Nursing Elites

1. What signs/symptoms would the nurse expect to find in the client diagnosed with an insulinoma?

• A. Nervousness, jitteriness, and diaphoresis
• B. Flushed skin, dry mouth, and tented skin turgor
• C. Polyuria, polydipsia, polyphagia
• D. Hypertension, tachycardia, and feeling hot

Correct answer: A

Rationale: The correct answer is A: 'Nervousness, jitteriness, and diaphoresis.' Insulinomas cause hypoglycemia due to excessive insulin production, leading to symptoms such as nervousness (from the sympathetic response to hypoglycemia), jitteriness, and diaphoresis (sweating). Choices B, C, and D are incorrect. Flushed skin, dry mouth, and tented skin turgor (Choice B) are not typical signs of insulinoma. Polyuria, polydipsia, and polyphagia (Choice C) are classic symptoms of diabetes mellitus, not insulinoma. Hypertension, tachycardia, and feeling hot (Choice D) are more indicative of hyperthyroidism or a hypermetabolic state, rather than an insulinoma presentation.

2. The client diagnosed with acute vein thrombosis is receiving a continuous heparin drip, an intravenous anticoagulant. The health care provider orders warfarin (Coumadin), an oral anticoagulant. Which action should the nurse take?

• A. Discontinue the heparin drip before initiating the Coumadin
• B. Check the client’s INR before beginning Coumadin
• C. Clarify the order with the healthcare provider as soon as possible
• D. Administer the Coumadin along with the heparin drip as ordered

Correct answer: D

Rationale: The correct answer is to administer the Coumadin along with the heparin drip as ordered. Heparin and warfarin are often given together initially because warfarin takes a few days to become effective. Discontinuing the heparin drip before initiating Coumadin can increase the risk of clot formation. Checking the client's INR before starting Coumadin is important but not the immediate action required. Clarifying the order with the healthcare provider is not necessary as both medications are commonly used together.

3. In patients receiving chemotherapy, which nutrient is often supplemented to manage mucositis?

• A. Vitamin E
• B. Vitamin B12
• C. Zinc
• D. Calcium

Correct answer: C

Rationale: Zinc supplementation is often recommended to manage mucositis in patients undergoing chemotherapy. Zinc plays a crucial role in wound healing and immune function, which can help alleviate the symptoms of mucositis. Vitamin E (Choice A) is known for its antioxidant properties but is not typically used to manage mucositis. Vitamin B12 (Choice B) is important for red blood cell production and nerve function but is not directly associated with mucositis management. Calcium (Choice D) is essential for bone health and muscle function but is not a primary nutrient supplemented to manage mucositis.

4. The system used at the division level and forward comprises six basic modules. Which module is staffed with two surgeons, two nurse anesthetists, a medical/surgical nurse, two operating room specialists, and two practical nurses?

• A. Treatment squad
• B. Area support squad
• C. Medical service squad
• D. Forward surgical team

Correct answer: D

Rationale: The correct answer is D, Forward Surgical Team (FST). The FST is staffed with two surgeons, two nurse anesthetists, a medical/surgical nurse, two operating room specialists, and two practical nurses. This specialized team is designed to provide immediate surgical care close to the frontline. Choices A, B, and C are incorrect as they do not match the specific composition of personnel described in the question.

5. Which of the following is inappropriate in collecting mid stream clean catch urine specimen for urine analysis?

• A. Collect early in the morning, First voided specimen
• B. Do perineal care before specimen collection
• C. Collect 5 to 10 ml for urine
• D. Discard the first flow of the urine

Correct answer: A

Rationale: When collecting a mid-stream clean catch urine specimen for urine analysis, it is important to collect an adequate amount of urine for accurate testing. A volume of 30 to 60 ml is usually recommended for optimal results, so collecting only 5 to 10 ml would not provide enough urine for testing purposes. It is essential to follow proper collection techniques to ensure accurate and reliable test results.

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