Nursing Elites

1. The nurse had developed a close relationship with the family of a client who is dying. Which nursing intervention(s) are most appropriate in dealing with the family?

• A. Encouraging family discussion of feelings
• B. Accepting the family’s experience of anger
• C. Facilitating the use of spiritual practices identified by the family
• D. All of the above

Correct answer: D

Rationale: When a nurse has developed a close relationship with a dying client's family, it is crucial to provide comprehensive support. Encouraging family discussion of feelings helps them express their emotions and concerns, fostering a sense of relief. Accepting the family's experience of anger without judgment validates their emotions and promotes trust. Facilitating the use of spiritual practices identified by the family acknowledges their beliefs and values, offering comfort and solace. Therefore, all of the above interventions are essential in providing holistic care and support during such a challenging time. Choices A, B, and C each play a vital role in addressing different aspects of the family's emotional and spiritual needs, making option D the correct answer.

2. The Practical Nurse Course is a training program conducted in phases that cover what period of time?

• A. 46 weeks
• B. 18 months
• C. 6 weeks
• D. 52 weeks

Correct answer: D

Rationale: The correct answer is D: 52 weeks. The Practical Nurse Course is typically conducted over a period of 52 weeks. This duration allows for comprehensive training in various aspects of nursing. Choice A, 46 weeks, is incorrect as it falls short of the standard duration of the course. Choice B, 18 months, is incorrect as it represents a longer timeframe than the typical duration of the course. Choice C, 6 weeks, is incorrect as it is too short for the comprehensive training provided in a Practical Nurse Course.

3. The nurse teaches the mother of an infant how to care for her infant following repair of a cleft lip. It is MOST important for the nurse to include which of the following instructions?

• A. Feed the infant with a newborn nipple while holding him in the recumbent position
• B. Clean the suture site with a cotton-tipped swab soaked in Betadine
• C. Place the infant in the prone position after feeding
• D. Feed the infant with a rubber-tipped syringe and burp frequently

Correct answer: D

Rationale: The correct answer is D because feeding the infant with a rubber-tipped syringe reduces the risk of injury to the surgical site and prevents aspiration. Choice A is incorrect because feeding in the recumbent position can increase the risk of aspiration. Choice B is incorrect as Betadine is not recommended for wound care near the mouth due to its potential toxicity if ingested. Choice C is incorrect because placing the infant in the prone position after feeding can increase the risk of regurgitation and aspiration.

4. The system used at the division level and forward is comprised of six basic modules. Which module is staffed with two surgeons, two nurse anesthetists, a medical/surgical nurse, two operating room specialists, and two practical nurses?

• A. Treatment squad
• B. Area support squad
• C. Medical service squad
• D. Forward surgical team

Correct answer: D

Rationale: The correct answer is D, Forward Surgical Team (FST). The FST is indeed staffed with two surgeons, two nurse anesthetists, a medical/surgical nurse, two operating room specialists, and two practical nurses. This team is specifically trained and equipped to provide surgical intervention in austere environments where immediate medical care is needed. Choices A, B, and C do not match the personnel composition described in the question, making them incorrect. The Treatment squad typically focuses on patient care and recovery, the Area support squad provides logistical and administrative support, and the Medical service squad deals with broader medical services beyond surgical interventions.

5. The client diagnosed with thalassemia, a hereditary anemia, is to receive a transfusion of packed RBCs. The cross-match reveals the presence of antibodies that cannot be cross-matched. Which precaution should the nurse implement when initiating the transfusion?

• A. Start the transfusion at 10-15 mL per hour for 15-30 minutes
• B. Re-crossmatch the blood until the antibodies are identified
• C. Have the client sign a permit to receive uncrossmatched blood
• D. Have the unlicensed nursing assistant stay with the client

Correct answer: A

Rationale: Starting the transfusion slowly at 10-15 mL per hour for 15-30 minutes is essential when the cross-match reveals the presence of antibodies that cannot be cross-matched. This precaution allows the nurse to monitor for any adverse reactions due to the antibodies. Re-crossmatching the blood until the antibodies are identified (choice B) may delay the transfusion process and put the client at risk. Having the client sign a permit to receive uncrossmatched blood (choice C) is not a standard practice and does not address the immediate need for precautions during transfusion. Having the unlicensed nursing assistant stay with the client (choice D) is unrelated to the safe initiation of the transfusion and is not a precaution specific to managing antibodies in blood products.

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