Nursing Elites

1. The nurse is caring for a client in a sickle cell crisis. Which is the pain regimen of choice to relieve the pain?

• A. Frequent aspirin (acetylsalicylic acid) and a non-narcotic analgesic
• B. Motrin (ibuprofen), an NSAID, PRN
• C. Demerol (meperidine), a narcotic analgesic, every four (4) hours
• D. Morphine, a narcotic analgesic, every two (2) to three (3) hours PRN

Correct answer: D

Rationale: In a sickle cell crisis, morphine is the preferred analgesic due to its potency and effectiveness in managing severe pain. Choice A is incorrect because aspirin is contraindicated in sickle cell disease due to its potential to cause a further decrease in blood flow. Choice B, Motrin (ibuprofen), is also not the ideal choice as NSAIDs can exacerbate renal complications in sickle cell patients. Choice C, Demerol (meperidine), is not recommended for sickle cell pain management due to its toxic metabolite accumulation which can cause seizures and other complications.

2. Who is the first individual in the combat health support chain to make medically substantiated decisions based on military occupational specialty-specific medical training?

• A. Physician
• B. Physician Assistant
• C. Combat medic
• D. Combat lifesaver

Correct answer: B

Rationale: The Physician Assistant is the first individual in the combat health support chain to make medically substantiated decisions based on their military occupational specialty-specific medical training. While physicians are highly trained medical professionals, in the context of combat health support, the Physician Assistant is typically the frontline provider who directly applies their specific military medical training to make decisions. Combat medics and combat lifesavers may provide critical care in the field, but they do not have the same level of training and scope of practice as a Physician Assistant in this context, making them less likely to be the first to make medically substantiated decisions.

3. A client who is postpartum and has been diagnosed with iron deficiency anemia is receiving education from a nurse. Which dietary recommendation should be included in the education plan?

• A. Yogurt and mozzarella
• B. Spinach and beef
• C. Fish and cottage cheese
• D. Turkey slices and milk

Correct answer: B

Rationale: The correct answer is B: 'Spinach and beef.' Spinach and beef are high in iron, which is crucial for treating iron deficiency anemia. Spinach is a good source of non-heme iron, while beef provides heme iron, making them effective choices to increase iron levels in the body. Yogurt and mozzarella (Choice A), fish and cottage cheese (Choice C), and turkey slices and milk (Choice D) do not contain as high iron content as spinach and beef, making them less effective in addressing iron deficiency anemia.

4. Clinitest is used in testing the urine of a client for glucose. Which of the following, if committed by a nurse, indicates an error?

• A. Specimen is collected after meals
• B. The nurse puts the Clinitest tablet into a test tube
• C. She added 5 drops of urine and 10 drops of water
• D. If the color becomes orange or red, it is considered

Correct answer: C

Rationale: When conducting a Clinitest for testing urinary glucose levels, it is essential to add the correct amounts of urine and Clinitest reagent as instructed. Adding more water than urine could dilute the sample, leading to inaccurate test results. It's important to follow the correct ratio of drops specified in the instructions for an accurate reading. Choice A is incorrect as the specimen should be collected before meals for accurate results. Choice B is incorrect as it should be the Clinitest tablet, not the clingiest tablet. Choice D is incorrect as the statement is incomplete and lacks clarity.

5. A client who _____ diet requires _____ amounts of vitamin C.

• A. Follows a vegan diet
• B. Smokes cigarettes
• C. Follows a vegetarian diet
• D. Follows a ketogenic diet

Correct answer: B

Rationale: Clients who smoke require more vitamin C due to increased oxidative stress and depletion of vitamin C. Smoking leads to the generation of free radicals in the body, causing oxidative stress and consuming higher levels of antioxidants like vitamin C. Choices A, C, and D are incorrect as they do not directly relate to the increased need for vitamin C as seen in smokers.

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