Nursing Elites

1. Which risk factor would the nurse expect to find in the client diagnosed with pancreatic cancer?

• A. Chewing tobacco
• B. Low-fat diet
• C. Chronic alcoholism
• D. Exposure to industrial chemicals

Correct answer: C

Rationale: The correct answer is C: Chronic alcoholism. Chronic alcoholism is a significant risk factor for pancreatic cancer as alcohol has a damaging effect on the pancreas. Chewing tobacco (choice A) is associated with oral and throat cancers, not specifically pancreatic cancer. A low-fat diet (choice B) is generally considered a healthier choice and not a direct risk factor for pancreatic cancer. Exposure to industrial chemicals (choice D) may be linked to other types of cancers but is not a major risk factor for pancreatic cancer.

2. The nurse is preparing a teaching care plan for the client diagnosed with nephritic syndrome. Which intervention should the nurse include?

• A. Discontinue the use of steroid therapy immediately if symptoms develop.
• B. Take diuretics as needed to treat the dependent edema in ankles.
• C. Increase the intake of dietary sodium every day to decrease fluid retention.
• D. Report any decrease in daily weight during treatment to the healthcare provider.

Correct answer: D

Rationale: The correct intervention for the nurse to include in the care plan for a client diagnosed with nephritic syndrome is to instruct the client to report any decrease in daily weight during treatment to the healthcare provider. A decrease in weight could indicate worsening of the nephritic syndrome or dehydration, making it crucial information for the healthcare provider to assess the client's condition. Option A is incorrect because discontinuing steroid therapy should be done under medical guidance rather than immediately if symptoms develop. Option B is incorrect because diuretics should not be taken without healthcare provider's guidance due to the risk of electrolyte imbalances. Option C is incorrect as increasing dietary sodium would exacerbate fluid retention, which is undesirable in nephritic syndrome.

3. Which nursing instruction should the nurse discuss with the client who is receiving glucocorticoids for Addison’s disease?

• A. Discuss the importance of tapering medications when discontinuing medication
• B. Explain that the dose will need to be decreased during times of stress or infection
• C. Instruct the client to take medication on an empty stomach with a glass of water
• D. Encourage the client to wear a MedicAlert bracelet and carry a card in the wallet

Correct answer: A

Rationale: The correct answer is to discuss the importance of tapering medications when discontinuing medication. Tapering glucocorticoids is crucial to prevent adrenal insufficiency, which can occur if the medication is stopped abruptly. Choice B is incorrect because it focuses on adjustments during stress or infection, not discontinuation. Choice C is unrelated to the management of glucocorticoids. Choice D is important for emergency identification but is not directly related to medication management.

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 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.' A MEDCEN (Medical Center) is a specialized medical treatment and teaching facility that offers general and specialized medical and dental care. Choice A, 'CONUS,' refers to the continental United States and is not related to medical facilities. Choice C, 'MEDCOM,' stands for Medical Command, which is an administrative entity responsible for overseeing medical units, not providing direct care. Choice D, 'MEDDAC,' refers to Medical Department Activity, which is a smaller medical unit compared to a MEDCEN and may not provide the same level of specialized care.

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