Nursing Elites

1. 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.

2. Care provided by specialists in health facilities such as medical centers, regional, and provincial hospitals falls under which level of care?

• A. Secondary level care
• B. Primary care
• C. Tertiary care
• D. Intermediate care

Correct answer: C

Rationale: Tertiary care is the correct answer because it involves specialized care provided by medical centers and regional or provincial hospitals. Primary care (Choice B) refers to basic healthcare services usually delivered by general practitioners, nurses, and other healthcare professionals. Secondary care (Choice A) involves specialized services provided by medical specialists and other health professionals who generally do not have first contact with patients. Intermediate care (Choice D) is not a recognized level of care in the typical healthcare system hierarchy; it may cause confusion as it's not a standard term used to describe levels of care.

3. What is the main objective of the Expanded Program on Immunization (EPI)?

• A. Provide healthcare to all individuals
• B. Reduce child mortality
• C. Eliminate vaccine-preventable diseases
• D. Promote healthy lifestyles

Correct answer: C

Rationale: The main objective of the Expanded Program on Immunization (EPI) is to eliminate vaccine-preventable diseases. While providing healthcare to all individuals and reducing child mortality are important goals, the primary focus of EPI is specifically on preventing diseases through immunization. Promoting healthy lifestyles, although beneficial, is not the primary aim of the EPI.

4. The Healthy People project is designed to:

• A. track health care trends to anticipate insurance liabilities, especially for poor and urban populations
• B. demonstrate that social factors have a significant impact on individual and community health
• C. follow health indicators such as activity, substance use, mental health, and environmental issues
• D. demonstrate that access to health care in the United States is adequate for all populations

Correct answer: C

Rationale: The Healthy People project is designed to follow health indicators such as activity, substance use, mental health, and environmental issues to improve public health outcomes. Choice A is incorrect because the project focuses on public health indicators rather than insurance liabilities. Choice B is incorrect as the project actually acknowledges the significant impact of social factors on health. Choice D is incorrect because one of the main goals of the Healthy People project is to identify and address disparities in access to healthcare, not to demonstrate that access is adequate for all populations.

5. What is usually the first contact between community members and other levels of health facilities called?

• A. Secondary level health care
• B. Primary health care
• C. Tertiary level care
• D. Intermediate level care

Correct answer: B

Rationale: The correct answer is B: Primary health care. Primary health care is the initial point of contact between community members and the healthcare system. This level of care focuses on preventive and primary treatment services. Choices A, C, and D are incorrect because secondary, tertiary, and intermediate care levels are more specialized and are usually accessed after primary care, depending on the complexity of the health issue.

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