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. A community health nurse is developing a program to decrease the incidence of Type 2 diabetes in the community. Which of the following interventions should be included?

• A. distributing brochures on managing diabetes
• B. conducting exercise classes at the community center
• C. providing free glucose monitors
• D. offering dietary counseling sessions

Correct answer: B

Rationale: The correct answer is B: conducting exercise classes at the community center. Regular physical activity plays a crucial role in preventing Type 2 diabetes by helping to maintain a healthy weight, improve insulin sensitivity, and regulate blood sugar levels. Distributing brochures (choice A) may raise awareness but might not lead to significant behavior change. Providing free glucose monitors (choice C) focuses on monitoring rather than prevention. Offering dietary counseling sessions (choice D) is important but focusing solely on diet may not address the comprehensive approach needed to prevent Type 2 diabetes.

3. The RN is making a home visit to a female client with end-stage heart disease. She has a living will and states she will never go back to the hospital. During the visit, the RN notes that the client is pale and SOB while speaking. The RN discovers 3+ edema in both ankles and bilateral pulmonary crackles. Which intervention should the RN implement first?

• A. Order a chest X-ray
• B. Obtain a peripheral O2 saturation reading
• C. Obtain an order for complete blood count
• D. Tell the patient to stay in bed

Correct answer: B

Rationale: Obtaining a peripheral O2 saturation reading is the priority intervention in this scenario. It helps assess the client's oxygenation status quickly, which is crucial in a client with signs of respiratory distress, such as shortness of breath and bilateral pulmonary crackles. Ordering a chest X-ray (Choice A) may be necessary later but does not address the immediate need for oxygen assessment. Obtaining an order for a complete blood count (Choice C) is not the priority in this situation as it does not directly address the client's respiratory distress. Instructing the patient to stay in bed (Choice D) does not address the underlying issue of potential hypoxia and respiratory compromise.

4. As a community health nurse engaged in the process of community empowerment, which action is essential for you to take?

• A. Gathering data from the community
• B. Making decisions for people in the community
• C. Forming partnerships with people in the community
• D. Accepting responsibility for people’s actions

Correct answer: C

Rationale: In the process of community empowerment, forming partnerships with people in the community is essential. This fosters collaboration, engagement, and shared decision-making, enabling the community to identify its needs, resources, and priorities. Gathering data from the community (Choice A) is important for understanding the community's health status but forming partnerships goes beyond data collection by actively involving community members in decision-making. Making decisions for people in the community (Choice B) undermines empowerment as it takes away their autonomy and control. Accepting responsibility for people’s actions (Choice D) is not synonymous with empowerment and can lead to disempowerment by creating dependency rather than fostering self-reliance and self-determination.

5. After accepting the position of school nurse in a public elementary school, what strategy is best for the nurse to use to obtain an overview understanding of the student body?

• A. Review all health records of the students currently enrolled in classes.
• B. Talk with the current members of the parent-teacher association.
• C. Send a survey form to parents of third-grade students.
• D. Conduct a windshield survey of the geographic areas served by the school.

Correct answer: D

Rationale: Conducting a windshield survey is the best strategy for the nurse to obtain an overview understanding of the student body. This method allows the nurse to observe the community, its resources, potential health hazards, and demographic information. Reviewing health records (Choice A) would provide detailed health information but not an overview of the student body. Talking with the parent-teacher association (Choice B) may offer insights but not a comprehensive overview. Sending a survey form to parents (Choice C) may provide specific information but may not capture a broad understanding of the student body.

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