Nursing Elites

1. The client diagnosed with diabetes mellitus type 2 is admitted to the hospital with cellulitis of the right foot secondary to an insect bite. Which intervention should the nurse implement first?

• A. Administer intravenous antibiotics
• B. Apply warm moist packs every two hours
• C. Elevate the right foot on two pillows
• D. Teach the client about skin and foot care

Correct answer: A

Rationale: Administering intravenous antibiotics is the priority intervention in this situation. Cellulitis is a bacterial infection that can spread rapidly, especially in individuals with diabetes. Immediate antibiotic therapy is crucial to prevent the infection from worsening and causing serious complications. Applying warm moist packs, elevating the foot, and teaching the client about skin and foot care are important interventions but should come after initiating antibiotic treatment to address the underlying infection.

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 'Educate soldiers in the history and traditions of the service'?

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

Correct answer: B

Rationale: The correct answer is B, 'Personal/professional development.' This category involves educating individuals in various aspects, including history and traditions. In this case, educating soldiers in the history and traditions of the service falls under personal/professional development rather than the other options provided. Choice A, 'Accountability,' focuses on responsibility and answerability, not education. Choice C, 'Individual training,' pertains more to specific skill development rather than broader education on history and traditions. Choice D, 'Military appearance/physical condition,' is related to maintaining physical standards and image, which is not directly relevant to educating soldiers in history and traditions.

3. Why may patients with hiatal hernia develop anemia?

• A. Iron absorption is reduced
• B. Gastritis may cause bleeding
• C. Iron stores turn over more quickly
• D. Patients have an aversion to foods that are good sources of iron

Correct answer: B

Rationale: The correct answer is B: Gastritis may cause bleeding. In patients with hiatal hernia, gastritis can occur due to the reflux of stomach acid into the esophagus. This gastritis can lead to gastrointestinal bleeding, resulting in anemia. Choice A is incorrect because iron absorption is not necessarily reduced in hiatal hernia. Choice C is incorrect as iron stores turnover rate is not directly related to the development of anemia in this context. Choice D is incorrect as an aversion to iron-rich foods is not a common reason for anemia in patients with hiatal hernia.

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 answer is C. Absence of adventitious breath sounds indicates that fluid is not accumulating in the lungs, a key outcome in managing fluid volume excess. Choices A, B, and D are incorrect. A client with fluid volume excess may not necessarily void a minimum of 30 mL per hour, have elastic skin turgor, or have a specific serum creatinine level. The absence of adventitious breath sounds is a more direct indicator of managing fluid volume excess.

5. A client takes an antidepressant and oral contraceptives. Which herbal supplement should the nurse educate the client about as a potential drug-herb interaction?

• A. Iron supplement
• B. Garlic
• C. Green tea
• D. St. John’s Wort

Correct answer: D

Rationale: St. John’s Wort is the correct answer because it can interact with antidepressants and oral contraceptives, potentially affecting their efficacy. Iron supplement, garlic, and green tea do not typically interact with antidepressants or oral contraceptives to the same extent as St. John’s Wort.

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