Nursing Elites

1. The nurse is caring for a client diagnosed with rule-out nephritic syndrome. Which intervention should be included in the plan of care?

• A. Monitor the urine for bright-red bleeding
• B. Evaluate the calorie count of the 500-mg protein diet
• C. Assess the client’s sacrum for dependent edema
• D. Monitor for a high serum albumin level

Correct answer: C

Rationale: Assessing the client’s sacrum for dependent edema is crucial in the care plan for nephritic syndrome as it is common due to protein loss. Dependent edema occurs as a result of decreased oncotic pressure from protein loss in the urine. Monitoring urine for bright-red bleeding (choice A) is more relevant to conditions like glomerulonephritis. Evaluating calorie count or protein intake (choice B) is important for other conditions but not specifically for nephritic syndrome. Monitoring for a high serum albumin level (choice D) is not typically part of the immediate care plan for nephritic syndrome.

2. Interacting with the patient and their family to obtain subjective information is part of which of the following steps in determining and fulfilling the nursing care needs of the patient?

• A. Evaluation
• B. Planning
• C. Implementation
• D. Assessment

Correct answer: D

Rationale: The correct answer is D, Assessment. In the nursing process, assessment is the first step where nurses gather subjective and objective data to understand the patient's needs. Interacting with the patient and their family to obtain subjective information is crucial in this phase. Choice A, Evaluation, comes later in the process and involves judging the effectiveness of the care provided. Choice B, Planning, is where the nurse develops a plan of care based on the assessment findings. Choice C, Implementation, is the phase where the nursing care plan is put into action.

3. Which of the following is a nonmedical member of a unit who receives additional training in providing care beyond basic first aid procedures?

• A. Area support squad leader
• B. ATLS specialist
• C. Tactical lifesaver
• D. Combat lifesaver

Correct answer: D

Rationale: The correct answer is D, 'Combat lifesaver.' A Combat Lifesaver is a nonmedical member of a unit who is trained in advanced first aid procedures, providing care beyond basic first aid. Choice A, 'Area support squad leader,' does not specifically refer to someone trained in providing advanced care. Choice B, 'ATLS specialist,' refers to someone trained in Advanced Trauma Life Support (ATLS), which is beyond the scope of the question. Choice C, 'Tactical lifesaver,' is not a recognized term for the role described in the question.

4. 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.

5. Which nursing instruction should the nurse discuss with the client who is receiving glucocorticoids for Addison’s disease?

• A. Discuss the importance of tapering medications when discontinuing medication
• B. Explain that the dose will need to be decreased during times of stress or infection
• C. Instruct the client to take medication on an empty stomach with a glass of water
• D. Encourage the client to wear a MedicAlert bracelet and carry a card in the wallet

Correct answer: A

Rationale: The correct answer is to discuss the importance of tapering medications when discontinuing medication. Tapering glucocorticoids is crucial to prevent adrenal insufficiency, which can occur if the medication is stopped abruptly. Choice B is incorrect because it focuses on adjustments during stress or infection, not discontinuation. Choice C is unrelated to the management of glucocorticoids. Choice D is important for emergency identification but is not directly related to medication management.

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