Nursing Elites

1. When drawing blood from the diabetic patient for a glycosylated hemoglobin (HBA1c) test, the nurse explains to the woman that the test is used to determine:

• A. The highest glucose level in the past week.
• B. Her insulin levels.
• C. Glucose levels over the past three months.
• D. Her usual fasting glucose level.

Correct answer: C

Rationale: The glycosylated hemoglobin (HBA1c) test reflects the average blood sugar levels over the past three months. It provides a more comprehensive view of the individual's glucose control compared to a single point-in-time measurement like a fasting glucose level or the highest glucose level in the past week. Choice A is incorrect because it focuses on a single high glucose level rather than the overall control over a period. Choice B is incorrect as HBA1c is not a test for insulin levels. Choice D is incorrect as the HBA1c test does not reflect a single fasting glucose level but rather an average over a more extended period.

2. Which of the following is NOT an appropriate treatment for an 18-year-old woman with severe vaginal bleeding?

• A. Covering the vagina with a trauma dressing.
• B. Administering high concentrations of oxygen.
• C. Placing sterile dressings into the vagina.
• D. Keeping her warm with blankets.

Correct answer: C

Rationale: Placing sterile dressings into the vagina is not an appropriate treatment for severe vaginal bleeding. The correct approach involves applying pressure to the external vaginal area to control bleeding, covering the vagina with a trauma dressing to help with compression, administering high concentrations of oxygen to support oxygenation, and keeping the patient warm with blankets to prevent hypothermia. Placing sterile dressings into the vagina can introduce foreign material, increase the risk of infection, and obstruct proper wound management, making it an incorrect treatment option in this scenario.

3. The nurse is preparing to administer erythromycin eye ointment to a newborn. The mother asks why this is necessary. What is the nurse's best response?

• A. It helps to prevent eye infections caused by bacteria in the birth canal.
• B. It protects the baby's eyes from bright lights in the delivery room.
• C. It prevents the development of jaundice.
• D. It helps the baby see more clearly after birth.

Correct answer: A

Rationale: Erythromycin eye ointment is administered to newborns to prevent eye infections caused by bacteria present in the birth canal. This ointment does not have a direct correlation with protecting the baby's eyes from bright lights, preventing jaundice, or improving the baby's vision clarity post-birth.

4. Use the scenario to answer questions 13-18. A patient has come to the OPD with complaints of anaesthesia and paresthesia of the lower limbs. After laboratory investigations, the doctor has diagnosed the patient with Diabetes Mellitus but failed to specify whether it is type 1 or type 2. Onset of Type 1 diabetes is characterized by:

• A. Occurs after pubertal onset in the majority of cases
• B. Occurs when parents are poor
• C. Occurs at an early age
• D. Occurs after childbirth

Correct answer: A

Rationale: Type 1 diabetes typically occurs after pubertal onset. This form of diabetes is most commonly diagnosed in individuals under the age of 30, with a peak incidence in the mid-teens to early 20s. Puberty is a period of hormonal changes and growth, which can trigger the onset of type 1 diabetes due to the stress it places on the body's insulin-producing cells.

5. A postpartum client is experiencing heavy lochia and a boggy uterus. What should be the nurse's initial action?

• A. Administer a uterotonic medication
• B. Encourage the client to void
• C. Perform fundal massage
• D. Increase the client's fluid intake

Correct answer: C

Rationale: The correct initial action for a postpartum client experiencing heavy lochia and a boggy uterus is to perform fundal massage. Fundal massage helps to firm the uterus and reduce bleeding by promoting uterine contractions, which can assist in preventing postpartum hemorrhage. Administering uterotonic medication may be necessary in some cases but should not be the initial action. Encouraging the client to void and increasing fluid intake can be important interventions but are not the priority in this situation where immediate uterine firmness is needed to control bleeding.

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