Nursing Elites

1. A client with a history of seizures is receiving phenytoin (Dilantin). The nurse should monitor the client for which of the following side effects?

• A. Hypertension
• B. Hyperglycemia
• C. Gingival hyperplasia
• D. Hypokalemia

Correct answer: C

Rationale: The correct answer is C: Gingival hyperplasia. Phenytoin can cause gingival hyperplasia, characterized by an overgrowth of gum tissue. It is important for the nurse to monitor the client for this side effect as it can lead to oral health issues. Choices A, B, and D are incorrect. Phenytoin does not typically cause hypertension, hyperglycemia, or hypokalemia as common side effects.

2. Which ethnic group has the highest risk for diabetes?

• A. African Americans
• B. Hispanic Americans
• C. Asian Americans
• D. Native Americans

Correct answer: D

Rationale: Native Americans have the highest risk for diabetes compared to other ethnic groups. This is due to genetic predisposition, lifestyle factors, and limited access to healthcare. African Americans, Hispanic Americans, and Asian Americans also have an increased risk of developing diabetes, but statistically, Native Americans have the highest prevalence of the disease. Therefore, choices A, B, and C are incorrect.

3. The home health nursing director is conducting an educational program for registered nurses and practical nurses about Medicare reimbursement. To obtain payment for Medicare services, what must be included in the client's record?

• A. A prescription from the healthcare provider for each visit made.
• B. Documentation of a skilled care service provided during the visit.
• C. A copy of the client's health history and social security card.
• D. A record of the preventative healthcare services provided during the visit.

Correct answer: B

Rationale: The correct answer is B: Documentation of skilled care services is required for Medicare reimbursement. Medicare reimbursement is based on the provision of skilled care services, not on prescriptions or preventative healthcare services. Including a copy of the client's health history and social security card is not a requirement for Medicare reimbursement.

4. What influences health status?

• A. lifestyle choices and community resources
• B. availability of health technology like diagnostic machines
• C. presence of toxic environmental conditions
• D. all of the above

Correct answer: D

Rationale: Health status is influenced by a combination of lifestyle choices, community resources, health technology like diagnostic machines, and environmental conditions. Each of these factors plays a role in determining an individual's overall health. Choice A is correct as lifestyle choices (such as diet, exercise, and smoking habits) and access to community resources (like healthcare facilities, support groups, and recreational spaces) are important determinants of health. Choice B is correct as the availability of health technology, including diagnostic machines, can impact early detection and treatment of health conditions. Choice C is correct as exposure to toxic environmental conditions (such as pollution, contaminated water, or hazardous waste) can have adverse effects on health. Therefore, the correct answer is D because all of these factors collectively influence health status.

5. Which of the following statements about TB treatment is INCORRECT?

• A. Combination of 3-4 anti-TB drugs is the treatment of choice
• B. Single drug therapy is appropriate
• C. Treatment renders patients non-infectious and cured
• D. Tuberculosis is a curable disease

Correct answer: B

Rationale: The correct answer is B. Single drug therapy is not appropriate for TB due to the risk of developing resistance. The most effective approach to TB treatment is a combination of 3-4 anti-TB drugs. This combination helps to prevent the development of drug resistance and improve treatment outcomes. Choice C is correct as TB treatment, when completed successfully, renders patients non-infectious and cured. Choice D is also correct as tuberculosis is indeed a curable disease with appropriate treatment. Therefore, the incorrect statement is B.

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