Nursing Elites

1. When providing nursing care to a client receiving oxygen therapy via a nasal cannula, which of the following interventions would be appropriate?

• A. Ensure that adequate mist is supplied
• B. Inspect the nares and ears for skin breakdown
• C. Lubricate the tips of the cannula before insertion
• D. Maintain sterile technique when handling the cannula

Correct answer: B

Rationale: The correct answer is to inspect the nares and ears for skin breakdown. This is important because the nasal cannula can cause skin breakdown due to prolonged use and friction. Ensuring that the skin is intact helps prevent complications. Choice A is incorrect as oxygen therapy via a nasal cannula does not involve mist. Choice C is incorrect as lubricating the tips of the cannula is not a standard practice and may lead to complications. Choice D is incorrect because while cleanliness is important, maintaining sterile technique is not necessary for handling a nasal cannula in this context.

2. The healthcare provider would expect which eating disorder to have the greatest fluctuations in potassium?

• A. Binge eating disorder
• B. Anorexia nervosa
• C. Bulimia
• D. Purge syndrome

Correct answer: C

Rationale: The correct answer is C: Bulimia. Bulimia involves cycles of binge eating and purging, where individuals may induce vomiting or use laxatives and diuretics. These purging behaviors can lead to significant fluctuations in potassium levels due to electrolyte imbalances caused by excessive loss of potassium through vomiting and purging. In contrast, Binge eating disorder (A) does not involve purging behaviors, so it is less likely to cause significant potassium fluctuations. Anorexia nervosa (B) is characterized by severe food restriction rather than purging, leading to a different pattern of electrolyte imbalances. Purge syndrome (D) is not a recognized eating disorder and is not associated with specific patterns of potassium fluctuations seen in bulimia.

3. Building a healthy community is based on the following basic principles except:

• A. concreteness and reasoning to understand and solve problems
• B. human beings do not function independently but as a group
• C. the target of change is not individual or family but community
• D. environmental factors are more basic than institutional factors

Correct answer: D

Rationale: Building a healthy community is indeed based on principles like concreteness, group dynamics, and focusing on community-level change. However, stating that environmental factors are more basic than institutional factors is incorrect. Both environmental and institutional factors play crucial roles in community health. Environmental factors like access to healthcare, clean water, and safe housing are vital, while institutional factors such as healthcare systems, education, and governance also significantly impact community health. Therefore, the correct answer is D, as environmental factors are not more basic than institutional factors.

4. The nurse uses the DRG (Diagnosis Related Group) manual to

• A. Classify nursing diagnoses from the client's health history
• B. Identify findings related to a medical diagnosis
• C. Determine reimbursement for a medical diagnosis
• D. Implement nursing care based on case management protocol

Correct answer: C

Rationale: The DRG manual is used to determine the reimbursement rate for medical diagnoses and treatments under the prospective payment system used by healthcare facilities. Choice A is incorrect because the DRG manual is not used to classify nursing diagnoses, but rather to group medical diagnoses for billing purposes. Choice B is incorrect as the DRG manual is not used to identify findings related to medical diagnoses, but rather to standardize payments for medical services. Choice D is incorrect as the DRG manual is not used to implement nursing care based on case management protocol, but rather to set reimbursement rates.

5. A community health nurse is developing a program to decrease the incidence of Type 2 diabetes in the community. Which of the following interventions should be included?

• A. distributing brochures on managing diabetes
• B. conducting exercise classes at the community center
• C. providing free glucose monitors
• D. offering dietary counseling sessions

Correct answer: B

Rationale: The correct answer is B: conducting exercise classes at the community center. Regular physical activity plays a crucial role in preventing Type 2 diabetes by helping to maintain a healthy weight, improve insulin sensitivity, and regulate blood sugar levels. Distributing brochures (choice A) may raise awareness but might not lead to significant behavior change. Providing free glucose monitors (choice C) focuses on monitoring rather than prevention. Offering dietary counseling sessions (choice D) is important but focusing solely on diet may not address the comprehensive approach needed to prevent Type 2 diabetes.

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