Nursing Elites

1. What is a major concern about the health-care system in the United States?

• A. Emphasis on disease prevention
• B. Quality of care
• C. Collaborative care
• D. Reduction in hospital-acquired drug-resistant infections

Correct answer: B

Rationale: The major concern about the health-care system in the United States is the quality of care provided. While disease prevention and collaborative care are important aspects, the primary focus of concern is ensuring that the care delivered meets high standards in terms of effectiveness, safety, and patient outcomes. Reduction in hospital-acquired drug-resistant infections, although relevant, is not the primary concern when evaluating the overall quality of healthcare services.

2. Select the type of skeletal fracture that is correctly paired with its description.

• A. A complete fracture: The fractured bone penetrates through the skin to the skin surface.
• B. A pathological fracture: A fracture that results from some physical trauma.
• C. A greenstick fracture: This bends but does not fracture the bone.
• D. An avulsion fracture: A fracture that pulls a part of the bone from the tendon or ligament

Correct answer: D

Rationale: The correct answer is D. An avulsion fracture occurs when a part of the bone is pulled away by a tendon or ligament. Choice A is incorrect because it describes an open fracture where the bone penetrates the skin. Choice B is incorrect as a pathological fracture results from an underlying disease weakening the bone, not physical trauma. Choice C is incorrect as a greenstick fracture involves the bone bending but not completely breaking.

3. Which anatomic malformations are associated with Tetralogy of Fallot?

• A. A sub-aortic septal defect, an overriding aorta, left ventricular hypertrophy, and right ventricular outflow
• B. A sub-aortic septal defect, an overriding aorta, right ventricular hypertrophy, and left ventricular outflow
• C. A sub-aortic septal defect, an overriding aorta, pulmonary atresia, and right ventricular outflow
• D. A sub-aortic septal defect, an overriding aorta, right ventricular hypertrophy, and right ventricular outflow

Correct answer: D

Rationale: Tetralogy of Fallot is characterized by a combination of four heart defects: a sub-aortic septal defect, an overriding aorta, right ventricular hypertrophy, and right ventricular outflow obstruction. This leads to mixing of oxygen-poor and oxygen-rich blood, resulting in cyanosis. Therefore, the correct answer is D. Choices A, B, and C are incorrect because they do not accurately describe the specific combination of anatomic malformations seen in Tetralogy of Fallot.

4. A clinical instructor teaches a class for the public about diabetes mellitus. Which individual does the nurse assess as being at highest risk for developing diabetes?

• A. The 50-year-old client who does not engage in any physical exercise
• B. The 56-year-old client who drinks three glasses of wine daily
• C. The 42-year-old client who is 50 pounds overweight
• D. The 38-year-old client who smokes one pack of cigarettes daily

Correct answer: C

Rationale: The 42-year-old client who is 50 pounds overweight is at the highest risk for developing diabetes. Excess weight is a significant risk factor for diabetes as it can lead to insulin resistance and metabolic abnormalities. Choices A, B, and D are also risk factors for diabetes, but being overweight has a stronger association with the development of the condition compared to lack of exercise, excessive alcohol consumption, or smoking.

5. Most water leaves the body by way of the:

• A. Lungs
• B. Intestines
• C. Skin
• D. Kidneys

Correct answer: D

Rationale: Most water leaves the body through the kidneys. The kidneys play a crucial role in filtering waste and excess substances from the blood to form urine, which is then excreted out of the body. Choices A, B, and C are incorrect because while a small amount of water can be lost through respiration, feces, and sweating, the primary organ responsible for regulating water balance and excretion is the kidneys.

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