Nursing Elites

1. Which question should the healthcare provider ask when assessing the client for an endocrine dysfunction?

• A. “Have you noticed any pain in your legs when walking?”
• B. “Have you had any unexplained weight loss?”
• C. “Have you noticed any change in your bowel movements?”
• D. “Have you experienced any joint pain or discomfort?”

Correct answer: B

Rationale: The correct answer is B: “Have you had any unexplained weight loss?” Unexplained weight loss can be a significant symptom of various endocrine disorders, such as hyperthyroidism and diabetes. Weight changes are often closely linked to endocrine dysfunction due to the hormonal imbalances affecting metabolism. Choices A, C, and D are less specific to endocrine dysfunction. Pain in the legs, changes in bowel movements, and joint pain or discomfort are symptoms that can be related to various health conditions but are not as indicative of endocrine disorders as unexplained weight loss.

2. The client is admitted to the emergency department complaining of acute epigastric pain and reports vomiting a large amount of bright red blood at home. Which interventions should the nurse implement?

• A. Assess the client’s vital signs
• B. Start an IV with an 18-gauge needle
• C. Begin iced saline lavage
• D. A, B

Correct answer: D

Rationale: The correct interventions for a client presenting with acute epigastric pain and vomiting bright red blood are to assess the client’s vital signs and start an IV with an 18-gauge needle. Assessing vital signs helps in determining the client's current condition and response to treatment, while starting an IV is crucial for administering medications and fluids. Beginning iced saline lavage is not appropriate in this situation as the priority is to stabilize the client and address potential bleeding. Therefore, options A and B are correct choices, making option D the most appropriate answer.

3. What is the combat health support system in the field designed to do?

• A. Provide evacuation to the far rear for treatment and delay return to duty
• B. Project, sustain, and protect the health of the soldier in war and operations other than war
• C. Provide rearward evacuation and reassignment
• D. Provide far rear area care and delayed return to duty

Correct answer: B

Rationale: The combat health support system in the field is primarily designed to project, sustain, and protect the health of soldiers during war and other operations. Choice A is incorrect as it focuses solely on evacuation and delaying return to duty, missing the broader scope of health support. Choice C is incorrect as it only mentions rearward evacuation and reassignment, which is not the sole purpose of the combat health support system. Choice D is also incorrect as it emphasizes far rear area care and delayed return to duty, neglecting the comprehensive nature of health support in combat situations.

4. Six hours after major abdominal surgery, a male client complains of severe abdominal pain; is pale and perspiring; has a thready, rapid pulse; and states he feels faint. The nurse checks the client’s medication administration record and determines that the client receives another injection of pain medication in an hour. What is the appropriate action by the nurse?

• A. Explain to the client that it is too early to have an injection for pain
• B. Call the practitioner, report the client’s symptoms, and obtain further orders
• C. Reposition the client for greater comfort and turn on the television as a distraction
• D. Prepare the injection and administer it to the client early because of the severe pain

Correct answer: B

Rationale: The correct action for the nurse to take in this situation is option B: Call the practitioner, report the client’s symptoms, and obtain further orders. The client is displaying symptoms that indicate potential complications, such as internal bleeding, which require immediate medical evaluation. Option A is incorrect because the client's condition suggests a more urgent need for assessment. Option C is inappropriate as it does not address the seriousness of the client's symptoms. Option D is dangerous and could exacerbate any underlying issue the client may be experiencing.

5. Which of the following is NOT one of the three basic areas of concern into which practical nurse management responsibilities can be categorized?

• A. Managing patients' legal affairs
• B. Managing the hypothalamus: The hypothalamus is a small area in the brain located just below the thalamus. It plays a crucial role in controlling various bodily functions, including temperature regulation, hunger, and thirst, sleep-wake cycles, and hormone regulation. The hypothalamus is also involved in the control of the autonomic nervous system and the release of hormones from the pituitary gland.
• C. Managing work center operations
• D. Managing personnel

Correct answer: A

Rationale: Managing patients' legal affairs is not a basic area of concern in practical nurse management responsibilities. The primary areas typically include managing work center operations, managing personnel, and overseeing patient care. Choice B, managing the hypothalamus, is irrelevant to nurse management responsibilities and is not a standard area of concern in this context. Choice C, managing work center operations, and Choice D, managing personnel, align more closely with the core responsibilities and concerns of practical nurse management roles.

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