Nursing Elites

1. Mrs. M has had diabetes for seven years. She has worked hard to control her blood glucose levels and watch her dietary intake. Her physician orders a hemoglobin A1C test. Which of the following best describes the action of this test?

• A. The test determines if the client is anemic and needs iron supplements
• B. The test determines if there is excess glucose building up in the urine
• C. The test determines the amount of hemoglobin reaching the liver to support gluconeogenesis
• D. The test determines the amount of hemoglobin that is coated with glucose

Correct answer: D

Rationale: A hemoglobin A1C test, also known as a glycated hemoglobin test, determines the amount of hemoglobin that is coated with glucose. Excess glucose in the bloodstream may cause it to attach to hemoglobin on red blood cells. Because the life of these cells is between 2 and 3 months, the hemoglobin A1C is an accurate measurement of a client's glucose during that time. Choices A, B, and C are incorrect. Choice A relates to anemia and iron supplements, which are not assessed by a hemoglobin A1C test. Choice B mentions excess glucose in the urine, which is typically assessed through a urine glucose test, not the hemoglobin A1C test. Choice C is incorrect as the test is not related to the amount of hemoglobin reaching the liver to support gluconeogenesis; instead, it specifically measures the amount of hemoglobin that is glycated or coated with glucose.

2. A client is found lying on the floor near the bathroom door, stating, 'I thought I could get up on my own.' What information must the nurse document in this situation?

• A. A statement explaining the condition the client was found in, quoting the client's words about the situation
• B. An explanation of how the fall happened and when the physician was notified
• C. An account of the conditions of the room that contributed to the client's fall
• D. A summary of the client's medical history and current medications

Correct answer: A

Rationale: When a fall or injury occurs while under nursing care, it is crucial to document the known aspects of the situation and the response to the injury. In this scenario, the nurse should document the client's condition as found and quote the client's own words about the situation. This helps provide a clear account of the event without implying blame. Options B, C, and D are incorrect because detailing how the fall happened, listing room conditions, or summarizing medical history are not directly relevant to documenting the immediate situation and the client's own words following the fall.

3. Sinusitis is caused by:

• A. Bacteria
• B. Fungus
• C. Virus
• D. Any of the above

Correct answer: D

Rationale: Sinusitis can be caused by bacteria, viruses, or fungi. While bacterial infections are the most common cause, viral or fungal infections can also lead to sinusitis. Therefore, the correct answer is 'Any of the above.' Choices A, B, and C are incorrect because they only represent individual causes of sinusitis, whereas choice D encompasses all possible causes.

4. A client returns from surgery after having a colon resection. The nurse is performing an assessment and notes the wound edges have separated. This condition is called:

• A. Evisceration
• B. Hematoma
• C. Dehiscence
• D. Granulation

Correct answer: C

Rationale: Wound dehiscence occurs when the edges of a wound pull apart. The condition may occur following a surgical procedure if the sutures were deficient. Wound dehiscence may also occur following a wound infection or in cases where a client significantly stretches or overuses the associated tissues. Evisceration refers to the protrusion of internal organs through an open wound. Hematoma is a localized collection of blood outside the blood vessels. Granulation is the formation of new connective tissue and tiny blood vessels on the surface of a wound during the healing process.

5. The priority goal for a family who practices Chinese medicine would be to:

• A. Achieve harmony
• B. Maintain a balance of energy
• C. Respect life
• D. Restore yin and yang

Correct answer: D

Rationale: In Chinese medicine, the concept of yin and yang represents the balance of opposing forces in the body. When there is an imbalance between yin and yang, it can result in illness. Therefore, the priority goal for a family practicing Chinese medicine would be to restore the harmony and balance between yin and yang. Choices A, B, and C are not the priority goal in Chinese medicine. While achieving harmony, maintaining a balance of energy, and respecting life are important aspects of Chinese medicine, the fundamental principle revolves around maintaining the equilibrium of yin and yang for optimal health.

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