Nursing Elites

1. The client is complaining of painful swallowing secondary to mouth ulcers. Which statement by the client indicates appropriate management?

• A. “I will brush my teeth with a soft-bristle toothbrush.”
• B. “I will rinse my mouth with Listerine mouthwash.”
• C. “I will swish my antifungal solution and then swallow.”
• D. “I will avoid spicy foods, tobacco, and alcohol.”

Correct answer: D

Rationale: The correct answer is D. Avoiding irritants like spicy foods, tobacco, and alcohol is crucial in managing mouth ulcers as they can further irritate the ulcers and delay healing. Choices A, B, and C could potentially worsen the condition. Brushing with a soft-bristle toothbrush may cause discomfort, rinsing with Listerine mouthwash can be too harsh on the ulcers, and swallowing antifungal solution is not recommended unless specified by a healthcare provider.

2. The nurse enters a client’s room and the client is demanding release from the hospital. The nurse reviews the client’s record and noted that the client was admitted 2 days ago for treatment of an anxiety disorder, and the admission was voluntary. Which intervention should the nurse initiate first?

• A. Telephone the client’s family and have them persuade the client to stay
• B. Have the client read and sign all the appropriate self-discharge papers
• C. Explain to the client that he cannot leave because he asked for treatment
• D. Notify the client’s healthcare provider of the client’s stated intent to leave the hospital

Correct answer: D

Rationale: The correct intervention for the nurse to initiate first is to notify the client’s healthcare provider of the client’s stated intent to leave the hospital. This action is crucial as it ensures that the client’s care and safety are appropriately managed. Option A is not the best choice as involving the family to persuade the client may not address the client's underlying concerns. Option B is incorrect because having the client sign self-discharge papers without further assessment is not appropriate. Option C is also incorrect as the client's request for treatment does not prevent them from leaving if they are deemed competent to make that decision.

3. The client is diagnosed with hereditary spherocytosis. Which treatment/procedure would the nurse prepare the client to receive?

• A. Bone marrow transplant
• B. Splenectomy
• C. Frequent blood transfusions
• D. Liver biopsy

Correct answer: B

Rationale: The correct answer is B: Splenectomy. Splenectomy is the treatment of choice for hereditary spherocytosis as it helps prevent hemolysis and improve anemia. Removing the spleen reduces the destruction of the abnormal red blood cells. Choice A, Bone marrow transplant, is not a standard treatment for hereditary spherocytosis. Choice C, Frequent blood transfusions, may be used to manage anemia in some cases but is not the primary treatment for hereditary spherocytosis. Choice D, Liver biopsy, is not a treatment for hereditary spherocytosis; it is a procedure used to diagnose liver conditions, not related to this hematologic disorder.

4. The client with peripheral vascular disease is being taught by the nurse. Which interventions should the nurse discuss with the client?

• A. Keep the area between the toes dry.
• B. Wear comfortable, well-fitting shoes.
• C. Cut toenails straight across.
• D. A, B

Correct answer: D

Rationale: The correct interventions for a client with peripheral vascular disease include keeping the area between the toes dry and wearing comfortable, well-fitting shoes. Choice A is correct as moisture between the toes can lead to skin breakdown and infection. Choice B is also correct as proper footwear helps prevent injury and promotes circulation. Choice C, cutting toenails straight across, is incorrect for peripheral vascular disease clients as cutting them in an arch can reduce the risk of ingrown toenails, which is important for clients with diabetes to prevent complications. Therefore, choices A and B are the most appropriate interventions for the client with peripheral vascular disease.

5. When a field medical element is not operational, it engages in training to achieve readiness for mobilization that involves all aspects of operation. Individuals must be proficient in their MOS/ASI and which of the following?

• A. Command and control procedures
• B. Computers and data processing
• C. Common soldier tasks
• D. Communications and automation

Correct answer: C

Rationale: In the context of field medical training for mobilization, proficiency in common soldier tasks is essential. This includes skills like first aid, navigation, marksmanship, and other fundamental military tasks. While command and control procedures, communications, and automation are important, common soldier tasks are specifically mentioned in the scenario as critical for achieving readiness and mobilization.

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