Nursing Elites

1. A client takes an antidepressant and oral contraceptives. Which herbal supplement should the nurse educate the client about as a potential drug-herb interaction?

• A. Iron supplement
• B. Garlic
• C. Green tea
• D. St. John’s Wort

Correct answer: D

Rationale: St. John’s Wort is the correct answer because it can interact with antidepressants and oral contraceptives, potentially affecting their efficacy. Iron supplement, garlic, and green tea do not typically interact with antidepressants or oral contraceptives to the same extent as St. John’s Wort.

2. A client has been given instructions about ferrous sulfate. Which statement made by the client would indicate the client needs further education?

• A. "I will take this medication with a full glass of milk."
• B. "I will take the morning dose 1 hour before breakfast."
• C. "I will need to avoid taking this medication with coffee."
• D. "I will take antacids if needed, 2 hours after I take ferrous sulfate."

Correct answer: A

Rationale: The correct answer is A. Ferrous sulfate should not be taken with milk as it can impair iron absorption. Choice B is correct as taking the morning dose 1 hour before breakfast is appropriate. Choice C is correct as coffee can interfere with iron absorption. Choice D is correct as antacids should be taken 2 hours after ferrous sulfate to avoid interference with its absorption.

3. What is the combat health support system in the field designed to do?

• A. Provide evacuation to the far rear for treatment and delay return to duty
• B. Project, sustain, and protect the health of the soldier in war and operations other than war
• C. Provide rearward evacuation and reassignment
• D. Provide far rear area care and delayed return to duty

Correct answer: B

Rationale: The correct answer is B. The combat health support system in the field is designed to project, sustain, and protect the health of soldiers in both war and operations other than war. Choice A is incorrect because the system is not primarily focused on providing evacuation to the far rear for treatment, but rather on overall health support. Choice C is incorrect as it only mentions rearward evacuation and reassignment, which is a limited scope compared to the comprehensive support provided by the system. Choice D is incorrect as it narrowly focuses on far rear area care and delayed return to duty, missing the broader aspects of health support and protection.

4. In assessing the client's chest, which position best shows chest expansion as well as its movements?

• A. Sitting
• B. Prone
• C. Sidelying
• D. Supine

Correct answer: A

Rationale: The correct answer is A: Sitting. When the client is seated, their chest is in an optimal position for observing the full range of chest expansion during breathing. This position allows for easy visualization of chest movements and expansion as the client breathes in and out, providing a comprehensive assessment of respiratory function. Choice B, Prone, is incorrect as lying face down would not provide a clear view of chest expansion. Choice C, Sidelying, is also incorrect as this position may limit the visibility of chest movements. Choice D, Supine, is not the best position for assessing chest expansion as it may not offer a clear observation of chest movements during breathing.

5. 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 implement 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. Leaning forward can help bring the heart closer to the chest wall, making it easier to detect the rub. Option A (Notifying the healthcare provider) is incorrect because further assessment is needed before escalating the situation. Option B (Documenting that the pericarditis has resolved) is incorrect as the absence of a friction rub does not necessarily mean resolution. Option D (Preparing to insert a unilateral chest tube) is incorrect as this intervention is not indicated for the absence of a friction rub.

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