Nursing Elites

1. The nurse instructs a client 5 days after a lumbar laminectomy with spinal fusion about how to move from a supine position to standing at the left side of the bed with a walker. Which of the following directions by the nurse is BEST?

• A. Raise the head of the bed so you are sitting straight up, bend your knees, and swing your legs to the side and then to the floor
• B. Rock your body from side to side, going further each time until you build up enough momentum to be lying on your right side, and then raise your trunk toward your toes
• C. Reach over to the left side rail with your right hand, pull your body onto its side, bend your upper leg so the foot is on the bed, and push down to elevate your trunk
• D. Focus on using your arms, the left elbow as a pivot with the left hand grasping the mattress edge and the right hand pushing on the mattress above the elbow, then slide your legs over the side of the mattress

Correct answer: C

Rationale: Choice C is the best direction provided by the nurse. This method involves reaching over to the left side rail with the right hand, pulling the body onto its side, bending the upper leg so the foot is on the bed, and pushing down to elevate the trunk. This approach helps maintain spinal alignment while moving from a lying to a standing position, reducing strain on the back. Choices A, B, and D involve movements that are not suitable for a client recovering from a lumbar laminectomy with spinal fusion and could potentially cause harm or discomfort.

2. A true statement about medications is that:

• A. Over-the-counter medications are unlikely to interact with food or nutrients
• B. Prescription medications always have significant interactions with food
• C. Prescription and nonprescription drugs and herbal remedies interact with food
• D. Herbal products are generally safe since they are natural

Correct answer: C

Rationale: The correct answer is C. This statement is true because both prescription and over-the-counter medications, as well as herbal remedies, can interact with food. Choice A is incorrect because over-the-counter medications can also interact with food or nutrients. Choice B is incorrect as not all prescription medications have significant interactions with food. Choice D is incorrect because natural herbal products can also have side effects and interactions with other substances.

3. What is the COMMZ level hospital whose principal mission is to treat and rehabilitate those patients who can return to duty within the stated theater evacuation policy?

• A. FSB
• B. CSH
• C. GH
• D. FH

Correct answer: C

Rationale: The correct answer is C: GH (General Hospital). General Hospitals have the principal mission of treating and rehabilitating patients who can return to duty within the theater evacuation policy. FSB (Forward Surgical Hospital), CSH (Combat Support Hospital), and FH (Field Hospital) do not focus on treating and rehabilitating patients for duty within the theater evacuation policy, making them incorrect choices.

4. The healthcare provider is conducting a respiratory assessment and is determining respirations per minute. Which factor(s) generally affect the character of respirations? Select all that apply.

• A. Anxiety
• B. Exercise
• C. Smoking
• D. A, B

Correct answer: D

Rationale: Correct! Anxiety and exercise can significantly alter the character of respirations, increasing the rate and depth. Smoking, while harmful to the respiratory system in the long term, does not directly affect the character of respirations like anxiety and exercise do. Therefore, choices C (Smoking) is incorrect. The correct answer is D (A, B).

5. The use of the antibiotic neomycin may decrease the absorption of:

• A. Iron, copper, and zinc
• B. Protein and amino acids
• C. Fat-soluble vitamins
• D. Water-soluble vitamins

Correct answer: C

Rationale: The correct answer is C. Neomycin can interfere with the absorption of fat-soluble vitamins such as vitamins A, D, E, and K. Choice A is incorrect because neomycin does not affect the absorption of iron, copper, and zinc. Choice B is incorrect as neomycin does not impact the absorption of protein and amino acids. Choice D is also incorrect as neomycin does not decrease the absorption of water-soluble vitamins like vitamin C and the B vitamins.

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