Nursing Elites

1. While caring for a client with infective endocarditis, the nurse must be alert for signs of pulmonary embolism. Which of the following assessment findings suggests this complication?

• A. Positive Homan's sign
• B. Fever and chills
• C. Dyspnea and cough
• D. Sensory impairment

Correct answer: C

Rationale: The correct answer is C: 'Dyspnea and cough.' Pulmonary embolism often presents with a sudden onset of dyspnea (difficulty breathing) and cough, which are due to the obstruction of blood flow in the pulmonary arteries. Choices A, B, and D are incorrect. Positive Homan's sign is associated with deep vein thrombosis, fever and chills are nonspecific symptoms commonly seen in infective endocarditis, and sensory impairment is not typically indicative of pulmonary embolism.

2. The new graduate nurse interviews for a position in a nursing department of a large health care agency, described by the interviewer as having shared governance. Which of these statements best illustrates the shared governance model?

• A. An appointed board oversees any administrative decisions
• B. Nursing departments share responsibility for client outcomes
• C. Staff groups are appointed to discuss nursing practice and client education issues
• D. Non-nurse managers supervise nursing staff in groups of units

Correct answer: B

Rationale: The correct answer is B because shared governance involves nurses and other staff sharing responsibility for decisions related to patient care and outcomes, promoting collaborative practice and shared accountability. Choice A is incorrect as shared governance includes active participation of frontline staff, not just an appointed board. Choice C is incorrect because shared governance goes beyond just discussing issues to actively sharing responsibility for decision-making. Choice D is incorrect as shared governance encourages nurses to have a significant role in decision-making rather than being supervised by non-nurse managers.

3. A health program that aims to reduce the incidence of chronic diseases through lifestyle modifications is an example of:

• A. Primary prevention
• B. Secondary prevention
• C. Tertiary prevention
• D. Quaternary prevention

Correct answer: A

Rationale: The correct answer is A: Primary prevention. Primary prevention focuses on preventing the development of diseases or injuries before they occur by promoting healthy behaviors and lifestyles. In this scenario, the health program targeting lifestyle modifications to reduce chronic diseases aligns with primary prevention efforts. Choice B, secondary prevention, involves early detection and treatment to prevent the progression of disease. Choice C, tertiary prevention, focuses on managing and treating existing diseases to prevent complications. Choice D, quaternary prevention, relates to actions taken to mitigate or avoid the consequences of unnecessary or excessive interventions in healthcare.

4. A home health nurse knows that a 70-year-old male client who is convalescing at home following a hip replacement is at risk for developing decubitus ulcers. Which physical characteristic of aging contributes to such a risk?

• A. 16% increase in overall body fat.
• B. Reduced melanin production.
• C. Thinning of the skin with loss of elasticity.
• D. Calcium loss in the bones.

Correct answer: C

Rationale: Thinning of the skin with loss of elasticity is the physical characteristic of aging that contributes to an increased risk of developing decubitus ulcers. As individuals age, the skin becomes thinner and loses its elasticity, making it more susceptible to damage from pressure, leading to the formation of pressure ulcers. Choices A, B, and D are incorrect as they do not directly contribute to the development of decubitus ulcers in this context.

5. What does the term 'health disparity' refer to?

• A. Equal access to healthcare for all individuals
• B. Differences in health outcomes between different population groups
• C. High-quality healthcare for everyone
• D. Providing the same treatments to everyone

Correct answer: B

Rationale: The correct answer is B. 'Health disparity' refers to differences in health outcomes between different population groups. This term highlights variations in health status or in the distribution of health determinants between different population groups. Choice A is incorrect as health disparity is about health outcomes, not just access to healthcare. Choice C is too broad and not specific to the concept of health disparity. Choice D is incorrect as health disparity recognizes that different populations may need tailored or different treatments based on their specific health needs.

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