Nursing Elites

1. Which of the following is a potential side effect associated with the use of nonsteroidal anti-inflammatory drugs?

• A. Stomach irritation and bleeding
• B. Stomatitis and esophagitis
• C. Impaired folate absorption
• D. Increased potassium excretion

Correct answer: A

Rationale: The correct answer is A: Stomach irritation and bleeding. Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause stomach irritation and bleeding due to their effects on gastric mucosa. Stomatitis and esophagitis (Choice B) are not typically associated with NSAID use. While NSAIDs may affect renal function, leading to fluid retention and edema, they do not directly cause increased potassium excretion (Choice D). Impaired folate absorption (Choice C) is not a common side effect of NSAIDs.

2. Listed below are five categories that identify the responsibilities of the practical nurse manager in personnel management. Which of these categories is most appropriate for the task of training soldiers for survival on the battlefield?

• A. Accountability
• B. Personal/professional development
• C. Individual training
• D. Military appearance/physical condition

Correct answer: C

Rationale: The correct answer is C: Individual training. This category involves the specific task of preparing soldiers for battlefield survival, making it the most appropriate choice for the given scenario. Choice A, Accountability, focuses on being answerable for one's actions and decisions, which is not directly related to training soldiers. Choice B, Personal/professional development, pertains to personal growth and career advancement, not specific training for battlefield survival. Choice D, Military appearance/physical condition, deals with the physical aspects and presentation of soldiers, not the training required for battlefield survival.

3. During peacetime, most CONUS hospital military personnel are organized into what type of organization?

• A. DVA
• B. TOE
• C. TDA
• D. NDMS

Correct answer: C

Rationale: During peacetime, most CONUS hospital military personnel are organized under a Table of Distribution and Allowances (TDA) structure. This organizational type outlines the personnel positions and equipment allocation within a unit. Choice A, 'DVA,' refers to the Department of Veterans Affairs and is not the organizational structure for military hospital personnel. Choice B, 'TOE,' stands for Table of Organization and Equipment which is more commonly used in a wartime setting to define unit structure and equipment requirements. Choice D, 'NDMS,' refers to the National Disaster Medical System which is not the typical organization for CONUS hospital military personnel during peacetime.

4. Which outcome should the nurse identify for the client diagnosed with fluid volume excess?

• A. The client will void a minimum of 30 mL per hour
• B. The client will have elastic skin turgor
• C. The client will have no adventitious breath sounds
• D. The client will have a serum creatinine of 1.4 mg/dL

Correct answer: C

Rationale: The correct outcome for a client diagnosed with fluid volume excess is the absence of adventitious breath sounds. This indicates that fluid is not accumulating in the lungs, a crucial sign in managing fluid volume excess. Choices A, B, and D are incorrect because voiding a specific amount of urine, having elastic skin turgor, and a serum creatinine level do not directly relate to managing fluid volume excess.

5. The client diagnosed with acute vein thrombosis is receiving a continuous heparin drip, an intravenous anticoagulant. The health care provider orders warfarin (Coumadin), an oral anticoagulant. Which action should the nurse take?

• A. Discontinue the heparin drip before initiating the Coumadin
• B. Check the client’s INR before beginning Coumadin
• C. Clarify the order with the healthcare provider as soon as possible
• D. Administer the Coumadin along with the heparin drip as ordered

Correct answer: D

Rationale: The correct answer is to administer the Coumadin along with the heparin drip as ordered. Heparin and warfarin are often given together initially because warfarin takes a few days to become effective. Discontinuing the heparin drip before initiating Coumadin can increase the risk of clot formation. Checking the client's INR before starting Coumadin is important but not the immediate action required. Clarifying the order with the healthcare provider is not necessary as both medications are commonly used together.

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