Nursing Elites

1. The nurse enters a client’s room and the client is demanding release from the hospital. The nurse reviews the client’s record and notes that the client was admitted 2 days ago for treatment of an anxiety disorder, and the admission was voluntary. Which intervention should the nurse initiate first?

• A. Telephone the client’s family and have them persuade the client to stay
• B. Have the client read and sign all the appropriate self-discharge papers
• C. Explain to the client that he cannot leave because he asked for treatment
• D. Notify the client’s healthcare provider of the client’s stated intent to leave the hospital

Correct answer: D

Rationale: The correct intervention for the nurse to initiate first is to notify the client’s healthcare provider of the client’s intention to leave the hospital. This is important to ensure that the client’s care and safety are appropriately managed. Option A is incorrect as involving the family without proper assessment or intervention could violate the client's autonomy. Option B is incorrect because it does not involve the healthcare provider in the decision-making process. Option C is incorrect as it does not address the client's rights to make decisions about their own care.

2. Which of the following is a primary intervention for managing hyperphosphatemia?

• A. Increasing calcium intake
• B. Increasing phosphorus intake
• C. Decreasing calcium intake
• D. Administering phosphate binders

Correct answer: D

Rationale: The correct answer is D, administering phosphate binders. Phosphate binders are a primary intervention for managing hyperphosphatemia as they help by binding phosphorus in the gut, preventing its absorption. Increasing calcium intake (choice A) or phosphorus intake (choice B) would exacerbate hyperphosphatemia. Decreasing calcium intake (choice C) is not a primary intervention for managing high phosphorus levels.

3. The system used at the division level and forward is comprised of 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 indeed staffed with two surgeons, two nurse anesthetists, a medical/surgical nurse, two operating room specialists, and two practical nurses. This team is specifically trained and equipped to provide surgical intervention in austere environments where immediate medical care is needed. Choices A, B, and C do not match the personnel composition described in the question, making them incorrect. The Treatment squad typically focuses on patient care and recovery, the Area support squad provides logistical and administrative support, and the Medical service squad deals with broader medical services beyond surgical interventions.

4. The nurse prepares to administer digoxin (Lanoxin) to a newborn with a diagnosis of heart failure and notes that the apical rate is 140 beats per minute. Which nursing action is appropriate?

• A. Hold the medication
• B. Administer the digoxin
• C. Notify the healthcare provider
• D. Recheck the apical rate in 1 hour

Correct answer: B

Rationale: An apical rate of 140 bpm is within the normal range for a newborn. Digoxin is commonly used to treat heart failure by increasing the strength and efficiency of the heart's contractions. Since the heart rate is within the normal range, there is no need to hold the medication or notify the healthcare provider. Rechecking the apical rate in an hour is unnecessary as the heart rate is not alarming. Therefore, the appropriate nursing action is to administer the digoxin.

5. A patient with a history of gout should avoid which type of food?

• A. Red meat
• B. Chicken
• C. Fish
• D. Dairy

Correct answer: A

Rationale: The correct answer is A: Red meat. Red meat is high in purines, which can exacerbate gout attacks. Gout is a form of arthritis that occurs when high levels of uric acid in the blood lead to the formation of urate crystals in the joints. Purine-rich foods can increase uric acid levels, leading to gout symptoms. Chicken and fish are lower in purines compared to red meat, making them better choices for individuals with gout. Dairy products are generally considered safe for gout patients and may even have a protective effect against gout.

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