Nursing Elites

1. The nurse uses the DRG (Diagnosis Related Group) manual to

• A. Classify nursing diagnoses from the client's health history
• B. Identify findings related to a medical diagnosis
• C. Determine reimbursement for a medical diagnosis
• D. Implement nursing care based on case management protocol

Correct answer: C

Rationale: The DRG manual is used to determine the reimbursement rate for medical diagnoses and treatments under the prospective payment system used by healthcare facilities. Choice A is incorrect because the DRG manual is not used to classify nursing diagnoses, but rather to group medical diagnoses for billing purposes. Choice B is incorrect as the DRG manual is not used to identify findings related to medical diagnoses, but rather to standardize payments for medical services. Choice D is incorrect as the DRG manual is not used to implement nursing care based on case management protocol, but rather to set reimbursement rates.

2. During a visit to the community health clinic, a 45-year-old Native American female, who has a BMI of 35, complains of changes in her vision. Which condition is most important for the RN to be aware of in the client's family history?

• A. Diabetes
• B. Glaucoma
• C. Hypertension
• D. Brain Tumor

Correct answer: A

Rationale: The correct answer is A: Diabetes. Given the client's Native American ethnicity, high BMI, and vision changes, diabetes is the most crucial condition for the nurse to be aware of in the client's family history. Diabetes is strongly associated with vision problems, especially diabetic retinopathy. Glaucoma (choice B) is a condition that affects the optic nerve and can lead to vision loss but is not as directly linked to the client's BMI and ethnic background. Hypertension (choice C) can also impact vision, but in this case, diabetes takes precedence based on the client's profile. Brain tumor (choice D) is less likely to be related to the client's BMI, ethnicity, and vision changes compared to diabetes.

3. Which of the following is designed to help clients reduce the risk of illness and maintain the maximum level of function?

• A. illness prevention
• B. crisis intervention
• C. rehabilitation
• D. health promotion

Correct answer: D

Rationale: The correct answer is 'D: health promotion.' Health promotion strategies are aimed at helping individuals reduce the risk of illness and maintain their maximum level of function by emphasizing preventive measures, healthy behaviors, and lifestyle choices. Illness prevention (choice A) focuses on specific actions to avoid illness but may not necessarily address overall function. Crisis intervention (choice B) refers to immediate assistance during emergencies rather than long-term prevention. Rehabilitation (choice C) involves restoring function after illness or injury rather than primarily focusing on preventive measures and maintaining maximum function.

4. Which of the following statements about breastfeeding is correct?

• A. Breastfeeding within 30 minutes after birth can stimulate breastmilk production
• B. Breastmilk should be started 24 hours after delivery
• C. Breastmilk given exclusively for the first 4 to 6 months of life helps avoid introduction of infection
• D. Breastfeeding should be done as often as the baby wants

Correct answer: C

Rationale: The correct statement about breastfeeding is that breastmilk given exclusively for the first 4 to 6 months of life helps avoid the introduction of infection. This practice is recommended by health experts for optimal infant health. Choice A is incorrect because breastfeeding should ideally start within the first hour after birth to stimulate breastmilk production. Choice B is incorrect because breastmilk should be initiated as soon as possible after delivery, not after 24 hours. Choice D is incorrect because while feeding on demand is generally encouraged, it should also follow a schedule to ensure adequate nutrition and growth for the baby.

5. When the Public Health Nurse assesses needs and plans health interventions for a group of people in coordination with other health professionals, they are demonstrating which of the following features of community health nursing:

• A. CHN involves interdisciplinary collaboration
• B. The use of an epidemiologic approach is an essential part of nursing practice
• C. CHN is oriented towards populations
• D. CHN encourages the client's participation in determining their own health

Correct answer: A

Rationale: The correct answer is A. Interdisciplinary collaboration is a fundamental feature of community health nursing. In this scenario, the nurse works with other health professionals to assess needs and plan interventions for a group of people, emphasizing the importance of teamwork and cooperation. Choice B is incorrect because while epidemiology plays a role in community health nursing, it is not the primary focus of this particular situation. Choice C is incorrect as it describes the population-focused nature of community health nursing, which is related but not directly demonstrated in the given scenario. Choice D is incorrect because while client participation is essential in community health nursing, it is not the primary feature demonstrated in the scenario provided.

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