Nursing Elites

1. A 67-year-old client is admitted with substernal chest pain with radiation to the jaw. His admitting diagnosis is Acute Myocardial Infarction (MI). The priority nursing diagnosis for this client during the immediate 24 hours is

• A. Constipation related to immobility
• B. High risk for infection
• C. Impaired gas exchange
• D. Fluid volume deficit

Correct answer: C

Rationale: The correct answer is C: Impaired gas exchange. In a client with an acute myocardial infarction, impaired gas exchange is a priority nursing diagnosis due to compromised heart function, which affects oxygenated blood circulation. Close monitoring and interventions are crucial to ensure adequate oxygenation. Choices A, B, and D are incorrect: A) Constipation related to immobility is not the priority in this acute situation; B) High risk for infection is not the immediate concern related to the client's primary diagnosis; D) Fluid volume deficit, while important, is not the priority compared to addressing impaired gas exchange in acute MI.

2. A client with acute pancreatitis is receiving total parenteral nutrition (TPN). The nurse should monitor the client for which of the following complications?

• A. Hypoglycemia
• B. Hyperkalemia
• C. Hyperglycemia
• D. Hyponatremia

Correct answer: C

Rationale: The correct answer is C: Hyperglycemia. Total parenteral nutrition (TPN) contains a high glucose content, which can lead to elevated blood sugar levels, resulting in hyperglycemia. Monitoring for hyperglycemia is crucial in clients receiving TPN to prevent complications such as osmotic diuresis, dehydration, and electrolyte imbalances. Choices A, B, and D are incorrect because TPN is more likely to cause hyperglycemia rather than hypoglycemia, hyperkalemia, or hyponatremia.

3. How do integrative models of human health see health factors?

• A. derived solely from physical phenomena
• B. intertwined and interactive, with multiple components such as physical, psychological, and social
• C. generally being attributable to psychosocial problems in individuals
• D. effective only when combined and integrated with alternative therapies

Correct answer: B

Rationale: Integrative models of human health consider health factors as intertwined and interactive, involving various components like physical, psychological, and social aspects. This holistic approach recognizes that health is influenced by a combination of factors, not just physical phenomena (choice A). While psychosocial problems can impact health, integrative models go beyond attributing health solely to psychosocial issues (choice C). Additionally, integrative models do not imply that health is effective only when combined with alternative therapies (choice D), but rather emphasize the interconnectedness of various health components.

4. In combating myths and misconceptions about family planning in the community, what should you do first as a health educator?

• A. Identify the influential leaders of the community
• B. Select an approach to be used in correcting myths and misconceptions
• C. Decide who will be involved in the conference
• D. Identify myths and misconceptions prevailing in the community and their sources

Correct answer: D

Rationale: The correct answer is to identify myths and misconceptions prevailing in the community and their sources. This is the initial step in addressing misconceptions effectively. By understanding the specific myths and where they originate from, a health educator can tailor their approach to correct these misconceptions. Choice A is incorrect because while influential leaders can play a role, identifying myths comes first. Choice B is incorrect as selecting an approach should come after understanding the myths. Choice C is incorrect as deciding who will be involved in a conference is not the primary step in combating myths and misconceptions.

5. Which of the following would be the best strategy for the nurse to use when teaching insulin injection techniques to a newly diagnosed client with diabetes?

• A. Provide written pre and post tests
• B. Ask questions during practice
• C. Allow another diabetic to assist
• D. Observe a return demonstration

Correct answer: D

Rationale: The best strategy for the nurse to use when teaching insulin injection techniques to a newly diagnosed client with diabetes is to observe a return demonstration. This method ensures that the client can correctly perform the technique. Providing written pre and post tests (choice A) may assess knowledge but not application. Asking questions during practice (choice B) may help with understanding but not necessarily with the actual performance. Allowing another diabetic to assist (choice C) may provide peer support but does not guarantee correct technique demonstration.

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