Nursing Elites

1. The nurse is caring for a client who goes into ventricular tachycardia. Which intervention should the nurse implement first?

• A. Call a code immediately
• B. Assess the client for a pulse
• C. Begin chest compressions
• D. Continue to monitor the client

Correct answer: B

Rationale: The correct first intervention when a client goes into ventricular tachycardia is to assess for a pulse. This is crucial as the presence or absence of a pulse guides subsequent actions. Initiating chest compressions or calling a code should only be done after confirming the absence of a pulse. Continuing to monitor the client without checking for a pulse delays potentially life-saving interventions.

2. One of the reasons hospital patients are at greater risk for drug-nutrient interactions than they used to be is because:

• A. Hospitalized patients are more acutely ill
• B. Hospital routines interfere with the correct timing of medications
• C. Drugs used today are more toxic and have more side effects
• D. Responsibility for monitoring this is shared by various members of the healthcare team

Correct answer: A

Rationale: The correct answer is A. Hospitalized patients are more acutely ill, often having multiple conditions and treatments, which increases the risk of drug-nutrient interactions. Choice B is incorrect because hospital routines do not specifically interfere with the timing of medications in relation to drug-nutrient interactions. Choice C is incorrect because the toxicity and side effects of drugs do not directly relate to an increased risk of drug-nutrient interactions. Choice D is incorrect as sharing responsibility for monitoring does not inherently increase the risk of drug-nutrient interactions in hospital patients.

3. Which potential complication should the nurse assess for in the client with infective endocarditis who has embolization of vegetative lesions from the mitral valve?

• A. Pulmonary embolism
• B. Decreased urine output
• C. Hemoptysis
• D. Deep vein thrombosis

Correct answer: B

Rationale: The correct answer is B: Decreased urine output. When vegetative lesions from the mitral valve embolize, they can block blood flow to the kidneys, leading to renal infarction. This can result in decreased urine output. Choices A, C, and D are incorrect. Pulmonary embolism involves a blockage of an artery in the lungs, not directly related to embolization from the mitral valve. Hemoptysis is the coughing up of blood from the respiratory tract, which is not a direct consequence of embolization from the mitral valve. Deep vein thrombosis is the formation of a blood clot in a deep vein, unrelated to embolization from the mitral valve.

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 into a TDA (Table of Distribution and Allowances) type of organization. TDA defines the structure and personnel requirements of a unit. Choice A, DVA (Department of Veterans Affairs), is not the typical organizational structure for military hospital personnel. Choice B, TOE (Table of Organization and Equipment), refers to the organization and equipment of a unit, not the personnel organization. Choice D, NDMS (National Disaster Medical System), is a federal program that coordinates medical responses to disasters and emergencies, but it is not the primary organizational structure for military hospital personnel during peacetime.

5. 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. By removing the spleen, the excessive destruction of red blood cells is reduced, preventing hemolysis and improving anemia. Bone marrow transplant (A) is not a standard treatment for hereditary spherocytosis. Frequent blood transfusions (C) may temporarily address anemia but do not treat the underlying cause. Liver biopsy (D) is not indicated as a primary treatment for hereditary spherocytosis.

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