Nursing Elites

1. The nurse is working in a community health clinic that serves a diverse population. Which of the following actions best demonstrates cultural competence?

• A. Learning about the cultural practices of the clinic's client population
• B. Providing translation services for non-English speaking clients
• C. Treating all clients the same regardless of their background
• D. Encouraging clients to adopt mainstream health practices

Correct answer: A

Rationale: Learning about the cultural practices of the clinic's client population is the best way to demonstrate cultural competence. This action shows respect for the diverse backgrounds of the clients and helps in providing care that is sensitive to their cultural beliefs and practices. Providing translation services (Choice B) is important for effective communication but may not address the deeper aspects of cultural competence. Treating all clients the same (Choice C) may overlook the unique needs that arise from cultural differences. Encouraging clients to adopt mainstream health practices (Choice D) may not be appropriate or respectful of their cultural traditions and preferences.

2. 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.

3. The hospital is planning to downsize and eliminate a number of staff positions as a cost-saving measure. To assist staff in this change process, the nurse manager is preparing for the "unfreezing" phase of change. With this approach and phase the nurse manager should

• A. Discuss with the staff how to deal with any defensive behavior
• B. Explain to the unit staff why change is necessary
• C. Assist the staff during the acceptance of the new changes
• D. Clarify what the changes mean to the community and hospital

Correct answer: B

Rationale: The "unfreezing" phase involves preparing staff for change by explaining the necessity and benefits of the change, helping them to understand and accept it.

4. A client tells the nurse he is fearful of planned surgery because of evil thoughts about a family member. What is the best initial response by the nurse?

• A. Call a chaplain
• B. Deny the feelings
• C. Cite recovery statistics
• D. Listen to the client

Correct answer: D

Rationale: The correct answer is to listen to the client. Listening allows the nurse to establish therapeutic communication, understand the client's fears and concerns, provide emotional support, and help alleviate anxiety. Calling a chaplain (Choice A) may be appropriate if the client requests spiritual support but should not be the initial response. Denying the feelings (Choice B) is dismissive and can hinder trust and communication. Citing recovery statistics (Choice C) is irrelevant and does not address the client's immediate emotional needs.

5. The client with asthma who is sensitive to house dust-mites is being instructed by the nurse. Which information about prevention of asthma episodes would be the most helpful to include during the teaching?

• A. Change the pillow covers every month
• B. Wash bed linens in warm water with a cold rinse
• C. Wash and rinse the bed linens in hot water
• D. Use air filters in the furnace system

Correct answer: C

Rationale: The correct answer is to wash and rinse the bed linens in hot water to help eliminate dust mites, a common trigger for asthma episodes. Washing in hot water is more effective in killing dust mites compared to warm water. Changing pillow covers every month may help but is not as effective as washing bed linens in hot water. Using air filters in the furnace system may improve air quality but does not directly target dust mites on bed linens.

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