Nursing Elites

1. The nurse is analyzing laboratory values for the assigned clients. Which finding, based on the client's medical history, indicates the need for immediate follow-up?

• A. Client with chronic kidney disease and serum creatinine of 1.6 mg/dL
• B. Client with diabetes mellitus and a glycosylated hemoglobin A1c (HbA1c) of 7.0%
• C. Client with heart failure and a B-type natriuretic peptide (BNP) of 140 pg/mL
• D. Client who is male and has anemia with hemoglobin of 16.5 g/dL and hematocrit of 45%

Correct answer: B

Rationale: An HbA1c of 7.0% in a client with diabetes mellitus indicates poor long-term glucose control, necessitating immediate follow-up. Choice A, chronic kidney disease with a serum creatinine of 1.6 mg/dL, though concerning, does not indicate an immediate need for follow-up. Choice C, heart failure with a BNP of 140 pg/mL, may require monitoring but not immediate follow-up. Choice D, a male client with anemia and normal hemoglobin and hematocrit levels, does not warrant immediate attention based on the provided information.

2. Determining whether the care provided is appropriate and effective in relation to the patient's current physiological and psychological status is a part of which of the following steps for determining and fulfilling the nursing care needs of the patient?

• A. Evaluation
• B. Planning
• C. Implementation
• D. Assessment

Correct answer: A

Rationale: The correct answer is A: Evaluation. Evaluation involves assessing the appropriateness and effectiveness of care provided to the patient. It helps determine if the care aligns with the patient's current physiological and psychological status. Choice B, Planning, refers to developing a plan of care based on assessment data. Choice C, Implementation, involves carrying out the planned interventions. Choice D, Assessment, is the initial step that involves collecting data about the patient's condition.

3. The system used at the division level and forward comprises six basic modules. Which module is composed of four medical specialists and two vehicles?

• A. Patient holding squad
• B. Surgical squad
• C. Ambulance squad
• D. Area support squad

Correct answer: C

Rationale: The correct answer is 'C: Ambulance squad.' The Ambulance Squad is composed of four medical specialists and two vehicles, making it the module described in the question. Choice A, 'Patient holding squad,' is incorrect as it does not match the composition specified. Choice B, 'Surgical squad,' is incorrect as it focuses on surgical rather than general medical support. Choice D, 'Area support squad,' is incorrect as it does not align with the composition of four specialists and two vehicles.

4. The nurse is teaching the client diagnosed with Type 2 diabetes mellitus about diet. Which diet selection indicates the client understands the teaching?

• A. A submarine sandwich, potato chips, and diet cola
• B. Four (4) slices of a supreme thin-crust pizza and milk
• C. Smoked turkey sandwich, celery sticks, and unsweetened tea
• D. A roast beef sandwich, fried onion rings, and a cola

Correct answer: C

Rationale: The correct answer is C because a smoked turkey sandwich with celery sticks and unsweetened tea is a healthier option for someone with Type 2 diabetes mellitus. Turkey is a lean protein source, celery sticks are low in calories and carbs, and unsweetened tea is a better choice than sugary beverages. Choices A, B, and D are incorrect. Choice A includes high-carb and high-sugar items like potato chips and diet cola, which are not ideal for diabetes management. Choice B contains a high-carb pizza and milk, which may not be suitable for controlling blood sugar levels. Choice D includes fried onion rings and cola, which are high in unhealthy fats and sugars, making it a poor choice for a diabetic diet.

5. The client diagnosed with diabetes mellitus type 2 is admitted to the hospital with cellulitis of the right foot secondary to an insect bite. Which intervention should the nurse implement first?

• A. Administer intravenous antibiotics
• B. Apply warm moist packs every two hours
• C. Elevate the right foot on two pillows
• D. Teach the client about skin and foot care

Correct answer: A

Rationale: Administering intravenous antibiotics is the priority intervention in this situation. Cellulitis is a bacterial infection that can spread rapidly, especially in individuals with diabetes. Immediate antibiotic therapy is crucial to prevent the infection from worsening and causing serious complications. Applying warm moist packs, elevating the foot, and teaching the client about skin and foot care are important interventions but should come after initiating antibiotic treatment to address the underlying infection.

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