Nursing Elites

1. The school nurse is coaching a group of high school students on ways to deal with the stress of final exams. Today the class is focusing on healthy food choices for lunch in the school cafeteria. Which option should the nurse recommend?

• A. cheeseburger on a whole wheat bun, French fries, and a large cola beverage
• B. tuna casserole with peas and corn, a fresh apple, crackers, and orange juice
• C. fruit salad with fresh berries and oranges, chicken vegetable soup, and tea
• D. chef salad with turkey, ham, and ranch dressing, apple juice, and milk

Correct answer: C

Rationale: The recommended option for managing stress during final exams is a balanced and nutritious meal. Fruit salad with fresh berries and oranges, chicken vegetable soup, and tea offer a variety of nutrients and antioxidants that can help combat stress. Option A is not ideal as it includes high-fat and high-calorie foods. Option B is a good choice, but Option C provides a wider range of nutrients and hydration. Option D is a healthy choice with a variety of proteins and vitamins, but Option C offers lighter options that may be easier to digest during stressful times.

2. A client with type 2 diabetes mellitus is admitted with hyperosmolar hyperglycemic state (HHS). Which laboratory result requires immediate intervention?

• A. Serum osmolality of 320 mOsm/kg.
• B. Serum glucose of 600 mg/dL.
• C. Serum potassium of 4.5 mEq/L.
• D. Serum sodium of 140 mEq/L.

Correct answer: B

Rationale: A serum glucose level of 600 mg/dL is extremely high in a client with hyperosmolar hyperglycemic state (HHS) and poses a significant risk of serious complications such as dehydration, coma, and electrolyte imbalances. Rapid intervention is crucial to normalize the glucose level and prevent further deterioration. Serum osmolality of 320 mOsm/kg, serum potassium of 4.5 mEq/L, and serum sodium of 140 mEq/L, while important to monitor in HHS, do not represent an immediate life-threatening condition that requires urgent intervention compared to the critically high glucose level.

3. Who is likely to have the most influence on these women's perceptions about their children's healthcare needs?

• A. husbands
• B. clinic healthcare provider
• C. older females
• D. tribal chief

Correct answer: C

Rationale: In many cultures, older women, such as grandmothers or aunts, hold significant influence over health-related decisions and practices within the family. They are often the ones consulted for advice on healthcare matters concerning children. Husbands (choice A) may have influence in other areas, but when it comes to healthcare decisions for children, older females are typically more influential. Clinic healthcare providers (choice B) may offer guidance, but the influence of older females within the community is usually stronger. Tribal chiefs (choice D) may hold authority but might not be as directly involved in individual healthcare decisions within families as older females.

4. Following an emergency Cesarean delivery, the nurse encourages the new mother to breastfeed her newborn. The client asks why she should breastfeed now. Which information should the nurse provide?

• A. To bond with the baby.
• B. To help the baby latch on better.
• C. To stimulate contraction of the uterus.
• D. To promote milk production.

Correct answer: C

Rationale: The correct answer is C: 'To stimulate contraction of the uterus.' After delivery, breastfeeding helps in stimulating the release of oxytocin, which triggers the contraction of the uterus. This contraction is crucial to prevent uterine hemorrhage and facilitate the involution process. Choices A, B, and D are incorrect. While breastfeeding can indeed help in bonding with the baby and promoting milk production, in the immediate postpartum period after a Cesarean section, the priority is to ensure uterine contraction to prevent complications.

5. The nurse is planning a community health fair to promote mental health awareness. Which activity is most likely to engage participants?

• A. a lecture on the signs and symptoms of depression
• B. a workshop on stress management techniques
• C. a panel discussion with mental health experts
• D. a booth distributing brochures on mental health resources

Correct answer: B

Rationale: A workshop on stress management techniques is the most engaging activity as it allows participants to actively participate, learn practical skills, and interact with others. This hands-on approach fosters engagement and provides attendees with tools they can directly apply in their lives. Choice A, a lecture, may be informative but lacks the interactive element that promotes engagement. Choice C, a panel discussion, might be informative but could be passive for attendees. Choice D, distributing brochures, is informative but lacks the interactive and engaging nature of a workshop.

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