Nursing Elites

1. The family health care plan includes the following listed in sequence:

• A. objective, statement of the problem, intervention, and evaluation
• B. objectives, intervention, evaluation, and statement of the problem
• C. evaluation, statement of the problems, objectives, and interventions
• D. statement of the problems, objectives, intervention, and evaluation

Correct answer: D

Rationale: In a family health care plan, the correct sequence should start with identifying the problems (statement of the problems), setting objectives, planning interventions, and then evaluating the outcomes. This sequence ensures a logical and structured approach to healthcare planning. Choices A, B, and C are incorrect as they do not follow the logical order of healthcare planning steps.

2. The client with asthma who is sensitive to house dust-mites is being instructed by the nurse. Which information about prevention of asthma episodes would be the most helpful to include during the teaching?

• A. Change the pillow covers every month
• B. Wash bed linens in warm water with a cold rinse
• C. Wash and rinse the bed linens in hot water
• D. Use air filters in the furnace system

Correct answer: C

Rationale: The correct answer is to wash and rinse the bed linens in hot water to help eliminate dust mites, a common trigger for asthma episodes. Washing in hot water is more effective in killing dust mites compared to warm water. Changing pillow covers every month may help but is not as effective as washing bed linens in hot water. Using air filters in the furnace system may improve air quality but does not directly target dust mites on bed linens.

3. 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.

4. A client comes into the community health center upset and crying stating, “I will die of cancer now that I have this disease.” And then the client hands the nurse a paper with one word written on it: 'Pheochromocytoma.' Which response should the nurse state initially?

• A. 'Pheochromocytomas usually aren't cancerous (malignant). But they may be associated with cancerous tumors in other endocrine glands such as the thyroid (medullary carcinoma of the thyroid).'
• B. 'This problem is diagnosed by blood and urine tests that reveal elevated levels of adrenaline and noradrenaline.'
• C. 'Computerized tomography (CT) or magnetic resonance imaging (MRI) are used to detect an adrenal tumor.'
• D. 'You probably have had episodes of sweating, heart pounding, and headaches.'

Correct answer: A

Rationale: The correct initial response for the nurse to provide in this situation is to offer reassurance. Stating that 'Pheochromocytomas usually aren't cancerous (malignant)' helps to alleviate the client's anxiety and fear of having cancer. This response also establishes a foundation for further discussion about the condition, allowing the nurse to address the client's concerns and provide accurate information. Choice B is incorrect as it focuses solely on the diagnostic tests for pheochromocytoma but does not address the client's emotional distress. Choice C is incorrect as it discusses imaging modalities without directly addressing the client's concerns. Choice D is also incorrect as it assumes symptoms without first addressing the client's emotional state and fear of cancer.

5. When discussing hypothyroidism and treatment with the family of a newborn, the nurse should emphasize

• A. Expecting mental retardation in the child is likely
• B. Administering thyroid hormone can prevent problems
• C. This rare problem is always hereditary
• D. Physical growth/development will be delayed

Correct answer: B

Rationale: The correct answer is B. Administering thyroid hormone to a newborn diagnosed with hypothyroidism can prevent developmental delays and mental retardation. This treatment is crucial to ensure optimal growth and development. Choice A is incorrect because with prompt treatment, mental retardation can be prevented. Choice C is incorrect as hypothyroidism can also be acquired and not only hereditary. Choice D is incorrect as physical growth and development can be supported through timely administration of thyroid hormone.

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