Nursing Elites

1. Which topic should the nurse include in planning a primary prevention class for adolescents?

• A. Risk factors for heart disease.
• B. Dietary management of obesity.
• C. Suicide risks and prevention.
• D. Coping with stressful situations.

Correct answer: C

Rationale: The correct topic that the nurse should include in planning a primary prevention class for adolescents is suicide risks and prevention. Adolescents are particularly vulnerable to mental health issues, including suicidal ideation. Educating them about suicide risks and prevention strategies is crucial for early intervention and support. Choices A, B, and D are important topics, but when considering primary prevention for adolescents, addressing suicide risks and prevention takes precedence due to its immediate life-saving implications.

2. A client with a history of deep vein thrombosis (DVT) is receiving warfarin (Coumadin). The nurse should monitor the client for which of the following laboratory values?

• A. Prothrombin time (PT)
• B. Serum potassium
• C. Blood urea nitrogen (BUN)
• D. White blood cell count (WBC)

Correct answer: A

Rationale: The correct answer is A: Prothrombin time (PT). Prothrombin time is monitored to assess the effectiveness of warfarin therapy. Warfarin is an anticoagulant medication that works by inhibiting the synthesis of vitamin K-dependent clotting factors, including factors II, VII, IX, and X. Monitoring the PT helps ensure that the client's blood is clotting within the desired therapeutic range to prevent complications such as recurrent DVT or excessive bleeding. Choices B, C, and D are incorrect because serum potassium, blood urea nitrogen, and white blood cell count are not directly related to monitoring warfarin therapy in a client with a history of DVT.

3. In addition to disturbances in mental awareness and orientation, a client with cognitive impairment is also likely to show loss of ability in

• A. Hearing, speech, and sight
• B. Endurance, strength, and mobility
• C. Learning, creativity, and judgment
• D. Balance, flexibility, and coordination

Correct answer: C

Rationale: Individuals with cognitive impairment often experience difficulties in learning new information, creative thinking, and making sound judgments. Loss of ability in hearing, speech, and sight (Choice A) is more closely related to sensory impairments rather than cognitive impairment. Endurance, strength, and mobility (Choice B) are more associated with physical capabilities rather than cognitive functions. Balance, flexibility, and coordination (Choice D) are related to motor skills and physical coordination, not cognitive impairment.

4. With an alert of an internal disaster and the need for beds, the charge nurse is asked to list clients who are potential discharges within the next hour. Which client should the charge nurse select?

• A. An elderly client who has had type 2 diabetes for over 20 years, admitted with diabetic ketoacidosis 24 hours ago
• B. An adolescent admitted the prior night with Tylenol intoxication
• C. A middle-aged client with an internal automatic defibrillator and complaints of 'passing out at unknown times' admitted yesterday
• D. A school-age child diagnosed with suspected bacterial meningitis and was admitted at the change of shifts

Correct answer: A

Rationale: The correct answer is A because a client with diabetic ketoacidosis (DKA) that is being well-managed and has shown improvement within 24 hours is more stable and can be considered for discharge sooner than those with more acute or unstable conditions. Choice B is incorrect as Tylenol intoxication may require further monitoring and intervention. Choice C is incorrect as a client with an automatic defibrillator and episodes of passing out needs careful evaluation and monitoring. Choice D is incorrect as suspected bacterial meningitis is a serious condition that typically requires a longer hospital stay for treatment and observation.

5. 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.

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