Nursing Elites

1. What is the FIRST step in providing health care for a patient?

• A. Obtain and interpret vital signs
• B. Determine the needs of the patient
• C. Develop a plan of care
• D. Obtain lab work and x-rays

Correct answer: B

Rationale: The correct first step in providing health care for a patient is to determine the needs of the patient. Understanding the patient's requirements, concerns, and medical history is crucial before proceeding with any further steps. Option A, 'Obtain and interpret vital signs,' may be necessary but typically follows assessing the patient's needs. Option C, 'Develop a plan of care,' comes after identifying the patient's needs. Option D, 'Obtain lab work and x-rays,' is usually done based on the patient's needs and the developed plan of care, making it a later step in the process.

2. During peacetime, most CONUS hospital military personnel are organized into what type of organization?

• A. DVA
• B. TOE
• C. TDA
• D. NDMS

Correct answer: C

Rationale: During peacetime, most CONUS hospital military personnel are organized into a TDA (Table of Distribution and Allowances) type of organization. TDA defines the structure and personnel requirements of a unit. Choice A, DVA (Department of Veterans Affairs), is not the typical organizational structure for military hospital personnel. Choice B, TOE (Table of Organization and Equipment), refers to the organization and equipment of a unit, not the personnel organization. Choice D, NDMS (National Disaster Medical System), is a federal program that coordinates medical responses to disasters and emergencies, but it is not the primary organizational structure for military hospital personnel during peacetime.

3. A nurse is reviewing the laboratory results for a client with a history of atherosclerosis and notes elevated cholesterol levels. Which statement by the client indicates the nurse should plan follow-up instruction on a low-cholesterol diet?

• A. ''I take an omega-3 supplement daily.''
• B. ''I cook my food with canola oil.''
• C. ''I eat three eggs for breakfast each morning.''
• D. ''I flavor my meat with lemon juice.''

Correct answer: C

Rationale: The correct answer is C. Eating three eggs daily increases cholesterol intake, which could exacerbate atherosclerosis. Choice A is incorrect because taking an omega-3 supplement can actually help reduce cholesterol levels. Choice B is incorrect as canola oil is a healthier choice compared to saturated fats. Choice D is incorrect since flavoring meat with lemon juice does not significantly impact cholesterol levels.

4. The nurse is administering a beta blocker to the client diagnosed with essential hypertension. Which data would cause the nurse to question administering the medication?

• A. The client’s BP is 110/70
• B. The client’s potassium level is 3.4 mEq/L
• C. The client has a barky cough
• D. The client’s apical pulse is 56

Correct answer: D

Rationale: The correct answer is D. A beta blocker should be withheld if the apical pulse is below 60, as it can further decrease the heart rate. Choice A is not a reason to question administering a beta blocker as the blood pressure is within normal range. Choice B is not directly related to the administration of a beta blocker. Choice C may indicate a potential adverse effect of another medication, but it does not specifically warrant questioning the administration of the beta blocker.

5. A 31-year-old client is seeking contraceptive information. Before responding to the client’s questions about contraceptives, the nurse obtains a health history. What factor in the client’s history indicates to the nurse that oral contraceptives are contraindicated?

• A. More than 30 years of age
• B. Had two multiple pregnancies
• C. Smokes 1 pack of cigarettes a day
• D. Has a history of borderline hypertension

Correct answer: C

Rationale: The correct answer is C. Smoking, especially in clients over 30, increases the risk of thromboembolic events, making oral contraceptives contraindicated. Choice A is incorrect as age alone is not a contraindication for oral contraceptives. Choice B is incorrect as having multiple pregnancies is not a contraindication for oral contraceptives. Choice D is incorrect as borderline hypertension is not a strict contraindication for oral contraceptives.

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