Nursing Elites

1. In assessing the client's chest, which position best shows chest expansion as well as its movements?

• A. Sitting
• B. Prone
• C. Sidelying
• D. Supine

Correct answer: A

Rationale: The position that best shows chest expansion as well as its movements is when the client is sitting. When the client is seated, their chest is in an optimal position for observing the full range of chest expansion during breathing. This position allows for easy visualization of chest movements and expansion as the client breathes in and out, providing a comprehensive assessment of respiratory function. Choice B (Prone) and Choice D (Supine) involve positions where the chest's movements and expansion are less visible and may not provide an accurate representation of respiratory function. Choice C (Sidelying) can also limit the visibility of chest expansion compared to the sitting position.

2. A patient with Crohn’s disease is experiencing diarrhea. Which dietary recommendation is appropriate?

• A. High-fiber diet
• B. Low-residue diet
• C. High-fat diet
• D. High-protein diet

Correct answer: B

Rationale: A low-residue diet is appropriate for a patient with Crohn’s disease experiencing diarrhea because it helps reduce bowel movements and manage symptoms. Choice A, a high-fiber diet, can exacerbate diarrhea in Crohn’s disease due to increased bulk and fermentation in the gut. Choice C, a high-fat diet, may be hard to digest and can worsen symptoms. Choice D, a high-protein diet, can be taxing on the digestive system and may not provide the relief needed for diarrhea in Crohn’s disease.

3. Which of the following is a specialized medical treatment and teaching facility that provides general and specialized medical and dental care and treatment?

• A. CONUS
• B. MEDCEN
• C. MEDCOM
• D. MEDDAC

Correct answer: B

Rationale: The correct answer is B, MEDCEN, which stands for Medical Center. A MEDCEN is a specialized medical treatment and teaching facility that provides general and specialized medical and dental care and treatment. Choices A, C, and D are incorrect. CONUS refers to the continental United States and is not a medical facility. MEDCOM stands for Medical Command, which is an organization rather than a specific facility for medical treatment. MEDDAC stands for Medical Department Activity and is also an organization responsible for medical care delivery, not a specific treatment facility.

4. The nurse is caring for a client in a sickle cell crisis. Which is the pain regimen of choice to relieve the pain?

• A. Frequent aspirin (acetylsalicylic acid) and a non-narcotic analgesic
• B. Motrin (ibuprofen), an NSAID, PRN
• C. Demerol (meperidine), a narcotic analgesic, every four (4) hours
• D. Morphine, a narcotic analgesic, every two (2) to three (3) hours PRN

Correct answer: D

Rationale: In a sickle cell crisis, morphine is the preferred analgesic due to its potency and effectiveness in managing severe pain. Choice A is incorrect because aspirin is contraindicated in sickle cell disease due to its potential to cause a further decrease in blood flow. Choice B, Motrin (ibuprofen), is also not the ideal choice as NSAIDs can exacerbate renal complications in sickle cell patients. Choice C, Demerol (meperidine), is not recommended for sickle cell pain management due to its toxic metabolite accumulation which can cause seizures and other complications.

5. Which referral would be most appropriate for the client diagnosed with thoracic outlet syndrome?

• A. The physical therapist
• B. The thoracic surgeon
• C. The occupational therapist
• D. The social worker

Correct answer: C

Rationale: The correct answer is C, the occupational therapist. An occupational therapist specializes in helping clients with conditions like thoracic outlet syndrome by providing exercises, adaptations, and strategies to improve function and reduce symptoms. Choice A, the physical therapist, may also be involved in treatment, but occupational therapists focus more on functional activities for daily living affected by the condition. Choices B and D are not the most appropriate referrals for thoracic outlet syndrome as they do not directly address the functional limitations associated with this condition.

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