Nursing Elites

1. The healthcare provider is assessing a client with a suspected pulmonary embolism. Which finding requires immediate intervention?

• A. Chest pain.
• B. Shortness of breath.
• C. Tachycardia.
• D. Cyanosis.

Correct answer: D

Rationale: Cyanosis is a late sign of hypoxemia and indicates severe oxygen deprivation, necessitating immediate intervention in a client with a suspected pulmonary embolism. Chest pain, shortness of breath, and tachycardia are also concerning symptoms in pulmonary embolism; however, cyanosis signifies critical oxygen deficiency and warrants urgent attention to prevent further complications.

2. The nurse is providing care for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which laboratory result requires immediate intervention?

• A. Serum sodium of 140 mEq/L.
• B. Serum potassium of 4.5 mEq/L.
• C. Serum osmolality of 280 mOsm/kg.
• D. Serum sodium of 130 mEq/L.

Correct answer: D

Rationale: The correct answer is D: Serum sodium of 130 mEq/L. In SIADH, there is excess release of antidiuretic hormone leading to water retention and dilutional hyponatremia. A serum sodium level of 130 mEq/L indicates severe hyponatremia, which can result in neurological symptoms, such as confusion, seizures, and coma. Therefore, immediate intervention is required to prevent further complications. Choice A, a serum sodium of 140 mEq/L, is within the normal range and does not require immediate intervention. Choice B, serum potassium of 4.5 mEq/L, is also within the normal range and is not directly related to SIADH. Choice C, serum osmolality of 280 mOsm/kg, is a measure of the concentration of solutes in the blood and may not be the most critical parameter to address in a client with SIADH and severe hyponatremia.

3. The healthcare professional is developing a community health program to address the high rates of childhood asthma in a neighborhood. Which intervention should the healthcare professional prioritize?

• A. conducting home visits to identify asthma triggers
• B. distributing asthma education materials at schools
• C. holding workshops on asthma management for parents
• D. partnering with local healthcare providers to offer free asthma screenings

Correct answer: A

Rationale: The healthcare professional should prioritize conducting home visits to identify asthma triggers as it is crucial for reducing asthma attacks in children. By identifying triggers in the home environment, interventions can be implemented to create a safer living space for children with asthma. This approach directly addresses the root cause of asthma exacerbations. Distributing asthma education materials at schools is beneficial for raising awareness but may not address individual triggers. Holding workshops on asthma management for parents is valuable for education but does not directly tackle trigger identification. Partnering with local healthcare providers to offer free asthma screenings focuses on detection rather than prevention through trigger identification.

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. 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.

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