Nursing Elites

1. 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.

2. 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 this scenario, when a field medical element is not operational, training is essential to prepare for mobilization. Proficiency in MOS/ASI (Military Occupational Specialty/Area of Specialization) is crucial, along with proficiency in common soldier tasks. Common soldier tasks encompass fundamental skills and knowledge that are essential for operational readiness and mobilization. Options A, B, and D are not as directly related to individual readiness for mobilization in this context.

3. During peacetime, most CONUS hospital military personnel are organized into what type of organization?

• A. DVA
• B. TOE
• C. TDA
• D. NDMS

Correct answer: C

Rationale: During peacetime, most CONUS hospital military personnel are organized under a Table of Distribution and Allowances (TDA) structure. This organizational type outlines the personnel positions and equipment allocation within a unit. Choice A, 'DVA,' refers to the Department of Veterans Affairs and is not the organizational structure for military hospital personnel. Choice B, 'TOE,' stands for Table of Organization and Equipment which is more commonly used in a wartime setting to define unit structure and equipment requirements. Choice D, 'NDMS,' refers to the National Disaster Medical System which is not the typical organization for CONUS hospital military personnel during peacetime.

4. Enteral feedings may be appropriate for patients with:

• A. Acute cholecystitis
• B. Hepatic encephalopathy
• C. Ulcerative colitis in remission
• D. Acute exacerbation of Crohn’s disease

Correct answer: D

Rationale: Enteral feedings are commonly utilized for patients experiencing acute exacerbations of Crohn’s disease to provide necessary nutrition and rest the bowel. Choices A, B, and C are incorrect because enteral feedings are not typically indicated for acute cholecystitis, hepatic encephalopathy, or ulcerative colitis in remission.

5. A patient with diabetes should be advised to avoid which type of carbohydrate?

• A. Simple carbohydrates
• B. Complex carbohydrates
• C. Fiber-rich carbohydrates
• D. All carbohydrates

Correct answer: A

Rationale: A patient with diabetes should be advised to avoid simple carbohydrates. Simple carbohydrates can cause rapid spikes in blood glucose levels due to their quick absorption, which can be challenging to manage for individuals with diabetes. Complex carbohydrates and fiber-rich carbohydrates are generally better choices for individuals with diabetes as they are absorbed more slowly, leading to more stable blood glucose levels. Avoiding all carbohydrates is not necessary or recommended, as carbohydrates are an essential source of energy and nutrients in a balanced diet.

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