Nursing Elites

1. A community health nurse is conducting a program evaluation for a diabetes management class. Which measure best indicates the program's effectiveness?

• A. Number of participants attending each session
• B. Participant satisfaction with the class
• C. Reduction in participants' average blood glucose levels
• D. Improvement in participants' knowledge about diabetes

Correct answer: C

Rationale: The most effective measure to indicate the program's effectiveness in a diabetes management class is the reduction in participants' average blood glucose levels. This measure directly reflects the impact of the program on managing diabetes and improving health outcomes. Choices A and B may provide valuable information but do not directly assess the program's impact on managing diabetes. Choice D, improvement in participants' knowledge about diabetes, is important but may not directly translate into improved diabetes management without actual health outcome measurements like blood glucose levels.

2. A client with a history of peptic ulcer disease is admitted with severe abdominal pain. Which assessment finding requires immediate intervention?

• A. Epigastric tenderness.
• B. Bowel sounds are hypoactive.
• C. The client reports sudden, severe abdominal pain.
• D. Bowel sounds are hyperactive.

Correct answer: C

Rationale: The correct answer is C. Sudden, severe abdominal pain can indicate a perforated ulcer, which is a medical emergency requiring immediate intervention. Epigastric tenderness (choice A) may be expected in a client with peptic ulcer disease but does not necessarily require immediate intervention. Hypoactive bowel sounds (choice B) are concerning but not as urgent as sudden, severe abdominal pain. Hyperactive bowel sounds (choice D) are more indicative of conditions like gastroenteritis rather than a perforated ulcer, making it a less critical finding compared to sudden, severe abdominal pain.

3. A client with a history of epilepsy is admitted with status epilepticus. Which medication should the nurse prepare to administer?

• A. Acetaminophen (Tylenol)
• B. Lorazepam (Ativan)
• C. Phenytoin (Dilantin)
• D. Carbamazepine (Tegretol)

Correct answer: B

Rationale: In the management of status epilepticus, the initial medication of choice is a benzodiazepine such as lorazepam (Ativan) to rapidly terminate the seizure activity. Lorazepam acts quickly and effectively in stopping seizures. Phenytoin (Dilantin) is often used as a second-line agent for status epilepticus, and carbamazepine (Tegretol) is not typically indicated for the acute treatment of status epilepticus. Acetaminophen (Tylenol) is a pain reliever and antipyretic but is not used in the treatment of status epilepticus.

4. A nurse starts classes for clients with type 2 diabetes. Which information would the nurse use as an outcome evaluation for the class?

• A. Parking convenience for attendees continues to be a major concern.
• B. Fasting blood glucose average readings were 20% lower by the end of classes.
• C. Discussion of food exchanges and calories was a well-attended class.
• D. Demonstrating the use of a blood glucose meter was an effective teaching strategy.

Correct answer: B

Rationale: A reduction in fasting blood glucose levels indicates the effectiveness of the diabetes management education provided. Monitoring blood glucose levels is a crucial aspect of diabetes management, and a decrease in average readings signifies improvement in managing blood sugar levels. Choices A, C, and D are not direct outcome evaluations related to the effectiveness of the education provided in managing diabetes. Parking convenience, attendance, and teaching strategies are not direct indicators of the impact on the clients' health outcomes.

5. An older adult client visits the community health clinic and reports the onset of pain, redness, and swelling of the right eye. Which question is most important for the clinic nurse to ask the client?

• A. Do you have any discharge from the eye?
• B. Have you started any new prescriptions?
• C. Are all of your immunizations current?
• D. How often do you wash your hands?

Correct answer: B

Rationale: The most important question for the nurse to ask the client is whether they have started any new prescriptions. New medications can have side effects that include eye issues, so it is crucial to determine if there is a potential link. Asking about discharge from the eye (Choice A) may be relevant but does not address the possibility of medication side effects. Inquiring about immunizations (Choice C) and handwashing frequency (Choice D) is important for overall health but is less directly related to the eye symptoms described by the client.

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