Nursing Elites

1. The nurse is teaching the client with peripheral vascular disease. Which intervention should the nurse discuss with the client?

• A. Keep the area between the toes dry.
• B. Wear comfortable, well-fitting shoes.
• C. Cut toenails straight across.
• D. A,B

Correct answer: D

Rationale: The correct interventions for a client with peripheral vascular disease include keeping the area between the toes dry to prevent moisture-related skin issues and wearing comfortable, well-fitting shoes to prevent injury and promote circulation. Cutting toenails straight across is important to prevent ingrown toenails, but in this case, an arch cut can lead to injury. Therefore, choices A and B are correct, making option D the most appropriate answer. Choice C is incorrect in this context.

2. 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.

3. Which of the following is NOT one of the three basic areas of concern into which practical nurse management responsibilities can be categorized?

• A. Managing patients' legal affairs
• B. Managing the hypothalamus: The hypothalamus is a small area in the brain located just below the thalamus. It plays a crucial role in controlling various bodily functions, including temperature regulation, hunger, and thirst, sleep-wake cycles, and hormone regulation. The hypothalamus is also involved in the control of the autonomic nervous system and the release of hormones from the pituitary gland.
• C. Managing work center operations
• D. Managing personnel

Correct answer: A

Rationale: Managing patients' legal affairs is not a basic area of concern in practical nurse management responsibilities. The primary areas typically include managing work center operations, managing personnel, and overseeing patient care. Choice B, managing the hypothalamus, is irrelevant to nurse management responsibilities and is not a standard area of concern in this context. Choice C, managing work center operations, and Choice D, managing personnel, align more closely with the core responsibilities and concerns of practical nurse management roles.

4. The nurse is caring for clients on a medical floor. Which client will the nurse assess first?

• A. The client with an abdominal aortic aneurysm who is constipated
• B. The client on bed rest who ambulated to the bathroom
• C. The client with essential hypertension who has epistaxis and a headache
• D. The client with arterial occlusive disease who has a decreased pedal pulse

Correct answer: C

Rationale: The correct answer is C because epistaxis and headache in a client with hypertension are signs of a hypertensive crisis that necessitate immediate intervention. Choice A is incorrect as constipation in a client with an abdominal aortic aneurysm, while important, does not indicate an immediate crisis. Choice B is incorrect as a client on bed rest ambulating to the bathroom is a positive sign. Choice D is incorrect because a decreased pedal pulse in arterial occlusive disease should be addressed promptly, but it does not indicate an acute emergency like a hypertensive crisis.

5. What condition should a patient on long-term steroid therapy be monitored for?

• A. Hyperglycemia
• B. Hypothyroidism
• C. Hypertension
• D. Osteoporosis

Correct answer: D

Rationale: Correct! Patients on long-term steroid therapy should be monitored for osteoporosis. Prolonged use of steroids can lead to decreased bone density, increasing the risk of osteoporosis. Hyperglycemia is more commonly associated with steroid-induced diabetes rather than long-term steroid use. Hypothyroidism is not a typical complication of long-term steroid therapy. While steroids can contribute to hypertension, osteoporosis is a more prominent concern in this scenario.

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