Nursing Elites

1. The client is admitted to the emergency department complaining of acute epigastric pain and reports vomiting a large amount of bright red blood at home. Which interventions should the nurse implement?

• A. Assess the client’s vital signs
• B. Start an IV with an 18-gauge needle
• C. Begin iced saline lavage
• D. A, B

Correct answer: D

Rationale: In this scenario, the client's presentation of acute epigastric pain and vomiting bright red blood indicates a potential gastrointestinal bleeding emergency. Assessing the client's vital signs is essential to monitor their hemodynamic status. Starting an IV with an 18-gauge needle is crucial to establish access for potential fluid resuscitation or blood transfusion. Beginning iced saline lavage is not appropriate in this situation and could potentially delay necessary interventions. Therefore, the correct interventions for the nurse to implement are to assess the client’s vital signs and start an IV, making option D the most appropriate choice. Options A and B are correct because they are essential initial steps in managing gastrointestinal bleeding. Option C is incorrect as iced saline lavage is not indicated and may not address the urgent needs of the client in this critical situation.

2. What is the best way to manage a patient's intake of dietary fiber?

• A. Increase intake gradually
• B. Increase intake suddenly
• C. Decrease intake abruptly
• D. Maintain a high intake

Correct answer: A

Rationale: The best way to manage a patient's intake of dietary fiber is to increase it gradually. This approach helps prevent gastrointestinal discomfort that may arise from a sudden increase in fiber intake. Choice B is incorrect because increasing intake suddenly can lead to digestive issues. Choice C is incorrect as decreasing fiber intake abruptly may not be necessary and can impact overall health. Choice D is incorrect as maintaining a high intake without considering the patient's current intake level can also cause digestive problems.

3. Under the health services support area concept, how is the medical care under the MEDCOM divided?

• A. Six geographical regions of the United States with command authority in each region
• B. Five levels of health service support, each providing different levels of health care services
• C. Primary and secondary health care regions, each containing a MEDDAC or MEDCEN
• D. Eight geographical areas of responsibility designated as health services support regions, each of which is subdivided into two or more health service areas

Correct answer: D

Rationale: The correct answer is D. Under the health services support area concept, medical care under MEDCOM is divided into eight geographical areas of responsibility. Each of these areas is designated as a health services support region, and they are further subdivided into two or more health service areas. Choices A, B, and C are incorrect because they do not accurately describe how the medical care under MEDCOM is divided.

4. The type of lipoprotein that carries cholesterol from tissues to the liver for excretion is:

• A. Very low-density lipoprotein
• B. Intermediate-density lipoprotein
• C. Low-density lipoprotein
• D. High-density lipoprotein

Correct answer: D

Rationale: The correct answer is D, High-density lipoprotein (HDL). HDL is known as the 'good' cholesterol and plays a crucial role in transporting cholesterol from tissues back to the liver for excretion. This process helps in reducing the buildup of cholesterol in the bloodstream, thus lowering the risk of heart diseases. Very low-density lipoprotein (Option A), Intermediate-density lipoprotein (Option B), and Low-density lipoprotein (Option C) are not responsible for carrying cholesterol back to the liver for excretion like HDL does. Instead, they are associated with different functions related to cholesterol transportation within the body.

5. 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 'Educate personnel on UCMJ'?

• 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. Educating personnel on UCMJ falls under the category of personal/professional development as it involves enhancing their understanding of the Uniform Code of Military Justice. This category focuses on improving individuals' knowledge and skills related to their professional roles and responsibilities. Choices A, C, and D are not directly related to educating personnel on UCMJ. Accountability pertains to being answerable for one's actions, individual training focuses on specific skill development, and military appearance/physical condition relates to grooming standards and fitness rather than UCMJ education.

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