Nursing Elites

1. Under the local government code, health services must be developed by the local governments. This means that local health agencies such as health centers/rural health centers must be under the:

• A. municipal government office
• B. barangay health councils
• C. district health office
• D. provincial health office

Correct answer: A

Rationale: The correct answer is A: municipal government office. According to the local government code, local health agencies like health centers and rural health centers are managed by the municipal government office. This is because the municipal government is responsible for providing essential public services within their jurisdiction. Choice B, barangay health councils, is incorrect as they operate at a smaller administrative level than municipal government offices. Choice C, district health office, is not the correct level of government responsible for managing local health agencies. Choice D, provincial health office, is at a higher administrative level than the municipal government office and is not directly responsible for managing local health agencies.

2. While assessing a client in an outpatient facility with a panic disorder, the nurse completes a thorough health history and physical exam. Which finding is most significant for this client?

• A. Compulsive behavior
• B. Sense of impending doom
• C. Fear of flying
• D. Predictable episodes

Correct answer: B

Rationale: The correct answer is B: 'Sense of impending doom.' In panic disorder, a sense of impending doom is a hallmark symptom often experienced by clients. This intense feeling of dread or fear is a key feature of panic attacks. Compulsive behavior (choice A) may be more indicative of obsessive-compulsive disorder rather than panic disorder. Fear of flying (choice C) may be more related to specific phobias rather than panic disorder. Predictable episodes (choice D) do not align with the unpredictable nature of panic attacks.

3. Which of these tests with frequency would the nurse expect to monitor for the evaluation of clients with poor glycemic control in persons aged 18 and older?

• A. A glycosylated hemoglobin (A1c) should be performed during an initial assessment and during follow-up assessments, which should occur at no longer than 3-month intervals
• B. A glycosylated hemoglobin should be obtained at least twice a year
• C. A fasting glucose and a glycosylated hemoglobin should be obtained at 3-month intervals after the initial assessment
• D. A glucose tolerance test, a fasting glucose, and a glycosylated hemoglobin should be obtained at 6-month intervals after the initial assessment

Correct answer: A

Rationale: Glycosylated hemoglobin (A1c) testing every 3 months is recommended for clients with poor glycemic control to monitor their average blood sugar levels and adjust treatment as necessary. Choice A is correct as it aligns with the guideline of performing A1c testing every 3 months. Choice B is incorrect because testing at least twice a year may not provide adequate monitoring for clients with poor glycemic control. Choice C is incorrect as it only mentions testing at 3-month intervals without specifying the importance of A1c testing. Choice D is incorrect as it includes unnecessary tests like glucose tolerance test and does not emphasize the importance of more frequent A1c monitoring for clients with poor glycemic control.

4. The RN is serving on a medical center committee to update goals and protocols based on the national standards. Which goal most directly addresses the Healthy People 2020 initiative?

• A. Reduce ED wait time for indigent clients
• B. Providing transportation for medically challenged clients
• C. Provide access to health services
• D. Refer clients to local health department for medical services

Correct answer: C

Rationale: The correct answer is C: 'Provide access to health services.' This goal most directly addresses the Healthy People 2020 initiative, which aims to improve health care access for all individuals. Option A, 'Reduce ED wait time for indigent clients,' focuses on efficiency rather than access. Option B, 'Providing transportation for medically challenged clients,' addresses a specific need but does not cover overall health service access. Option D, 'Refer clients to local health department for medical services,' involves referral rather than direct access to services.

5. 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.

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