Nursing Elites

1. The nurse is assessing a client with chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse expect?

• A. Decreased anteroposterior diameter
• B. Hyperresonance on percussion
• C. Increased breath sounds
• D. Prolonged expiratory phase

Correct answer: D

Rationale: The correct answer is D: Prolonged expiratory phase. In COPD, there is airflow obstruction leading to difficulty in exhaling air. This results in a prolonged expiratory phase. Choices A, B, and C are incorrect. Decreased anteroposterior diameter is associated with conditions like barrel chest in emphysema, not COPD. Hyperresonance on percussion is typical in conditions like emphysema, not necessarily in COPD. Increased breath sounds are not a typical finding in COPD; instead, diminished breath sounds may be present due to air trapping.

2. Which of these tests with frequency would the nurse expect to monitor for the evaluation of clients with poor glycemic control in persons aged 18 and older?

• A. A glycosylated hemoglobin (A1c) should be performed during an initial assessment and during follow-up assessments, which should occur at no longer than 3-month intervals
• B. A glycosylated hemoglobin should be obtained at least twice a year
• C. A fasting glucose and a glycosylated hemoglobin should be obtained at 3-month intervals after the initial assessment
• D. A glucose tolerance test, a fasting glucose, and a glycosylated hemoglobin should be obtained at 6-month intervals after the initial assessment

Correct answer: A

Rationale: Glycosylated hemoglobin (A1c) testing every 3 months is recommended for clients with poor glycemic control to monitor their average blood sugar levels and adjust treatment as necessary. Choice A is correct as it aligns with the guideline of performing A1c testing every 3 months. Choice B is incorrect because testing at least twice a year may not provide adequate monitoring for clients with poor glycemic control. Choice C is incorrect as it only mentions testing at 3-month intervals without specifying the importance of A1c testing. Choice D is incorrect as it includes unnecessary tests like glucose tolerance test and does not emphasize the importance of more frequent A1c monitoring for clients with poor glycemic control.

3. The nurse is performing a physical assessment on a client with insulin-dependent diabetes mellitus. Which client complaint calls for immediate nursing action?

• A. Diaphoresis and shakiness
• B. Reduced sensation in the lower leg
• C. Intense thirst and hunger
• D. Painful hematoma on thigh

Correct answer: A

Rationale: Diaphoresis and shakiness are classic signs of hypoglycemia in a client with insulin-dependent diabetes mellitus. Hypoglycemia is a medical emergency that requires immediate intervention to prevent further complications. The nurse should address this complaint promptly by providing a fast-acting source of glucose to raise the client's blood sugar levels. Reduced sensation in the lower leg may indicate peripheral neuropathy, which is a common complication of diabetes but does not require immediate action unless there are signs of injury. Intense thirst and hunger are symptoms of hyperglycemia, which also requires intervention but not as urgently as hypoglycemia. A painful hematoma on the thigh may require assessment and management, but it is not as urgent as addressing hypoglycemia.

4. Which bioterrorism agent poses a high risk for use as a potential biological weapon due to its ability to be readily transmitted through several portals of entry?

• A. Anthrax.
• B. Smallpox.
• C. Botulism.
• D. Tularemia.

Correct answer: A

Rationale: The correct answer is Anthrax. Anthrax is a high-risk bioterrorism agent because it can be readily transmitted through multiple portals of entry such as inhalation, ingestion, or skin contact. This makes it a significant concern for use as a biological weapon. Smallpox, though highly contagious, is not known for multiple portals of entry like Anthrax. Botulism is a potent toxin but is not as easily transmissible through various routes as Anthrax. Tularemia, while a serious bacterial infection, does not have the same ease of transmission through multiple portals of entry as Anthrax.

5. Which of the following qualifications is not required for a Nurse Supervisor at the provincial level?

• A. BSN, RN
• B. at least 3 years experience
• C. Master's in public health
• D. at least 5 years experience in public health

Correct answer: B

Rationale: The correct answer is B because the qualifications for a Nurse Supervisor at the provincial level include a BSN, RN, and a Master's in public health, along with a minimum of 5 years of experience in public health. Choice B, which states 'at least 3 years experience,' is incorrect as the requirement is for at least 5 years of experience in public health. Choices A, C, and D are necessary qualifications for a Nurse Supervisor at the provincial level based on the provided information.

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