Nursing Elites

1. What causes hepatic encephalopathy?

• A. Buildup of ammonia in the body
• B. Buildup of urea in the body
• C. Fatty infiltration of the liver
• D. Jaundice

Correct answer: A

Rationale: Hepatic encephalopathy is caused by the buildup of ammonia in the body. Ammonia, a byproduct of protein metabolism, normally gets converted to urea in the liver for excretion. However, in liver dysfunction, such as cirrhosis, the liver cannot effectively convert ammonia to urea, leading to its accumulation in the body and subsequently causing hepatic encephalopathy. Choices B, C, and D are incorrect as they do not directly relate to the pathophysiology of hepatic encephalopathy.

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. The nurse is preparing to assist in examining a Hispanic child who was brought to the clinic by the mother. During the assessment of the child, the nurse should take which action(s)?

• A. Admiring the child
• B. Taking the child’s temperature
• C. A, D
• D. Obtaining an interpreter if necessary

Correct answer: C

Rationale: In a multicultural healthcare setting, it's essential for the nurse to build rapport with the child and family. Admiring the child can help establish trust and comfort. Additionally, since the child's mother brought them to the clinic, it's crucial to ensure effective communication. Obtaining an interpreter, if necessary, is vital for clear and accurate information exchange. Taking the child's temperature, while important in a physical assessment, is not specifically highlighted in this scenario. Therefore, choices A and B alone are not sufficient, making the correct answer C, which includes both building rapport by admiring the child and ensuring clear communication by obtaining an interpreter if needed.

4. The nurse is teaching the client diagnosed with Type 2 diabetes mellitus about diet. Which diet selection indicates the client understands the teaching?

• A. A submarine sandwich, potato chips, and diet cola
• B. Four (4) slices of a supreme thin-crust pizza and milk
• C. Smoked turkey sandwich, celery sticks, and unsweetened tea
• D. A roast beef sandwich, fried onion rings, and a cola

Correct answer: C

Rationale: The correct answer is C because a smoked turkey sandwich with celery sticks and unsweetened tea is a healthier option for someone with Type 2 diabetes mellitus. Turkey is a lean protein source, celery sticks are low in calories and carbs, and unsweetened tea is a better choice than sugary beverages. Choices A, B, and D are incorrect. Choice A includes high-carb and high-sugar items like potato chips and diet cola, which are not ideal for diabetes management. Choice B contains a high-carb pizza and milk, which may not be suitable for controlling blood sugar levels. Choice D includes fried onion rings and cola, which are high in unhealthy fats and sugars, making it a poor choice for a diabetic diet.

5. 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 Physician Assistant is the first individual in the combat health support chain to make medically substantiated decisions based on their military occupational specialty-specific medical training. While physicians are highly trained medical professionals, in the context of combat health support, the Physician Assistant is typically the frontline provider who directly applies their specific military medical training to make decisions. Combat medics and combat lifesavers may provide critical care in the field, but they do not have the same level of training and scope of practice as a Physician Assistant in this context, making them less likely to be the first to make medically substantiated decisions.

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