Nursing Elites

1. A client with a history of diabetes mellitus is admitted with hypoglycemia. Which finding requires immediate intervention?

• A. Blood glucose of 60 mg/dL.
• B. Heart rate of 100 beats per minute.
• C. Tremors.
• D. Diaphoresis.

Correct answer: C

Rationale: In a client with a history of diabetes mellitus admitted with hypoglycemia, the finding that requires immediate intervention is tremors. Tremors can indicate severe hypoglycemia, which needs prompt attention to prevent complications such as seizures or loss of consciousness. While a blood glucose level of 60 mg/dL is low, the presence of tremors signifies a more urgent situation. A heart rate of 100 beats per minute and diaphoresis are common physiological responses to hypoglycemia and do not necessarily require immediate intervention unless other severe symptoms are present.

2. The nurse is preparing to administer an oral medication to a client with dysphagia. Which action should the nurse take?

• A. Crush the medication and mix it with applesauce.
• B. Have the client drink a full glass of water with the medication.
• C. Administer the medication with a small amount of pudding.
• D. Place the medication at the back of the client's tongue.

Correct answer: C

Rationale: The correct action for the nurse to take when administering oral medication to a client with dysphagia is to administer the medication with a small amount of pudding. This method helps prevent aspiration in clients with dysphagia by ensuring easier swallowing. Crushing the medication and mixing it with applesauce (Choice A) might alter the medication's efficacy. Having the client drink a full glass of water with the medication (Choice B) may not be suitable for a client with dysphagia as it can increase the risk of aspiration. Placing the medication at the back of the client's tongue (Choice D) can also lead to aspiration and is not recommended.

3. The nurse is documenting the medical history of a young adult who was recently diagnosed with type 1 diabetes mellitus. The client smokes 2 packs of cigarettes a day, and his father died of a heart attack at the age of 45. Which annual screening is most important for the nurse to include?

• A. peripheral neuropathy
• B. renal insufficiency
• C. retinopathy
• D. hyperlipidemia

Correct answer: D

Rationale: The most important annual screening for the nurse to include is hyperlipidemia. Given the client's smoking history, family history of premature heart disease, and the increased risk of cardiovascular complications associated with diabetes, screening for hyperlipidemia is crucial. This screening is essential in assessing the client's risk of developing cardiovascular disease, which is a significant concern in this case. Peripheral neuropathy (choice A) is a common long-term complication of diabetes but may not be the most immediate concern in this scenario. Renal insufficiency (choice B) is also a complication of diabetes, but given the client's high cardiovascular risk, hyperlipidemia screening takes priority. Retinopathy (choice C) is an important complication of diabetes affecting the eyes, but in this case, focusing on cardiovascular risk assessment through hyperlipidemia screening is more critical.

4. A public health nurse is developing a campaign to promote breast cancer screening. Which population should be the primary target of this campaign?

• A. women aged 20-30
• B. women aged 30-40
• C. women aged 40-50
• D. women aged 50-60

Correct answer: C

Rationale: The correct answer is women aged 40-50. This age group is at an increased risk for breast cancer and should be the primary target for screening campaigns. Women in this age range are more likely to benefit from regular screening as early detection can lead to better outcomes. Choices A, B, and D are incorrect because women aged 20-30 are generally not recommended for routine screening due to their lower risk, women aged 30-40 have a moderate risk but are not the primary target group, and women aged 50-60 should still be screened but targeting the 40-50 age group is more crucial for early detection and intervention.

5. The public health nurse is evaluating resources in a rural community. Which healthcare resource is most important for the community?

• A. family planning center
• B. accessibility to trauma care
• C. annual health fair
• D. weather-related disaster plan

Correct answer: B

Rationale: In rural areas, accessibility to trauma care is the most critical healthcare resource due to the longer emergency response times. Trauma care can be life-saving in situations where immediate medical attention is required for severe injuries. The other options, such as a family planning center, annual health fair, and weather-related disaster plan, are important but not as crucial as trauma care in addressing urgent health needs in a rural community.

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