Nursing Elites

1. The client is four hours post-operative abdominal aortic aneurysm repair. Which nursing intervention should be implemented for this client?

• A. Assist the client in ambulating
• B. Assess the client's bilateral pedal pulses
• C. Maintain a continuous IV heparin drip
• D. Provide clear liquids to the client

Correct answer: B

Rationale: Assessing the client's bilateral pedal pulses is essential in this situation as it helps in evaluating the peripheral perfusion and circulation in the lower extremities. This assessment is crucial to detect any signs of decreased blood flow or complications, such as arterial occlusion or thrombosis. Ambulating the client may be important in the postoperative period, but assessing pedal pulses takes priority to ensure adequate perfusion. Maintaining continuous IV heparin drip is not typically indicated immediately post-operatively for an abdominal aortic aneurysm repair, as the risk of bleeding complications may outweigh the benefits. Providing a clear liquid diet is not a priority nursing intervention at this stage, as the focus should be on vascular assessment and postoperative monitoring.

2. 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.' A MEDCEN (Medical Center) is a specialized medical treatment and teaching facility that offers general and specialized medical and dental care. Choice A, 'CONUS,' refers to the continental United States and is not related to medical facilities. Choice C, 'MEDCOM,' stands for Medical Command, which is an administrative entity responsible for overseeing medical units, not providing direct care. Choice D, 'MEDDAC,' refers to Medical Department Activity, which is a smaller medical unit compared to a MEDCEN and may not provide the same level of specialized care.

3. The unlicensed nursing assistant is applying elastic compression stockings to the client. Which action by the assistant warrants immediate intervention by the nurse?

• A. The assistant is putting the stockings on while the client is in the chair.
• B. The assistant inserted two (2) fingers under the proximal end of the stocking.
• C. The assistant elevated the feet while lying down to put on the stockings.
• D. The assistant made sure the toes were warm after putting the stockings on.

Correct answer: A

Rationale: The correct answer is A because compression stockings should be applied while the client is lying down to prevent pooling of blood in the legs, which can occur when the client is sitting or standing. Choice B is not a cause for immediate intervention as inserting two fingers under the proximal end of the stocking helps ensure proper fit. Choice C demonstrates the correct technique of elevating the feet while lying down to put on the stockings. Choice D also shows good care by making sure the toes were warm after putting the stockings on.

4. The HCP orders cultures of the urethral urine, bladder urine, and prostatic fluid. Which instructions would the nurse teach to achieve the first two (2) specimens?

• A. Collect the first 15 mL in one jar and then the next 50 mL in another
• B. Collect three (3) early morning, clean voided urine specimens
• C. Collect the specimens after the HCP massages the prostate
• D. Collect a routine urine specimen for analysis

Correct answer: A

Rationale: The correct answer is to collect the first 15 mL in one jar and then the next 50 mL in another. This method allows for accurate cultures of urethral and bladder urine. Choice B is incorrect because it does not specify the correct method for collecting urethral and bladder urine separately. Choice C is incorrect because prostatic fluid is a separate specimen that does not require prostatic massage for collection. Choice D is incorrect as it suggests collecting a routine urine specimen, which does not fulfill the HCP's orders for specific cultures.

5. The client diagnosed with Type 2 diabetes mellitus is being taught about diet by the nurse. Which diet selection indicates the client understands the teaching?

• A. A submarine sandwich, potato chips, and diet cola
• B. Four (4) slices of a supreme thin-crust pizza and milk
• C. Smoked turkey sandwich, celery sticks, and unsweetened tea
• D. A roast beef sandwich, fried onion rings, and a cola

Correct answer: C

Rationale: The correct answer is C because a smoked turkey sandwich with celery sticks and unsweetened tea reflects a balanced and healthy choice suitable for a client with Type 2 diabetes mellitus. Turkey is a lean protein choice, celery sticks offer fiber and low calories, and unsweetened tea is a sugar-free beverage. Choices A, B, and D are incorrect as they include high-carb, high-fat, and sugary options that are not recommended for individuals with diabetes as they can spike blood sugar levels.

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