Nursing Elites

1. The client is admitted to the emergency department complaining of acute epigastric pain and reports vomiting a large amount of bright red blood at home. Which interventions should the nurse implement?

• A. Assess the client’s vital signs
• B. Start an IV with an 18-gauge needle
• C. Begin iced saline lavage
• D. A, B

Correct answer: D

Rationale: The correct interventions for a client presenting with acute epigastric pain and vomiting bright red blood are to assess the client’s vital signs and start an IV with an 18-gauge needle. Assessing vital signs helps in determining the client's current condition and response to treatment, while starting an IV is crucial for administering medications and fluids. Beginning iced saline lavage is not appropriate in this situation as the priority is to stabilize the client and address potential bleeding. Therefore, options A and B are correct choices, making option D the most appropriate answer.

2. 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. Overseeing neurological functions
• C. Managing work center operations
• D. Managing personnel

Correct answer: A

Rationale: The correct answer is A: 'Managing patients' legal affairs.' Practical nurse management responsibilities are typically categorized into managing work center operations, managing personnel, and overseeing patient care. Legal affairs management is not a standard responsibility for practical nurse management. Choice B is incorrect as it introduces information about the hypothalamus, which is unrelated to the question. Choice C and D are both common areas of concern in practical nurse management, involving the operations of the work center and managing personnel, respectively.

3. The nurse is caring for the client recovering from intestinal surgery. Which assessment finding would require immediate intervention?

• A. Presence of thin pink drainage in the Jackson Pratt
• B. Guarding when the nurse touches the abdomen
• C. Tenderness around the surgical site during palpation
• D. Complaints of chills and feeling feverish

Correct answer: D

Rationale: Complaints of chills and feeling feverish may indicate infection, which requires immediate intervention. This finding suggests a systemic response to infection, which can be life-threatening if not promptly addressed. Options A, B, and C are common postoperative findings and may not necessarily require immediate intervention unless accompanied by other concerning signs or symptoms.

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. 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.

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