Nursing Elites

1. Which of the following is an example of a positive outcome for one of the Leading Health Indicators of Healthy People 2020?

• A. A community has adopted a no smoking policy.
• B. A rural community has a public transportation system.
• C. The high school dropout rate has decreased by 15%.
• D. A county has decreased its divorce rate by 10%.

Correct answer: A

Rationale: The correct answer is A. A community adopting a no smoking policy is a positive outcome for the Leading Health Indicators of Healthy People 2020 as it promotes a healthier environment by reducing exposure to secondhand smoke and decreasing smoking-related illnesses. Choices B, C, and D do not directly align with the goals of the Leading Health Indicators. While public transportation and reduced dropout rates are beneficial for community well-being, they are not specific examples of Leading Health Indicators. Decreasing divorce rates, while potentially beneficial for family stability, is not a focus area of the Leading Health Indicators.

2. In a long term rehabilitation care unit a client with spinal cord injury complains of a pounding headache. The client is sitting in a wheelchair watching television in the assigned room. Further assessment by the nurse reveals excessive sweating, a splotchy rash, pilomotor erection, facial flushing, congested nasal passages and a heart rate of 50. The nurse should do which action next?

• A. Take the client's respirations, blood pressure (BP), temperature and then pupillary responses
• B. Place the client into the bed and administer the ordered PRN analgesic
• C. Check the client for bladder distention and the client's urinary catheter for kinks
• D. Turn the television off and then assist client to use relaxation techniques

Correct answer: C

Rationale: These symptoms suggest autonomic dysreflexia, often triggered by bladder distention.

3. 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.

4. For whom is the community health nurse primarily responsible?

• A. individuals
• B. populations
• C. families
• D. class E citizens

Correct answer: B

Rationale: Community health nurses are primarily responsible for populations. While they do provide care and support to individuals and families within the community, their focus is on the health and well-being of entire populations. Choice A is incorrect as the primary responsibility is broader than just individuals. Choice C is incorrect as families are part of the population but not the sole focus. Choice D, 'class E citizens', is too specific and not a standard term in public health, making it an incorrect choice.

5. 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.

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