Nursing Elites

1. The nurse is caring for clients on a cardiac floor. Which client should the nurse assess first?

• A. The client with three (3) unifocal PVCs in a minute
• B. The client diagnosed with coronary artery disease who wants to ambulate
• C. The client diagnosed with mitral valve prolapse with an audible S3
• D. The client diagnosed with pericarditis who is in normal sinus rhythm

Correct answer: C

Rationale: The correct answer is C because an audible S3 in a client with mitral valve prolapse could indicate heart failure, which requires immediate assessment. Choice A is less urgent as occasional unifocal PVCs are common. Choice B is important but can be addressed after the client with an audible S3. Choice D, a client with pericarditis in normal sinus rhythm, is stable compared to a client with potential heart failure symptoms.

2. Which of the following is a specialized medical treatment and teaching facility that provides general and specialized medical and dental care and treatment?

• A. CONUS
• B. MEDCEN
• C. MEDCOM
• D. MEDDAC

Correct answer: B

Rationale: The correct answer is B, MEDCEN, which stands for Medical Center. A MEDCEN is a specialized medical treatment and teaching facility that provides general and specialized medical and dental care and treatment. Choices A, C, and D are incorrect. CONUS refers to the continental United States and is not a medical facility. MEDCOM stands for Medical Command, which is an organization rather than a specific facility for medical treatment. MEDDAC stands for Medical Department Activity and is also an organization responsible for medical care delivery, not a specific treatment facility.

3. The nurse counsels a client diagnosed with iron deficiency anemia. The nurse determines that teaching is effective if the client selects which of the following menus?

• A. Roast beef, brown rice, green beans, carrot and raisin salad, and milk
• B. Cheese pizza, tossed green salad, oatmeal-raisin cookie, and lemonade
• C. Two scrambled eggs, bacon, white toast with strawberry jam, and coffee
• D. Corn flakes with milk, whole wheat toast, and orange juice

Correct answer: A

Rationale: The correct answer is A. Roast beef is high in heme iron, which is best absorbed and helps treat iron deficiency anemia. Choices B, C, and D do not contain significant amounts of heme iron or other iron-rich foods that would be beneficial in managing iron deficiency anemia. Cheese pizza, scrambled eggs, bacon, white toast, corn flakes, and whole wheat toast do not provide the necessary heme iron needed to address the client's condition.

4. Enteral feedings may be appropriate for patients with:

• A. Acute cholecystitis
• B. Hepatic encephalopathy
• C. Ulcerative colitis in remission
• D. Acute exacerbation of Crohn’s disease

Correct answer: D

Rationale: Enteral feedings are commonly used in patients with Crohn’s disease during acute exacerbations to provide adequate nutrition while resting the bowel. Acute cholecystitis, hepatic encephalopathy, and ulcerative colitis in remission wouldn't typically require enteral feedings as the primary nutritional support. Acute cholecystitis may necessitate fasting and intravenous fluids, hepatic encephalopathy may require dietary modifications but not enteral feedings, and patients with ulcerative colitis in remission usually have their nutritional needs met through a regular diet.

5. Which of the following is inappropriate in collecting mid stream clean catch urine specimen for urine analysis?

• A. Collect early in the morning, First voided specimen
• B. Do perineal care before specimen collection
• C. Collect 5 to 10 ml for urine
• D. Discard the first flow of the urine

Correct answer: A

Rationale: When collecting a mid-stream clean catch urine specimen for urine analysis, it is important to collect an adequate amount of urine for accurate testing. A volume of 30 to 60 ml is usually recommended for optimal results, so collecting only 5 to 10 ml would not provide enough urine for testing purposes. It is essential to follow proper collection techniques to ensure accurate and reliable test results.

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