Nursing Elites

1. 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.

2. The new graduate nurse interviews for a position in a nursing department of a large health care agency, described by the interviewer as having shared governance. Which of these statements best illustrates the shared governance model?

• A. An appointed board oversees any administrative decisions
• B. Nursing departments share responsibility for client outcomes
• C. Staff groups are appointed to discuss nursing practice and client education issues
• D. Non-nurse managers supervise nursing staff in groups of units

Correct answer: B

Rationale: The correct answer is B because shared governance involves nurses and other staff sharing responsibility for decisions related to patient care and outcomes, promoting collaborative practice and shared accountability. Choice A is incorrect as shared governance includes active participation of frontline staff, not just an appointed board. Choice C is incorrect because shared governance goes beyond just discussing issues to actively sharing responsibility for decision-making. Choice D is incorrect as shared governance encourages nurses to have a significant role in decision-making rather than being supervised by non-nurse managers.

3. You organize community groups to participate in community activities. You can BEST motivate participation in the community health development program by:

• A. Conducting group work
• B. Instructing the people to agree with your plans
• C. Allowing the people to exercise decision-making
• D. Assigning people participative roles

Correct answer: C

Rationale: Allowing people to exercise decision-making is the best way to motivate participation in community activities. By involving the community in decision-making processes, you empower them and make them feel valued, which can lead to increased engagement and commitment. Choices A, B, and D do not foster a sense of ownership and empowerment among the community members, which are crucial for sustainable participation in community programs.

4. As a community organizer, the PHN facilitates the planning and implementation of program subjects in the community. In the light of the PHC approach, these programs/projects should be characterized by the following except:

• A. managed by the community leaders/members
• B. managed by non-government organizations for the people to ensure success
• C. compatible with available resources
• D. developmental in nature

Correct answer: B

Rationale: In the context of the PHC approach, programs should be characterized by being managed by community leaders/members (Choice A). This ensures community involvement and ownership. Programs should also be compatible with available resources (Choice C) to be sustainable and effective. Additionally, programs should be developmental in nature (Choice D), focusing on long-term improvements. Choice B is incorrect because programs should not be solely managed by non-government organizations; instead, they should be driven by the community to promote sustainability and empowerment.

5. A community health nurse is planning to implement an outreach program for a community group. Which criteria should the nurse clarify about the program when examining sources for funding?

• A. Focuses on addressing multiple health problems or concerns.
• B. Identifies populations and individuals in need of healthcare services.
• C. Evaluates differences in health services and health status among populations.
• D. Provides healthcare services to community members in local factories, schools, and churches.

Correct answer: B

Rationale: Identifying populations and individuals in need of healthcare services is essential when seeking funding for an outreach program. This criterion helps demonstrate the relevance and impact of the program on specific groups requiring healthcare services. Choice A is incorrect because while addressing multiple health problems is important, identifying the target population in need of services is more critical for funding considerations. Choice C is incorrect as evaluating variations in health services and status, though valuable, is not directly related to securing funding. Choice D is incorrect as offering services in various community locations is a component of the program's implementation, not a criterion for funding.

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