Nursing Elites

1. How did the Social Security Act of 1935 impact public health nursing?

• A. Disabled children
• B. Mentally disabled
• C. Older adults
• D. Opioid addicts

Correct answer: A

Rationale: The Social Security Act of 1935 impacted public health nursing by containing provisions for care for disabled children. This helped in improving the health and well-being of this vulnerable population. The Act did not specifically address care for mentally disabled individuals, older adults, or opioid addicts. Therefore, the correct answer is disabled children.

2. An active 28-year-old male with type 1 diabetes is being seen in the endocrine clinic. Which finding may indicate the need for a change in therapy?

• A. Hemoglobin A1C level 6.2%
• B. Blood pressure 146/88 mmHg
• C. Heart rate at rest 58 beats/minute
• D. High-density lipoprotein (HDL) level 65 mg/dL

Correct answer: B

Rationale: The correct answer is B. In a young adult with type 1 diabetes, a blood pressure of 146/88 mmHg may indicate the need for a change in therapy as it is above the recommended target levels. High blood pressure can increase the risk of cardiovascular complications in diabetic patients. Choices A, C, and D are within normal ranges and do not necessarily indicate the need for an immediate change in therapy. A Hemoglobin A1C level of 6.2% is generally considered good control for a diabetic patient, a resting heart rate of 58 beats/minute is normal for an active individual, and an HDL level of 65 mg/dL is considered to be in the desirable range for heart health.

3. A 26-year-old female with type 1 diabetes develops a sore throat and runny nose after caring for her sick toddler. The patient calls the clinic for advice about her symptoms and a blood glucose level of 210 mg/dL despite taking her usual glargine (Lantus) and lispro (Humalog) insulin. The nurse advises the patient to

• A. use only the lispro insulin until the symptoms are resolved
• B. limit calorie intake until the glucose is less than 120 mg/dL
• C. monitor blood glucose every 4 hours and notify the clinic if it continues to rise
• D. decrease carbohydrate intake until glycosylated hemoglobin is less than 7%

Correct answer: C

Rationale: In this scenario, the nurse should advise the patient to monitor her blood glucose every 4 hours and notify the clinic if it continues to rise. This is important because the patient is experiencing symptoms of an illness (sore throat and runny nose) that can lead to fluctuations in blood glucose levels. By monitoring frequently, any significant rise in blood glucose can be detected early, enabling prompt intervention. Choice A is incorrect because abruptly stopping glargine (Lantus) insulin can lead to uncontrolled blood glucose levels. Choice B is incorrect as limiting calorie intake is not the appropriate immediate action for managing high blood glucose levels. Choice D is also incorrect as adjusting carbohydrate intake based on glycosylated hemoglobin levels is not the immediate action needed in this acute situation.

4. Which of the following is a common characteristic of a Magnet-designated hospital?

• A. High nurse turnover rates
• B. Strong emphasis on interdisciplinary teamwork
• C. Limited opportunities for professional development
• D. Focus on advanced technology for patient care

Correct answer: B

Rationale: A common characteristic of a Magnet-designated hospital is a strong emphasis on interdisciplinary teamwork. This emphasis promotes collaboration among healthcare professionals from different disciplines to provide holistic and patient-centered care. Choice A is incorrect as Magnet hospitals typically have lower nurse turnover rates due to better work environments. Choice C is also incorrect as Magnet hospitals usually offer ample opportunities for professional growth and development. Choice D is not a defining characteristic of Magnet hospitals, although they may utilize advanced technology, the primary focus is on the quality of care provided through teamwork and excellence in nursing practice.

5. The staff on a medical-surgical unit is in conflict with the occupational therapy department. What type of communication will be used to discuss the problems?

• A. Downward communication
• B. Lateral communication
• C. Distorted communication
• D. Upward communication

Correct answer: B

Rationale: The correct answer is B: Lateral communication. Lateral communication occurs between individuals or departments of the same hierarchical level, making it suitable for addressing conflicts between the staff on a medical-surgical unit and the occupational therapy department. Upward communication involves communication from staff to management or from lower management to middle or upper management. Downward communication is typically directive communication from an authority figure or manager to staff. Distorted communication is not a recognized type of communication and does not apply to this scenario.

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