Nursing Elites

1. The client with peripheral venous disease is scheduled to go to the whirlpool for a dressing change. Which is the nurse’s priority intervention?

• A. Escort the client to the physical therapy department
• B. Medicate the client 30 minutes before going to the whirlpool
• C. Obtain the sterile dressing supplies for the client
• D. Assist the client to the bathroom prior to the treatment

Correct answer: B

Rationale: The correct answer is B. Pain management is essential before the procedure to ensure the client’s comfort and cooperation during the dressing change. Escorting the client to the physical therapy department (choice A) is not the priority at this time. While obtaining sterile dressing supplies (choice C) is important, ensuring pain management takes precedence. Assisting the client to the bathroom (choice D) is not directly related to the priority intervention of pain management before the whirlpool treatment.

2. Warfarin (Coumadin) is an anticoagulant and interferes with the action of:

• A. Platelets
• B. Vitamin K
• C. Calcium
• D. Vitamin B12

Correct answer: B

Rationale: The correct answer is B: Vitamin K. Warfarin works by inhibiting the action of vitamin K, which is crucial for the synthesis of clotting factors in the blood. By interfering with vitamin K, warfarin decreases the production of these clotting factors, thereby prolonging the time it takes for blood to clot. This is why individuals on warfarin therapy need to monitor their vitamin K intake. Choices A, C, and D are incorrect because warfarin does not directly interfere with platelets, calcium, or vitamin B12.

3. What is the mission of the Army Medical Department?

• A. Ensure that each soldier receives a physical examination annually
• B. Deliver healthcare to regions of the U.S. designated as disaster areas by the President
• C. Maintain the health of the Army and preserve its combat effectiveness
• D. Offer medical, dental, and veterinary education and training

Correct answer: C

Rationale: The correct answer is C: 'Maintain the health of the Army and preserve its combat effectiveness.' This mission statement reflects the primary goal of the Army Medical Department, which is to ensure that military personnel remain healthy and fit for duty to preserve the Army's fighting strength. Choices A, B, and D are incorrect because they do not capture the core purpose of the Army Medical Department, which is focused on the health and readiness of the military forces, rather than performing annual physical examinations, responding to disasters, or providing education and training.

4. The client is four hours post-operative abdominal aortic aneurysm repair. Which nursing intervention should be implemented for this client?

• A. Assist the client in ambulating
• B. Assess the client's bilateral pedal pulses
• C. Maintain a continuous IV heparin drip
• D. Provide clear liquids to the client

Correct answer: B

Rationale: Assessing the client's bilateral pedal pulses is essential in this situation as it helps in evaluating the peripheral perfusion and circulation in the lower extremities. This assessment is crucial to detect any signs of decreased blood flow or complications, such as arterial occlusion or thrombosis. Ambulating the client may be important in the postoperative period, but assessing pedal pulses takes priority to ensure adequate perfusion. Maintaining continuous IV heparin drip is not typically indicated immediately post-operatively for an abdominal aortic aneurysm repair, as the risk of bleeding complications may outweigh the benefits. Providing a clear liquid diet is not a priority nursing intervention at this stage, as the focus should be on vascular assessment and postoperative monitoring.

5. Why are hospital patients at greater risk for drug-nutrient interactions than they used to be?

• 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 at greater risk for drug-nutrient interactions because they are more acutely ill, often having multiple conditions and treatments that increase the risk of such interactions. Choice B is incorrect as hospital routines interfering with medication timing are not directly related to drug-nutrient interactions. Choice C is incorrect as the toxicity and side effects of drugs do not necessarily relate to interactions with nutrients. Choice D is incorrect as shared responsibility for monitoring does not directly contribute to the increased risk of drug-nutrient interactions in hospitalized patients.

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