Nursing Elites

1. Several employees who have a 10-year or longer history of smoking ask the occupational nurse for assistance with smoking cessation. The RN develops a 2-month program that includes weekly group sessions on lifestyle changes and use of OTC products. Which measurement provides the best indication of the program's effectiveness?

• A. Encourage the employees to disclose if they have joined another smoking cessation group.
• B. Ask the employees to inform the group if they stop smoking and if they start back up again.
• C. Survey the employees about their smoking habits.
• D. Observe if the employees are smoking in the designated smoking areas.

Correct answer: C

Rationale: Surveying the employees about their smoking habits provides measurable data on program effectiveness. By collecting data directly from the employees through surveys, the occupational nurse can track changes in smoking habits, frequency, and quantity of cigarettes smoked. This direct feedback allows for a more accurate assessment of the program's impact on smoking cessation. Choices A and B rely on self-disclosure and may not provide reliable or objective data. Choice D does not directly measure changes in smoking habits but rather observes behavior in designated areas, which may not reflect overall smoking cessation progress.

2. As an important tool for planning a community health survey was conducted, the first tangible outcome of collaboration and teamwork with the Local Health Department and its Rural Health Units (RHUs) was seen. This later led to case-finding activities via collection and examination of stools from children for suspected parasitism. Which of the following community nursing diagnoses will guide the Parish Health Team for concrete action?

• A. Parasitism as a foreseeable crisis
• B. Malnutrition as a health deficit
• C. Parasitism as a health deficit
• D. Parasitism as a health threat

Correct answer: D

Rationale: The correct answer is 'Parasitism as a health threat.' This choice accurately describes the ongoing issue of parasitic infections in the community, highlighting the seriousness and urgency of the problem. Choice A ('Parasitism as a foreseeable crisis') is incorrect as it does not emphasize the immediate danger posed by parasitic infections. Choice B ('Malnutrition as a health deficit') is not the most relevant diagnosis considering the context provided. Choice C ('Parasitism as a health deficit') is also incorrect as it fails to capture the level of risk and urgency associated with parasitic infections in this scenario.

3. Which of these tests with frequency would the nurse expect to monitor for the evaluation of clients with poor glycemic control in persons aged 18 and older?

• A. A glycosylated hemoglobin (A1c) should be performed during an initial assessment and during follow-up assessments, which should occur at no longer than 3-month intervals
• B. A glycosylated hemoglobin should be obtained at least twice a year
• C. A fasting glucose and a glycosylated hemoglobin should be obtained at 3-month intervals after the initial assessment
• D. A glucose tolerance test, a fasting glucose, and a glycosylated hemoglobin should be obtained at 6-month intervals after the initial assessment

Correct answer: A

Rationale: Glycosylated hemoglobin (A1c) testing every 3 months is recommended for clients with poor glycemic control to monitor their average blood sugar levels and adjust treatment as necessary. Choice A is correct as it aligns with the guideline of performing A1c testing every 3 months. Choice B is incorrect because testing at least twice a year may not provide adequate monitoring for clients with poor glycemic control. Choice C is incorrect as it only mentions testing at 3-month intervals without specifying the importance of A1c testing. Choice D is incorrect as it includes unnecessary tests like glucose tolerance test and does not emphasize the importance of more frequent A1c monitoring for clients with poor glycemic control.

4. A client is admitted with the diagnosis of myocardial infarction (MI). Which of the following lab values would be consistent with this diagnosis?

• A. Low serum albumin
• B. High serum cholesterol
• C. Abnormally low white blood cell count
• D. Elevated creatinine phosphokinase (CPK)

Correct answer: D

Rationale: The correct answer is D: Elevated creatinine phosphokinase (CPK). Elevated CPK levels indicate muscle damage, including damage to the cardiac muscle, which aligns with the diagnosis of myocardial infarction. Choice A, low serum albumin, is not directly related to myocardial infarction. Choice B, high serum cholesterol, is more associated with conditions like atherosclerosis rather than acute myocardial infarction. Choice C, abnormally low white blood cell count, is typically not a lab value associated with myocardial infarction; instead, it could suggest other conditions like infections or bone marrow issues.

5. At a routine health assessment, a client tells the nurse that she is planning a pregnancy in the near future. She asks about preconception diet changes. Which of the statements made by the nurse is best?

• A. Include fibers in your daily diet.
• B. Increase green leafy vegetable intake.
• C. Drink a glass of milk with each meal.
• D. Eat at least 1 serving of fish weekly.

Correct answer: B

Rationale: The correct answer is B: "Increase green leafy vegetable intake." This is the best advice because green leafy vegetables are rich in folic acid, which is essential for fetal development and helps prevent neural tube defects. Choice A is not specific enough and does not address the importance of folic acid. Choice C, drinking milk with each meal, does not provide the necessary folic acid intake. Choice D, eating fish weekly, is not as crucial for preconception diet changes as increasing folic acid intake.

Similar Questions