Nursing Elites

1. Which laboratory data indicate the client’s pancreatitis is improving?

• A. The amylase and lipase serum levels are decreased
• B. The white blood cell count (WBC) is decreased
• C. The conjugated and unconjugated bilirubin levels are decreased
• D. The blood urea nitrogen (BUN) serum level is decreased

Correct answer: A

Rationale: The correct answer is A. Amylase and lipase are enzymes specifically related to pancreatitis. A decrease in their serum levels indicates improvement in pancreatitis. White blood cell count (WBC), choices C and D, are not direct markers for pancreatitis improvement. Bilirubin levels, choice C, are more related to liver function rather than pancreatitis. Blood urea nitrogen (BUN) level, choice D, is a marker for kidney function, not pancreatitis.

2. In supply and equipment management, what is the FIRST step in the procurement process?

• A. Keep hand receipts up to date
• B. Establish requirements
• C. Requisition supplies and equipment through the proper channels
• D. Properly receive, inspect, and store required items

Correct answer: B

Rationale: In the procurement process, the FIRST step is to establish requirements. This step involves identifying and defining the needs for supplies and equipment before moving forward with the procurement process. Keeping hand receipts up to date (Choice A) is a task related to tracking and managing inventory but comes after the requirements have been established. Requisitioning supplies and equipment (Choice C) and receiving, inspecting, and storing items (Choice D) are subsequent steps in the procurement process that follow after the requirements have been determined.

3. The client is diagnosed with pericarditis. When assessing the client, the nurse is unable to auscultate a friction rub. Which action should the nurse implement?

• A. Notify the healthcare provider
• B. Document that the pericarditis has resolved
• C. Ask the client to lean forward and listen again
• D. Prepare to insert a unilateral chest tube

Correct answer: C

Rationale: The correct action for the nurse to take when unable to auscultate a pericardial friction rub in a client diagnosed with pericarditis is to ask the client to lean forward and listen again. This position brings the heart closer to the chest wall, making it easier to detect a friction rub if present. Notifying the healthcare provider is not necessary at this point as it may just be a matter of positioning for better auscultation. Documenting that the pericarditis has resolved is premature without proper assessment. Preparing to insert a unilateral chest tube is not indicated based on the absence of a friction rub.

4. Whenever possible, patients evacuated from the theater of operations who are expected to return within 60 days are admitted to which of the following?

• A. Civilian hospitals participating in the National Disaster Medical System
• B. DOD tri-service hospitals
• C. Department of Veterans Affairs hospitals
• D. Field hospitals

Correct answer: B

Rationale: Patients evacuated from the theater of operations who are expected to return within 60 days are admitted to DOD tri-service hospitals. These hospitals are equipped to provide specialized care tailored to military personnel. Choice A, civilian hospitals participating in the National Disaster Medical System, may not always have the necessary expertise and resources to cater specifically to military-related injuries. Choice C, Department of Veterans Affairs hospitals, primarily serve veterans and may not always accommodate short-term care for active-duty personnel. Choice D, field hospitals, are usually set up in temporary or emergency situations and are not designed for long-term care, making them less suitable for patients expected to return within 60 days.

5. Three major causes of atherosclerosis are:

• A. Hyperthyroidism, underweight, and poor appetite
• B. High blood cholesterol, high blood pressure, and cigarette smoking
• C. Constipation, peptic ulcer disease, and pancreatitis
• D. Kidney failure, edema, and sodium retention

Correct answer: B

Rationale: Atherosclerosis is primarily caused by high blood cholesterol, high blood pressure, and cigarette smoking. These factors contribute to the buildup of plaque in the arteries. Choices A, C, and D are incorrect. Hyperthyroidism, underweight, and poor appetite do not directly cause atherosclerosis. Similarly, constipation, peptic ulcer disease, pancreatitis, kidney failure, edema, and sodium retention are not among the primary causes of atherosclerosis.

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