Nursing Elites

1. 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.

2. A client with type 1 diabetes is diagnosed with diabetic ketoacidosis and initially treated with intravenous fluids followed by an IV bolus of regular insulin. The nurse anticipates that the practitioner will prescribe a continuous infusion of insulin of:

• A. Novolin L insulin
• B. Novolin R insulin
• C. Novolin N insulin
• D. Novolin U insulin

Correct answer: B

Rationale: The correct answer is Novolin R (Regular insulin). Regular insulin is used for continuous infusion to treat diabetic ketoacidosis due to its rapid onset of action. Novolin L (Intermediate-acting insulin) (choice A), Novolin N (Intermediate-acting insulin) (choice C), and Novolin U (Ultra-Long-acting insulin) (choice D) are not suitable for continuous infusion in the treatment of diabetic ketoacidosis.

3. Which nursing action(s) can result in disciplinary action by state boards of nursing?

• A. Release of client health information to a client’s neighbor
• B. Delegation of a dressing change to unlicensed assistive personnel (UAP)
• C. Release of client health information to the client’s durable power of attorney
• D. A, B

Correct answer: D

Rationale: The correct answer is D. Disclosing client health information to unauthorized individuals, such as a client's neighbor (choice A) or improper delegation of nursing tasks to unlicensed personnel like UAPs (choice B), are violations of patient confidentiality and safety. Releasing client health information to the client's durable power of attorney (choice C) is a legal and appropriate action, not warranting disciplinary action. Therefore, choices A and B can result in disciplinary action by state boards of nursing, making option D the correct answer.

4. Whenever possible, patients evacuated from the theater of operations who are expected to return within 60 days are admitted to which of the following?

• A. Civilian hospitals participating in the National Disaster Medical System
• B. DOD tri-service hospitals
• C. Department of Veterans Affairs hospitals
• D. Temporary field hospitals

Correct answer: B

Rationale: Patients evacuated from the theater of operations and expected to return within 60 days are admitted to DOD tri-service hospitals. These hospitals are well-equipped to handle military personnel and are strategically placed for operational efficiency. Choice A, civilian hospitals participating in the National Disaster Medical System, may not have the specialized care and resources required for military personnel. Choice C, Department of Veterans Affairs hospitals, cater to veterans rather than active-duty personnel in theater. Choice D, temporary field hospitals, might not provide the comprehensive care and resources needed for an extended period of treatment.

5. One potential side effect associated with the use of nonsteroidal anti-inflammatory drugs is:

• 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 lead to stomach irritation and bleeding by affecting the gastric mucosa. Stomatitis and esophagitis (choice B) are not commonly associated with NSAIDs. Impaired folate absorption (choice C) is not a typical side effect of NSAIDs. Increased potassium excretion (choice D) is not a common side effect of NSAIDs.

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