Nursing Elites

1. 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.

2. Which of the following is an example of a modifiable risk factor for chronic diseases?

• A. Age
• B. Gender
• C. Genetic predisposition
• D. Physical inactivity

Correct answer: D

Rationale: Physical inactivity is a modifiable risk factor for chronic diseases because individuals have control over their level of physical activity. By increasing physical activity, the risk of chronic diseases can be reduced. Choices A, B, and C are not modifiable risk factors: Age is a non-modifiable factor, gender is a biological characteristic, and genetic predisposition is inherent and cannot be altered.

3. The nurse is caring for a client admitted to the hospital with right lower lobe (RLL) pneumonia. On assessment, the nurse notes crackles over the RLL. The client has significant pleuritic pain and is unable to take in a deep breath in order to cough effectively.

• A. Impaired gas exchange related to acute infection and sputum production
• B. Ineffective airway clearance related to sputum production and ineffective cough
• C. Ineffective breathing pattern related to acute infection
• D. Anxiety related to hospitalization and role conflict

Correct answer: B

Rationale: The client's inability to effectively clear the airway due to pain and sputum production hinders the cough mechanism, making 'Ineffective airway clearance' the most appropriate nursing diagnosis. Although impaired gas exchange may occur due to the pneumonia, the immediate issue is the inability to clear the airway. 'Ineffective breathing pattern' does not address the specific issue of airway clearance. 'Anxiety' is not the priority when the focus should be on the physical complications of pneumonia.

4. Which of the following statements is not correct regarding family planning?

• A. Family planning services should be made available to those who need them.
• B. It is the responsibility of every parent to determine whether to have children, when, or how many.
• C. Family planning is geared towards individual and family welfare.
• D. The ultimate goal of family planning is to prevent pregnancies.

Correct answer: D

Rationale: The correct answer is D because the ultimate goal of family planning is not solely to prevent pregnancies but to promote individual and family well-being. Family planning encompasses various aspects such as helping individuals and families make informed choices about the number and spacing of their children, access to healthcare services, and overall reproductive health. Option A is correct as making family planning services available to those who need them is essential for promoting reproductive health. Option B is also correct as it emphasizes the role of parents in making decisions about having children. Option C is correct as family planning indeed aims to improve the welfare of individuals and families. Therefore, option D is not correct as the ultimate goal of family planning is not limited to preventing pregnancies, but it includes broader aspects of promoting health and well-being.

5. During the care of a client with Legionnaire's disease, which finding would require the nurse's immediate attention?

• A. Pleuritic pain on inspiration
• B. Dry mucus membranes in the mouth
• C. A decrease in respiratory rate from 34 to 24
• D. Decrease in chest wall expansion

Correct answer: D

Rationale: A decrease in chest wall expansion suggests that the client may be experiencing a serious complication, such as worsening pneumonia or respiratory failure, requiring immediate medical attention. This finding indicates a potential decrease in lung function, which could lead to respiratory distress. Pleuritic pain on inspiration may be related to the disease process but does not indicate an immediate need for intervention. Dry mucus membranes in the mouth may require attention but are not as critical as a decrease in chest wall expansion. A decrease in respiratory rate could be concerning but is not as urgent as a decrease in chest wall expansion, which directly impacts respiratory function.

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