Nursing Elites

1. After attempting suicide by taking 200 acetaminophen (Tylenol) tablets, a client is transferred from the emergency department to the locked psychiatric unit. The client is now awake and alert but refuses to speak with the nurse. In this situation, what is the nurse’s first priority?

• A. Establish a rapport to foster trust
• B. Place the client in full restraints
• C. Try to communicate with the client in writing
• D. Ensure safety by initiating suicide precautions

Correct answer: D

Rationale: The nurse's first priority in this situation is to ensure the client's safety by initiating suicide precautions. This involves removing any potential means of self-harm and closely monitoring the client to prevent further attempts. While establishing rapport and communication are important, safety is paramount at this critical juncture. Placing the client in full restraints should be avoided unless absolutely necessary for immediate safety concerns.

2. Which nutrient deficiency is most likely to be seen in patients with chronic alcoholism?

• A. Vitamin C
• B. Vitamin D
• C. Vitamin B12
• D. Vitamin B1

Correct answer: D

Rationale: Patients with chronic alcoholism are most likely to develop a deficiency in Vitamin B1 (thiamine) due to poor dietary intake and impaired absorption. This deficiency can lead to conditions like Wernicke's encephalopathy and Korsakoff's syndrome. While deficiencies in other vitamins can also occur in chronic alcoholism, Vitamin B1 deficiency is more commonly associated with this condition, making it the most likely nutrient deficiency in these patients. Therefore, the correct answer is Vitamin B1 (Choice D). Deficiencies in Vitamin C (Choice A), Vitamin D (Choice B), and Vitamin B12 (Choice C) can also be seen in patients with chronic alcoholism, but they are not as commonly linked to this condition compared to Vitamin B1 deficiency.

3. What is the mission of the Army Medical Department?

• A. Ensure that each soldier receives a physical examination each year
• B. Provide health care to areas of the U.S. declared disaster zones by the President
• C. Maintain the health of the Army and conserve its fighting strength
• D. Offer medical, dental, and veterinary education and training

Correct answer: C

Rationale: The correct answer is C: 'Maintain the health of the Army and conserve its fighting strength.' This mission statement reflects the primary goal of the Army Medical Department, which is to ensure the overall health and readiness of military personnel. Choices A, B, and D are incorrect because they do not fully capture the core purpose of the Army Medical Department. While providing physical examinations, healthcare in disaster areas, and education/training are important aspects, the central mission is to uphold the health and combat readiness of the Army.

4. In patients with heart failure, which type of diet is most recommended?

• A. High-sodium
• B. Low-sodium
• C. High-fat
• D. Low-carbohydrate

Correct answer: B

Rationale: In patients with heart failure, a low-sodium diet is most recommended. This type of diet helps manage fluid retention by reducing the amount of sodium in the body. Excess sodium can lead to fluid accumulation, putting additional strain on the heart. High-sodium diets can exacerbate symptoms of heart failure by causing fluid retention and increasing blood pressure. High-fat and low-carbohydrate diets are not specifically recommended for heart failure patients and may not address the underlying issues related to fluid balance and heart function.

5. 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 'Recommend awards and promotions'?

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

Correct answer: A

Rationale: The correct answer is A: 'Accountability.' Accountability involves recommending awards and promotions as part of managing personnel. This responsibility revolves around assessing employee performance and recognizing achievements through awards and promotions. Choice B, 'Personal/professional development,' focuses on enhancing employees' skills and knowledge, not specifically related to recommending awards or promotions. Choice C, 'Individual training,' pertains to providing instruction and guidance to improve specific skills, not directly linked to awarding or promoting individuals. Choice D, 'Military appearance/physical condition,' deals with maintaining physical standards and presentation, unrelated to recommending awards and promotions.

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