Nursing Elites

1. While caring for a client with infective endocarditis, the nurse must be alert for signs of pulmonary embolism. Which of the following assessment findings suggests this complication?

• A. Positive Homan's sign
• B. Fever and chills
• C. Dyspnea and cough
• D. Sensory impairment

Correct answer: C

Rationale: The correct answer is C: 'Dyspnea and cough.' Pulmonary embolism often presents with a sudden onset of dyspnea (difficulty breathing) and cough, which are due to the obstruction of blood flow in the pulmonary arteries. Choices A, B, and D are incorrect. Positive Homan's sign is associated with deep vein thrombosis, fever and chills are nonspecific symptoms commonly seen in infective endocarditis, and sensory impairment is not typically indicative of pulmonary embolism.

2. Which of the following is designed to help clients reduce the risk of illness and maintain the maximum level of function?

• A. illness prevention
• B. crisis intervention
• C. rehabilitation
• D. health promotion

Correct answer: D

Rationale: The correct answer is 'D: health promotion.' Health promotion strategies are aimed at helping individuals reduce the risk of illness and maintain their maximum level of function by emphasizing preventive measures, healthy behaviors, and lifestyle choices. Illness prevention (choice A) focuses on specific actions to avoid illness but may not necessarily address overall function. Crisis intervention (choice B) refers to immediate assistance during emergencies rather than long-term prevention. Rehabilitation (choice C) involves restoring function after illness or injury rather than primarily focusing on preventive measures and maintaining maximum function.

3. The healthcare provider is evaluating the health status of a 16-year-old client with a history of Type 1 diabetes. Which laboratory test would provide the most accurate information about long-term blood glucose control?

• A. Blood glucose level
• B. Glycosylated hemoglobin
• C. Urine ketones
• D. Serum insulin level

Correct answer: B

Rationale: The correct answer is B: Glycosylated hemoglobin (HbA1c). Glycosylated hemoglobin provides valuable information about blood glucose control over the past 2-3 months. This test measures the average blood sugar levels during this period, offering a more comprehensive view of long-term glycemic control. Choice A, blood glucose level, reflects the blood sugar concentration at the time of testing and may fluctuate throughout the day. Choice C, urine ketones, indicates the presence of ketones and is more relevant for assessing acute complications like diabetic ketoacidosis. Choice D, serum insulin level, evaluates insulin production and is not a direct indicator of long-term blood glucose control in diabetes management.

4. In combating myths and misconceptions about family planning in the community, what should you do first as a health educator?

• A. Identify the influential leaders of the community
• B. Select an approach to be used in correcting myths and misconceptions
• C. Decide who will be involved in the conference
• D. Identify myths and misconceptions prevailing in the community and their sources

Correct answer: D

Rationale: The correct answer is to identify myths and misconceptions prevailing in the community and their sources. This is the initial step in addressing misconceptions effectively. By understanding the specific myths and where they originate from, a health educator can tailor their approach to correct these misconceptions. Choice A is incorrect because while influential leaders can play a role, identifying myths comes first. Choice B is incorrect as selecting an approach should come after understanding the myths. Choice C is incorrect as deciding who will be involved in a conference is not the primary step in combating myths and misconceptions.

5. The nurse has just admitted a client with severe depression. From which focus should the nurse identify a priority nursing diagnosis?

• A. Nutrition
• B. Elimination
• C. Activity
• D. Safety

Correct answer: D

Rationale: In severe depression, the priority nursing diagnosis is safety. Individuals with severe depression are at risk of self-harm or suicide. Ensuring the client's safety by implementing measures to prevent harm to themselves or others is crucial. While nutrition, elimination, and activity are important aspects of care, ensuring the client's immediate safety takes precedence in this situation.

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