Nursing Elites

1. While caring for a client with infective endocarditis, the nurse must be alert for signs of pulmonary embolism. Which of the following assessment findings suggests this complication?

• A. Positive Homan's sign
• B. Fever and chills
• C. Dyspnea and cough
• D. Sensory impairment

Correct answer: C

Rationale: The correct answer is C: 'Dyspnea and cough.' Pulmonary embolism often presents with a sudden onset of dyspnea (difficulty breathing) and cough, which are due to the obstruction of blood flow in the pulmonary arteries. Choices A, B, and D are incorrect. Positive Homan's sign is associated with deep vein thrombosis, fever and chills are nonspecific symptoms commonly seen in infective endocarditis, and sensory impairment is not typically indicative of pulmonary embolism.

2. A 16-year-old female client returns to the clinic because she is pregnant for the third time by a new boyfriend. Which vaccine should the nurse plan to administer?

• A. Measles-mumps-rubella.
• B. Hepatitis B.
• C. Human papillomavirus.
• D. Pneumococcal.

Correct answer: B

Rationale: The correct answer is B: Hepatitis B. The Hepatitis B vaccine is crucial for pregnant women as it helps prevent transmission of the virus to the baby during childbirth. Measles-mumps-rubella vaccine (choice A) is not directly related to the current situation of the client being pregnant. Human papillomavirus vaccine (choice C) is recommended for adolescents but is not specifically indicated in this case. Pneumococcal vaccine (choice D) is not a priority in this scenario compared to Hepatitis B, which is crucial for preventing vertical transmission.

3. A community health nurse is planning a health promotion campaign. What should be the first step?

• A. Developing educational materials
• B. Assessing the needs of the community
• C. Implementing interventions
• D. Evaluating outcomes

Correct answer: B

Rationale: The correct first step in planning a health promotion campaign is to assess the needs of the community. By understanding the community's specific health needs, preferences, and resources, the nurse can tailor the campaign effectively. Developing educational materials (choice A) should come after assessing needs to ensure relevance. Implementing interventions (choice C) and evaluating outcomes (choice D) should also follow the assessment phase to measure the impact of the campaign accurately.

4. A client with chronic congestive heart failure should be instructed to contact the home health nurse if which finding occurs?

• A. Weight gain of 2 pounds or more in a 48-hour period
• B. Urinating 4 to 5 times a day
• C. A significant decrease in appetite
• D. Appearance of non-pitting ankle edema

Correct answer: A

Rationale: A rapid weight gain of 2 pounds or more in a 48-hour period may indicate fluid retention and worsening heart failure, requiring prompt medical evaluation and intervention. This finding is crucial in managing chronic congestive heart failure as it signifies a potential exacerbation of the condition. Choices B, C, and D are less concerning in this context. Urinating 4 to 5 times a day is within the normal range for most individuals and may not be directly related to heart failure. A significant decrease in appetite may be due to various factors and might not be an immediate cause for concern in heart failure patients. The appearance of non-pitting ankle edema, although related to heart failure, is a more chronic and less urgent symptom when compared to a rapid weight gain, which requires immediate attention.

5. What is the measure of the number of new cases of a disease in a specific population during a certain time period called?

• A. Prevalence
• B. Incidence
• C. Mortality rate
• D. Morbidity rate

Correct answer: B

Rationale: The correct answer is B, Incidence. Incidence refers to the number of new cases of a disease in a specific population during a certain time period. Prevalence (choice A) refers to the total number of cases of a disease in a population at a specific point in time. Mortality rate (choice C) is the measure of the number of deaths in a particular population due to a specific cause. Morbidity rate (choice D) is a broader term that encompasses the incidence and prevalence of a disease in a population.

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