Nursing Elites

1. The nurse is teaching a client about the healthy use of ego defense mechanisms. An appropriate goal for this client would be

• A. Reduce fear and protect self-esteem
• B. Minimize anxiety and delay apprehension
• C. Avoid conflict and leave unpleasant situations
• D. Increase independence and communicate more effectively

Correct answer: A

Rationale: The correct answer is A: 'Reduce fear and protect self-esteem.' When teaching a client about the healthy use of ego defense mechanisms, the goal is to help the individual manage emotions effectively without denying reality. Using defense mechanisms in a healthy way aims to reduce fear and protect self-esteem while still addressing underlying issues. Choices B, C, and D are incorrect because they do not focus on the core principles of using defense mechanisms in a healthy manner. Minimizing anxiety and delaying apprehension, avoiding conflict and leaving unpleasant situations, and increasing independence and communicating more effectively do not directly align with the goal of utilizing ego defense mechanisms in a constructive way.

2. When admitting a client with Parkinson's disease to the home healthcare service, which nursing diagnosis should have priority in planning care?

• A. Impaired physical mobility related to muscle rigidity and weakness.
• B. Ineffective coping related to depression and dysfunction due to disease progression.
• C. Ineffective breathing pattern related to respiratory muscle weakness.
• D. Fear related to constant possibility of experiencing seizures.

Correct answer: A

Rationale: The correct answer is A: 'Impaired physical mobility related to muscle rigidity and weakness.' For a client with Parkinson's disease, impaired physical mobility is a priority nursing diagnosis because of the characteristic motor symptoms such as muscle rigidity, bradykinesia, and postural instability. Addressing impaired physical mobility is crucial to enhance the client's quality of life. Choices B, C, and D are not the priority nursing diagnoses for a client with Parkinson's disease. Ineffective coping (Choice B) and fear of seizures (Choice D) may be concerns but are not the priority. Ineffective breathing pattern (Choice C) is not typically associated with Parkinson's disease.

3. The healthcare provider is evaluating the health status of a 16-year-old client with a history of Type 1 diabetes. Which laboratory test would provide the most accurate information about long-term blood glucose control?

• A. Blood glucose level
• B. Glycosylated hemoglobin
• C. Urine ketones
• D. Serum insulin level

Correct answer: B

Rationale: The correct answer is B: Glycosylated hemoglobin (HbA1c). Glycosylated hemoglobin provides valuable information about blood glucose control over the past 2-3 months. This test measures the average blood sugar levels during this period, offering a more comprehensive view of long-term glycemic control. Choice A, blood glucose level, reflects the blood sugar concentration at the time of testing and may fluctuate throughout the day. Choice C, urine ketones, indicates the presence of ketones and is more relevant for assessing acute complications like diabetic ketoacidosis. Choice D, serum insulin level, evaluates insulin production and is not a direct indicator of long-term blood glucose control in diabetes management.

4. Under the present system, which of the following is the local government unit responsible for?

• A. Operation and maintenance of health facilities
• B. All of these activities
• C. Implementation of health programs/projects
• D. Delivery of health services

Correct answer: B

Rationale: Under the present system, the local government unit is responsible for all the listed activities. This includes the operation and maintenance of health facilities, implementation of health programs/projects, and delivery of health services. Therefore, choice B, 'All of these activities,' is the correct answer. Choices A, C, and D are incorrect because they are all responsibilities that fall under the local government unit's jurisdiction as well.

5. The nurse is screening children at a local community health clinic for infectious diseases. Which child is at highest risk for hepatitis B virus (HBV)?

• A. A newborn.
• B. A 3-year-old.
• C. A 7-year-old.
• D. An 11-year-old.

Correct answer: A

Rationale: The correct answer is A: a newborn. Newborns are at the highest risk for HBV due to potential transmission from the mother. The hepatitis B virus can be transmitted from an infected mother to her baby during childbirth. Choices B, C, and D are incorrect because newborns have a higher risk due to this mode of transmission, making them more vulnerable compared to older children.

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