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. What is the ability to obtain, process, and understand basic health information and services needed to make appropriate health decisions known as?

• A. Health literacy
• B. Health equity
• C. Health disparity
• D. Health promotion

Correct answer: A

Rationale: Health literacy refers to the ability to obtain, process, and understand basic health information and services necessary to make informed health decisions. It empowers individuals to navigate the healthcare system, understand medical instructions, and advocate for their own health needs. - Choice B, Health equity, is the concept of everyone having a fair opportunity to attain their full health potential and not being disadvantaged due to their social or economic status. - Choice C, Health disparity, refers to differences in health outcomes or access to healthcare between different populations, often influenced by social, economic, or environmental factors. - Choice D, Health promotion, involves efforts to enhance and protect the health of individuals and communities through education, behavior change, and public health initiatives.

3. The nurse is assessing a client with chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse expect?

• A. Decreased anteroposterior diameter
• B. Hyperresonance on percussion
• C. Increased breath sounds
• D. Prolonged expiratory phase

Correct answer: D

Rationale: The correct answer is D: Prolonged expiratory phase. In COPD, there is airflow obstruction leading to difficulty in exhaling air. This results in a prolonged expiratory phase. Choices A, B, and C are incorrect. Decreased anteroposterior diameter is associated with conditions like barrel chest in emphysema, not COPD. Hyperresonance on percussion is typical in conditions like emphysema, not necessarily in COPD. Increased breath sounds are not a typical finding in COPD; instead, diminished breath sounds may be present due to air trapping.

4. During the beginning shift assessment of a client with asthma who is receiving oxygen via nasal cannula at 2 liters per minute, the nurse would be most concerned about which unreported finding?

• A. Pulse oximetry reading of 89%
• B. Crackles at the base of the lungs on auscultation
• C. Rapid shallow respirations with intermittent wheezes
• D. Excessive thirst with a dry cracked tongue

Correct answer: C

Rationale: Rapid, shallow respirations with intermittent wheezes are concerning as they indicate a potential worsening of the client's asthma. This finding suggests airway narrowing, which can lead to respiratory failure. Immediate intervention is required to address this respiratory distress. A pulse oximetry reading of 89% is low and indicates hypoxemia, but the respiratory pattern described in option C takes priority as it directly reflects the client's respiratory status. Crackles at the base of the lungs suggest fluid accumulation, which is important but not as immediately critical as the respiratory distress in asthma. Excessive thirst and a dry cracked tongue may indicate dehydration, which is relevant but not as urgent as the respiratory compromise presented in option C.

5. A key component of primary prevention strategies is:

• A. aggressive interventions
• B. detection
• C. culture
• D. education

Correct answer: D

Rationale: The correct answer is 'D: education.' Education plays a vital role in primary prevention strategies by empowering individuals with knowledge and skills to prevent the onset of diseases. Through education, people can make informed decisions about their health, adopt healthy behaviors, and engage in preventive measures. Choice A, 'aggressive interventions,' is incorrect as primary prevention focuses on proactive measures to avoid the development of diseases rather than aggressive reactive interventions. Choice B, 'detection,' is more aligned with secondary prevention, which involves early identification of diseases. Choice C, 'culture,' while important in shaping health behaviors, is not a key component specifically in primary prevention strategies.

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