Nursing Elites

1. Which of the following is considered an internal disaster?

• A. A patient fall
• B. The massive spread of pneumonia
• C. A computer hacking episode
• D. Unexpected staff absences due to illness

Correct answer: C

Rationale: A computer hacking episode is considered an internal disaster as it disrupts the internal operations of the healthcare facility, compromising data security and potentially impacting patient care. Choices A, B, and D do not directly relate to internal disasters in a healthcare setting. A patient fall is a patient safety issue, the massive spread of pneumonia is a public health concern, and unexpected staff absences due to illness may affect staffing levels but are not typically classified as internal disasters.

2. What is the most common cause of HHNS?

• A. Insulin overdose
• B. Removal of the adrenal gland
• C. Undiagnosed, untreated hyperpituitarism
• D. Undiagnosed, untreated diabetes mellitus

Correct answer: D

Rationale: The correct answer is D: Undiagnosed, untreated diabetes mellitus. Hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is most commonly caused by undiagnosed and untreated diabetes mellitus. Insulin overdose (Choice A) is not a typical cause of HHNS; it is more related to hypoglycemia. Removal of the adrenal gland (Choice B) can lead to adrenal insufficiency but is not a common cause of HHNS. Undiagnosed, untreated hyperpituitarism (Choice C) is not a usual cause of HHNS; it is more related to pituitary hormone imbalances rather than hyperglycemia.

3. What is the primary goal of public health?

• A. To focus on individual patient care
• B. To improve the health of populations
• C. To reduce healthcare costs
• D. To increase hospital admissions

Correct answer: B

Rationale: The primary goal of public health is to improve the health of populations by focusing on prevention, health promotion, and addressing the social determinants of health. Choice A is incorrect because public health looks at health from a population perspective rather than focusing on individual patient care. Choice C, while a potential benefit, is not the primary goal of public health. Choice D is incorrect as increasing hospital admissions is not a goal of public health; in fact, public health aims to prevent unnecessary hospitalizations through preventive measures.

4. A nurse at a long-term care facility is planning a fall prevention program for the residents. Which of the following interventions should the nurse include?

• A. Apply vest restraints to residents who are confused
• B. Keep all four side rails up on beds at night
• C. Accompany residents over 85 years of age during ambulation
• D. Implement rounds every 2 hours during the day to offer toileting

Correct answer: D

Rationale: The correct answer is to implement rounds every 2 hours during the day to offer toileting. This intervention helps prevent falls by addressing the common cause of unassisted mobility, which is the need to use the bathroom. Choice A is incorrect as restraints should not be the first choice for fall prevention due to the risk of injury and loss of independence. Choice B is incorrect because all side rails up can lead to entrapment and should only be used based on individualized assessments. Choice C may not be feasible for all residents over 85 years old and does not directly address the risk of falls.

5. A client with DM has an above-knee amputation because of severe peripheral vascular disease. Two days following surgery, when preparing the client for dinner, what is the nurse's primary responsibility?

• A. Check the client's serum glucose level
• B. Assist the client out of bed to the chair
• C. Place the client in a high-Fowler's position
• D. Ensure that the client's residual limb is elevated

Correct answer: A

Rationale: The correct answer is to check the client's serum glucose level. In a client with diabetes who just had surgery, monitoring the serum glucose level is crucial to ensure proper management of the condition. This helps in preventing complications related to blood sugar fluctuations. Assisting the client out of bed may be important but not the primary responsibility at this time. Placing the client in a high-Fowler's position or ensuring the residual limb is elevated are important interventions for comfort and circulation but are not the primary concern in this scenario.

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