Nursing Elites

1. The nurse is aware that norepinephrine is secreted by which endocrine gland?

• A. The pancreas
• B. The adrenal cortex
• C. The adrenal medulla
• D. The anterior pituitary gland

Correct answer: C

Rationale: The correct answer is C: The adrenal medulla. Norepinephrine is secreted by the adrenal medulla and is involved in the body's 'fight or flight' response. The pancreas (choice A) secretes insulin and glucagon, not norepinephrine. The adrenal cortex (choice B) secretes hormones like cortisol and aldosterone, but not norepinephrine. The anterior pituitary gland (choice D) secretes various hormones like growth hormone and thyroid-stimulating hormone, but not norepinephrine.

2. Under the health services support area concept, how is the medical care under the MEDCOM divided?

• A. Six geographical regions of the United States with command authority in each region
• B. Five levels of health service support, each providing different levels of health care services
• C. Primary and secondary health care regions, each containing a MEDDAC or MEDCEN
• D. Eight geographical areas of responsibility designated as health services support regions, each of which is subdivided into two or more health service areas

Correct answer: D

Rationale: The correct answer is D. Under the health services support area concept, the medical care under the MEDCOM is divided into eight geographical areas of responsibility designated as health services support regions, each of which is further subdivided into two or more health service areas. This structure allows for a more organized and efficient delivery of medical care across different regions. Choices A, B, and C are incorrect because they do not accurately describe how medical care under the MEDCOM is divided according to the concept of health services support areas.

3. When a patient is prescribed an oral anticoagulant, what should the nurse monitor for?

• A. Elevated blood glucose
• B. Decreased blood pressure
• C. Signs of bleeding
• D. Increased appetite

Correct answer: C

Rationale: When a patient is prescribed an oral anticoagulant, the nurse should monitor for signs of bleeding. Oral anticoagulants work by inhibiting the blood's ability to clot, which increases the risk of bleeding. Monitoring for signs of bleeding such as easy bruising, petechiae, hematuria, or bleeding gums is crucial to prevent complications. Elevated blood glucose (Choice A) is not directly related to oral anticoagulant use. Decreased blood pressure (Choice B) is not a common effect of oral anticoagulants. Increased appetite (Choice D) is not a typical side effect of oral anticoagulants and is not a primary concern when monitoring a patient on this medication.

4. The nurse on the postsurgical unit received a client who was transferred from the post-anesthesia care unit (PACU) and is planning care for this client. The nurse understands that staff should begin planning for this client’s discharge at which point during the hospitalization?

• A. Is admitted to the surgical unit
• B. Is transferred from the PACU to the postsurgical unit
• C. Is able to perform activities of daily living independently
• D. Has been assessed by the healthcare provider for the first time after surgery

Correct answer: A

Rationale: Discharge planning should begin as soon as the patient is admitted to the surgical unit to ensure a smooth transition. It is important to start early to address any potential barriers to discharge, coordinate resources, and provide adequate education and support. Choices B, C, and D are not the appropriate points to start discharge planning as they do not mark the beginning of the hospitalization phase related to the surgical unit.

5. 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 and requires immediate assessment. Choice A is not as urgent as an audible S3 in mitral valve prolapse. Choice B, a client with coronary artery disease wanting to ambulate, does not present an immediate concern compared to a potential heart failure indicated by an audible S3. Choice D, a client with pericarditis in normal sinus rhythm, is stable and does not require immediate attention when compared to a potential heart failure situation signified by an audible S3 in mitral valve prolapse.

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