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. Identifying the strengths and weaknesses in the nursing care plan is part of which of the following steps in determining and fulfilling the patient's nursing care needs?

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

Correct answer: A

Rationale: Correct. Evaluation involves assessing the effectiveness of the nursing care plan by identifying its strengths and weaknesses. This step helps in determining if the plan is meeting the patient's needs. Choice B (Planning) is incorrect because planning involves developing the nursing care plan based on the assessment of the patient's needs. Choice C (Implementation) is incorrect as it refers to putting the nursing care plan into action. Choice D (Assessment) is incorrect as assessment is the initial step in the nursing process, involving data collection and analysis to identify the patient's needs.

3. 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.

4. Who is the first individual in the combat health support chain to make medically substantiated decisions based on military occupational specialty-specific medical training?

• A. Physician
• B. Physician assistant
• C. Combat medic
• D. Combat lifesaver

Correct answer: B

Rationale: The correct answer is 'Physician assistant.' Physician assistants are trained to make medically substantiated decisions based on their specific medical training within the combat health support chain. Choice A, 'Physician,' is incorrect as they may be involved but are not typically the first in line for such decisions as physician assistants. Choice C, 'Combat medic,' is incorrect as they usually provide immediate medical care but may not be the first to make medically substantiated decisions. Choice D, 'Combat lifesaver,' is incorrect as they are trained to provide basic life-saving interventions but may not have the specialized medical training to make complex medical decisions.

5. The nurse cares for a client receiving furosemide (Lasix). The nurse determines that teaching is effective if the client selects which of the following foods?

• A. One medium baked potato
• B. One slice of white bread
• C. One medium apple
• D. One scrambled egg

Correct answer: A

Rationale: The correct answer is A: One medium baked potato. Potatoes are high in potassium, which is crucial for clients on furosemide (Lasix) to prevent hypokalemia, as furosemide can cause potassium loss. White bread (choice B) and scrambled egg (choice D) are not high-potassium foods and do not address the specific need related to furosemide therapy. While apples (choice C) contain some potassium, they are not as rich in potassium as a baked potato, making them a less optimal choice for a client on furosemide.

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