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. A client with acute pancreatitis is receiving total parenteral nutrition (TPN). The nurse should monitor the client for which of the following complications?

• A. Hypoglycemia
• B. Hyperkalemia
• C. Hyperglycemia
• D. Hyponatremia

Correct answer: C

Rationale: The correct answer is C: Hyperglycemia. Total parenteral nutrition (TPN) contains a high glucose content, which can lead to elevated blood sugar levels, resulting in hyperglycemia. Monitoring for hyperglycemia is crucial in clients receiving TPN to prevent complications such as osmotic diuresis, dehydration, and electrolyte imbalances. Choices A, B, and D are incorrect because TPN is more likely to cause hyperglycemia rather than hypoglycemia, hyperkalemia, or hyponatremia.

3. The process by which an individual gains knowledge and skills to improve their health and well-being is known as:

• A. Health literacy
• B. Health education
• C. Health promotion
• D. Health behavior

Correct answer: B

Rationale: The correct answer is B: Health education. Health education is the process through which individuals acquire knowledge and skills to enhance their health and well-being. Health literacy (choice A) refers to the ability to understand and use health information, but it is not the same as the process of gaining knowledge and skills. Health promotion (choice C) involves advocating for health and implementing interventions to improve health outcomes, rather than the individual learning process. Health behavior (choice D) pertains to the actions individuals take regarding their health, not specifically the process of gaining knowledge and skills.

4. The hospital is planning to downsize and eliminate a number of staff positions as a cost-saving measure. To assist staff in this change process, the nurse manager is preparing for the "unfreezing" phase of change. With this approach and phase the nurse manager should

• A. Discuss with the staff how to deal with any defensive behavior
• B. Explain to the unit staff why change is necessary
• C. Assist the staff during the acceptance of the new changes
• D. Clarify what the changes mean to the community and hospital

Correct answer: B

Rationale: The "unfreezing" phase involves preparing staff for change by explaining the necessity and benefits of the change, helping them to understand and accept it.

5. Which of the following is an example of a social determinant of health?

• A. Blood pressure
• B. Genetic mutations
• C. Housing conditions
• D. Age

Correct answer: C

Rationale: The correct answer is C: Housing conditions. Social determinants of health are the conditions in which people are born, grow, live, work, and age. Housing conditions directly impact health outcomes as they can affect exposure to toxins, safety, and overall well-being. Choice A, blood pressure, is a physiological measure and not a social determinant. Choice B, genetic mutations, relates to an individual's genetic makeup and is not influenced by social factors. Choice D, age, is a demographic factor and not a social determinant of health.

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