Nursing Elites

1. 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.

2. Which of the following would be the best strategy for the nurse to use when teaching insulin injection techniques to a newly diagnosed client with diabetes?

• A. Provide written pre and post tests
• B. Ask questions during practice
• C. Allow another diabetic to assist
• D. Observe a return demonstration

Correct answer: D

Rationale: The best strategy for the nurse to use when teaching insulin injection techniques to a newly diagnosed client with diabetes is to observe a return demonstration. This method ensures that the client can correctly perform the technique. Providing written pre and post tests (choice A) may assess knowledge but not application. Asking questions during practice (choice B) may help with understanding but not necessarily with the actual performance. Allowing another diabetic to assist (choice C) may provide peer support but does not guarantee correct technique demonstration.

3. All of the following are objectives of FHSIS EXCEPT:

• A. To complete the clinical picture of chronic diseases and describe their natural history
• B. To provide a standardized, facility-level database that can be accessed for more in-depth studies
• C. To minimize recording and reporting burden, allowing more time for patient care and promotive activities
• D. To ensure that data reported are useful and accurate and are disseminated in a timely and easy-to-use fashion

Correct answer: A

Rationale: The correct answer is A. Completing the clinical picture of chronic diseases and describing their natural history is not an objective of FHSIS. The objectives of FHSIS include providing a standardized, facility-level database for more in-depth studies (B), minimizing recording and reporting burden to allow more time for patient care and promotive activities (C), and ensuring that reported data are useful, accurate, and disseminated in a timely and easy-to-use manner (D). Therefore, A is the exception among the listed objectives.

4. A female adult walks into a local community health clinic and tells the nurse that she is homeless and cannot seem to find help. Which statement indicates to the nurse that a client is feeling separated from society and helpless?

• A. "I'm feeling really isolated from everyone and scared."
• B. "I feel like I cannot get enough food to live any longer."
• C. "I know that I will always be poor so what's the use of trying?"
• D. "People like me are never respected, no matter how well we do."

Correct answer: A

Rationale: The correct answer is A. The statement "I'm feeling really isolated from everyone and scared" indicates a sense of separation from society and helplessness. This choice reflects feelings of loneliness and fear, which are common among individuals who feel disconnected and helpless. Choices B, C, and D do not directly convey a sense of isolation and helplessness. Choice B focuses on food insecurity, choice C on a resigned attitude towards poverty, and choice D on lack of respect, none of which directly address the feelings of being separated from society and helpless as indicated in the scenario.

5. Which of the following best describes the goal of primary health care?

• A. Treating chronic diseases
• B. Providing specialized medical services
• C. Promoting health and preventing illness
• D. Conducting medical research

Correct answer: C

Rationale: The correct answer is C: 'Promoting health and preventing illness.' Primary health care aims to provide essential health services, promote health, prevent diseases, and manage common health problems. Choices A, B, and D are incorrect because primary health care focuses on a holistic approach to health that includes health promotion, disease prevention, treatment of common illnesses, and community participation, rather than specialized services, chronic disease treatment, or medical research.

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