Nursing Elites

1. In our culturally diverse society, barriers to health care result from:

• A. Prejudice
• B. Different socioeconomic status
• C. Differences in language
• D. All of the above

Correct answer: D

Rationale: In a culturally diverse society, barriers to health care can stem from various factors. These include differences in language, various socioeconomic statuses, and prejudices. These factors can create obstacles for individuals in accessing healthcare services. Therefore, the correct answer is 'All of the above' as all the provided choices contribute to barriers in healthcare access. Choice A, 'Prejudice,' is correct as biases and discrimination can prevent individuals from receiving proper care. Choice B, 'Different socioeconomic status,' is accurate as financial disparities can limit access to healthcare services. Choice C, 'Differences in language,' is also valid as language barriers can hinder effective communication and understanding between patients and healthcare providers.

2. A client who is postoperative is verbalizing pain as a 2 on a pain scale of 0 to 10. Which of the following statements should the nurse identify as an indication that the client understands the preoperative teaching they received about pain management?

• A. ''I think I should take my pain medication more often, since it is not controlling my pain.''
• B. ''Breathing faster will help me keep my mind off of the pain.''
• C. ''It might help me to listen to music while I'm lying in bed.''
• D. ''I don't want to walk today because I have some pain.''

Correct answer: D

Rationale: The correct answer is D because the client is demonstrating an understanding of the preoperative teaching by acknowledging the pain and relating it to the need to rest. Walking may exacerbate the pain, and the client's decision not to walk shows an awareness of their body's signals. Choices A, B, and C are incorrect as they do not reflect a good understanding of pain management. Choice A suggests self-medicating without consulting healthcare providers, choice B focuses on distraction rather than addressing the pain, and choice C offers a coping mechanism but does not address the pain directly.

3. What is the major difference between managers and leaders?

• A. Leaders usually have legitimate power.
• B. Leaders do not necessarily make good managers.
• C. Managers are not always leaders.
• D. Managers always have legitimate power.

Correct answer: D

Rationale: The major difference between managers and leaders is that managers always have legitimate power. This is because managers derive their authority from their position within an organization, giving them legitimate power over subordinates. On the other hand, leaders do not always have legitimate power; their influence may come from various sources such as expertise, charisma, or the ability to inspire others. Choice A is incorrect because not all leaders necessarily have legitimate power. Choice B is incorrect as it is a generalization that leaders do not make good managers, which is not always the case. Choice C is incorrect as there can be managers who are also effective leaders.

4. A few weeks after an 82-year-old with a new diagnosis of type 2 diabetes has been placed on metformin (Glucophage) therapy and taught about appropriate diet and exercise, the home health nurse makes a visit. Which finding by the nurse is most important to discuss with the healthcare provider?

• A. Hemoglobin A1C level is 7.9%.
• B. Last eye exam was 18 months ago.
• C. Glomerular filtration rate is decreased.
• D. Patient has questions about the prescribed diet.

Correct answer: C

Rationale: The most important finding to discuss with the healthcare provider is the decreased glomerular filtration rate. In patients on metformin therapy, monitoring kidney function is crucial as metformin is primarily excreted through the kidneys. A decreased glomerular filtration rate can lead to metformin accumulation in the body, increasing the risk of lactic acidosis, a serious adverse effect. The hemoglobin A1C level being 7.9% indicates poor diabetes control but can be addressed through medication adjustments and lifestyle modifications. The patient needing an eye exam after 18 months is important but not as urgent as discussing the decreased glomerular filtration rate. Patient questions about the prescribed diet can be addressed during the visit without the need for immediate healthcare provider intervention.

5. Which of the following is an example of a tertiary prevention strategy?

• A. Administering childhood vaccinations
• B. Chemotherapy for cancer treatment
• C. Routine screening for hypertension
• D. Physical therapy for stroke rehabilitation

Correct answer: D

Rationale: The correct answer is D: Physical therapy for stroke rehabilitation. Tertiary prevention aims to prevent complications and manage existing conditions to improve the quality of life. Administering childhood vaccinations (A) is an example of primary prevention to prevent the onset of diseases. Chemotherapy for cancer treatment (B) is a form of secondary prevention focusing on early detection and treatment to stop the progression of the disease. Routine screening for hypertension (C) is also a form of secondary prevention to detect and treat hypertension early, preventing further complications.

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