PNC Clinical Procedures & Protocols 2 — Questions and Answers
Question 1: A parish nurse is conducting a blood pressure screening at a health fair. Which arm position is correct for an accurate reading?
- Arm raised above heart level
- Arm supported at heart level (Correct answer)
- Arm hanging at the side
- Arm crossed over the chest
Correct answer: Arm supported at heart level
The arm should be supported at heart level to ensure accurate blood pressure measurement, as positions above or below affect readings.
Question 2: When performing a blood glucose screening, a parish nurse obtains a fasting result of 126 mg/dL on two separate occasions. This finding is consistent with:
- Normal fasting glucose
- Prediabetes
- Diabetes mellitus (Correct answer)
- Hypoglycemia
Correct answer: Diabetes mellitus
A fasting blood glucose of 126 mg/dL or higher on two separate tests meets the diagnostic criteria for diabetes mellitus per ADA guidelines.
Question 3: A parish nurse is teaching a congregation member how to use a peak flow meter. Which instruction is correct?
- Inhale slowly after placing the mouthpiece
- Exhale as hard and fast as possible after a deep breath (Correct answer)
- Breathe normally into the device for 30 seconds
- Inhale sharply through the mouthpiece
Correct answer: Exhale as hard and fast as possible after a deep breath
The correct technique is to take a deep breath, seal the lips around the mouthpiece, and exhale as hard and fast as possible to measure peak expiratory flow.
Question 4: During a home visit, a parish nurse notices a client's nitroglycerin tablets are stored in a clear glass container on a sunny windowsill. The appropriate action is to:
- Leave them as the client prefers familiarity
- Advise storing in the original dark glass container away from light and heat (Correct answer)
- Suggest refrigerating the tablets immediately
- Replace them with a newer nitroglycerin formulation
Correct answer: Advise storing in the original dark glass container away from light and heat
Nitroglycerin is sensitive to light, heat, and moisture and must be stored in the original dark glass container in a cool, dry location to maintain potency.
Question 5: A parish nurse is assessing a diabetic client's feet during a home visit. Which finding requires immediate referral to a physician?
- Slightly thickened toenails
- A 2 cm open ulcer on the plantar surface of the foot (Correct answer)
- Mild callus formation on the heel
- Dry skin on the lower legs
Correct answer: A 2 cm open ulcer on the plantar surface of the foot
An open ulcer on the foot of a diabetic client is a serious wound at high risk for infection and osteomyelitis, requiring immediate physician referral.
Question 6: When obtaining a capillary blood glucose sample, the parish nurse should puncture which part of the finger?
- The center of the fingertip pad
- The lateral side of the fingertip (Correct answer)
- The base of the finger near the knuckle
- The nail bed area
Correct answer: The lateral side of the fingertip
The lateral side of the fingertip is preferred because it has fewer nerve endings than the center pad, reducing discomfort while providing adequate blood flow.
Question 7: A parish nurse performs a visual acuity screening using the Snellen chart and documents 20/40 in the right eye. This means the client:
- Has normal vision in both eyes
- Can see at 40 feet what a person with normal vision sees at 20 feet
- Can see at 20 feet what a person with normal vision sees at 40 feet (Correct answer)
- Has complete vision loss in the right eye
Correct answer: Can see at 20 feet what a person with normal vision sees at 40 feet
The notation 20/40 means the client must stand at 20 feet to see what someone with normal vision can see at 40 feet, indicating reduced visual acuity.
PNC Clinical Procedures & Protocols 2
A parish nurse is conducting a blood pressure screening at a health fair.
Which arm position is correct for an accurate reading?