Nursing Elites

1. A client is at risk for excess fluid volume. Which nursing intervention ensures the most accurate monitoring of the client’s fluid status?

• A. Measuring and recording fluid intake and output
• B. Weighing the client daily at the same time each day
• C. Assessing the client’s vital signs every 4 hours
• D. Checking the client’s lungs for crackles during every shift

Correct answer: B

Rationale: The correct answer is B. Weighing the client daily at the same time each day is the most accurate method for monitoring fluid balance. Changes in body weight can indicate fluid retention or loss. Measuring and recording fluid intake and output (choice A) is important but may not reflect total body fluid status accurately. Assessing vital signs (choice C) and checking the client's lungs for crackles (choice D) are important assessments but do not directly provide the most accurate monitoring of fluid status.

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. Participating in the development of long-term and preventive health goals with the patient and their family is part of which of the following steps for determining and fulfilling the nursing care needs of the patient?

• A. Evaluation
• B. Planning
• C. Implementation
• D. Assessment

Correct answer: B

Rationale: The correct answer is B: Planning. Planning in nursing care involves setting long-term and preventive goals for the patient in collaboration with the patient and their family. This step ensures that a comprehensive and individualized care plan is developed. Choice A, Evaluation, comes after the interventions have been implemented to assess their effectiveness. Choice C, Implementation, is the step where the care plan is put into action. Choice D, Assessment, is the initial step that involves collecting data to identify the patient's needs, which is done before planning the care.

4. 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 training soldiers for survival on the battlefield?

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

Correct answer: C

Rationale: The correct answer is C: Individual training. This category involves the specific task of preparing soldiers for battlefield survival, making it the most appropriate choice for the given scenario. Choice A, Accountability, focuses on being answerable for one's actions and decisions, which is not directly related to training soldiers. Choice B, Personal/professional development, pertains to personal growth and career advancement, not specific training for battlefield survival. Choice D, Military appearance/physical condition, deals with the physical aspects and presentation of soldiers, not the training required for battlefield survival.

5. The nurse is caring for the client recovering from a percutaneous renal biopsy. Which data indicate that the client is complying with client teaching?

• A. The client lies flat in the supine position for 12 hours
• B. The client continues oral fluids restriction while on bed rest
• C. The client’s family changed the dressing on return to the room
• D. The family activates the patient-controlled analgesia pump

Correct answer: A

Rationale: The correct answer is A. Lying flat in the supine position for 12 hours after a renal biopsy is essential to prevent bleeding and promote recovery. This position helps apply pressure to the biopsy site, reducing the risk of bleeding. Choices B, C, and D are incorrect because continuing oral fluids restriction, changing the dressing, and activating the patient-controlled analgesia pump do not directly indicate compliance with the crucial post-biopsy teaching of maintaining the supine position.

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