Nursing Elites

1. During a visit to the community health clinic, a 45-year-old Native American female, who has a BMI of 35, complains of changes in her vision. Which condition is most important for the RN to be aware of in the client's family history?

• A. Diabetes
• B. Glaucoma
• C. Hypertension
• D. Brain Tumor

Correct answer: A

Rationale: The correct answer is A: Diabetes. Given the client's Native American ethnicity, high BMI, and vision changes, diabetes is the most crucial condition for the nurse to be aware of in the client's family history. Diabetes is strongly associated with vision problems, especially diabetic retinopathy. Glaucoma (choice B) is a condition that affects the optic nerve and can lead to vision loss but is not as directly linked to the client's BMI and ethnic background. Hypertension (choice C) can also impact vision, but in this case, diabetes takes precedence based on the client's profile. Brain tumor (choice D) is less likely to be related to the client's BMI, ethnicity, and vision changes compared to diabetes.

2. BCG vaccine is supplied in:

• A. freeze-dried form in a sealed glass ampule
• B. liquid form in a sealed glass ampule
• C. liquid form in a vial
• D. both 2 and 3

Correct answer: A

Rationale: The correct answer is A. BCG vaccine is commonly supplied in freeze-dried form, not in liquid form. Therefore, choices B and C are incorrect. Option D is also incorrect as the vaccine is not supplied in liquid form in a glass ampule.

3. The nurse is assessing a client with portal hypertension. Which of the following findings would the nurse expect?

• A. Expiratory wheezes
• B. Blurred vision
• C. Ascites
• D. Dilated pupils

Correct answer: C

Rationale: Ascites is a common finding in clients with portal hypertension. Portal hypertension results in increased pressure in the portal vein, leading to the development of ascites, which is the accumulation of fluid in the abdominal cavity. Expiratory wheezes (Choice A) are associated with respiratory conditions. Blurred vision (Choice B) is more commonly linked to eye disorders or neurological issues. Dilated pupils (Choice D) can be related to neurological conditions or drug effects, but not specifically to portal hypertension.

4. The term 'epidemiology' is best defined as the study of:

• A. The causes of disease
• B. The distribution and determinants of health-related states in populations
• C. The treatment and prevention of disease
• D. The healthcare system and its effectiveness

Correct answer: B

Rationale: Epidemiology is the study of the distribution and determinants of health-related states in populations. Choice A is incorrect because epidemiology focuses on more than just causes but also on distribution and determinants. Choice C is incorrect as it specifically relates to public health and not just treatment and prevention. Choice D is incorrect as epidemiology is broader than just focusing on the healthcare system and its effectiveness.

5. The RN is serving on a medical center committee to update goals and protocols based on the national standards. Which goal most directly addresses the Healthy People 2020 initiative?

• A. Reduce ED wait time for indigent clients
• B. Providing transportation for medically challenged clients
• C. Provide access to health services
• D. Refer clients to local health department for medical services

Correct answer: C

Rationale: The correct answer is C: 'Provide access to health services.' This goal most directly addresses the Healthy People 2020 initiative, which aims to improve health care access for all individuals. Option A, 'Reduce ED wait time for indigent clients,' focuses on efficiency rather than access. Option B, 'Providing transportation for medically challenged clients,' addresses a specific need but does not cover overall health service access. Option D, 'Refer clients to local health department for medical services,' involves referral rather than direct access to services.

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