Health Organization that describes healthcare problems in the United States, which healthcare issue should the nurse prioritize the highest when planning the project?

• A. Overuse of diagnostic technology.
• B. Government-based health insurance.
• C. The neonatal and infant mortality rates.
• D. Number of people without access to health care.

Correct answer: C

Rationale: The neonatal and infant mortality rates should be given the highest priority when planning the project because they are critical indicators of the overall health and healthcare system's effectiveness. High neonatal and infant mortality rates signify underlying issues in prenatal care, access to healthcare services, and quality of care for newborns and infants. Choice A, overuse of diagnostic technology, though important, may not be as critical as addressing neonatal and infant mortality rates. Choice B, government-based health insurance, is significant but may not directly impact neonatal and infant mortality rates. Choice D, the number of people without access to healthcare, is a crucial issue, but addressing neonatal and infant mortality rates should take precedence due to their immediate impact on the health and well-being of the most vulnerable population.

3. A child and his family were exposed to Mycobacterium tuberculosis about 2 months ago. To confirm the presence or absence of an infection, it is most important for all family members to have a

• A. Chest x-ray
• B. Blood culture
• C. Sputum culture
• D. PPD intradermal test

Correct answer: D

Rationale: The PPD (purified protein derivative) intradermal test is the standard screening method for detecting tuberculosis infection. It helps identify individuals who have been infected with Mycobacterium tuberculosis. A chest x-ray (Choice A) is used to assess the extent of active disease, not for screening purposes. Blood culture (Choice B) is not typically used for tuberculosis screening. Sputum culture (Choice C) is used to confirm active tuberculosis in symptomatic individuals, not for initial screening purposes.

4. What is a key component of a successful smoking cessation program?

• A. Providing nicotine replacement therapy
• B. Offering surgical interventions
• C. Conducting regular health screenings
• D. Promoting alcohol consumption

Correct answer: A

Rationale: The correct answer is A. Providing nicotine replacement therapy is a key component of smoking cessation programs as it helps individuals manage nicotine withdrawal symptoms. Nicotine replacement therapy includes options like nicotine gum, patches, lozenges, or inhalers. Choice B, offering surgical interventions, is incorrect as smoking cessation programs primarily focus on behavioral and pharmacological interventions rather than surgical procedures. Choice C, conducting regular health screenings, is also incorrect as it is not a direct key component of smoking cessation programs. Choice D, promoting alcohol consumption, is not only incorrect but counterproductive, as it can be detrimental to overall health and hinder smoking cessation efforts.

5. The nurse is teaching a community group about risks of cardiovascular disease. Several clients ask the nurse to determine their risk. Which client should the nurse identify as having the greatest risk for cardiovascular disease?

• A. A male with a serum cholesterol level of 199 mg/dl.
• B. A female with a serum cholesterol level of 201 mg/dl.
• C. A male with a low-density lipoprotein (LDL) level of 200 mg/dl.
• D. A female with a low-density lipoprotein (LDL) level of 160 mg/dl.

Correct answer: C

Rationale: The correct answer is C. A male with a high LDL level (200 mg/dl) has a significant risk for cardiovascular disease. High levels of LDL cholesterol are associated with an increased risk of atherosclerosis and heart disease. Choices A, B, and D have serum cholesterol levels that are slightly elevated but are not as specific or directly linked to cardiovascular risk as high LDL levels. Therefore, the client with the high LDL level is at the greatest risk for cardiovascular disease.

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