Nursing Elites

1. 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.

2. Who is the first individual in the combat health support chain to make medically substantiated decisions based on military occupational specialty-specific medical training?

• A. Physician
• B. Physician assistant
• C. Combat medic
• D. Combat lifesaver

Correct answer: B

Rationale: The correct answer is 'Physician assistant.' Physician assistants are trained to make medically substantiated decisions based on their specific medical training within the combat health support chain. Choice A, 'Physician,' is incorrect as they may be involved but are not typically the first in line for such decisions as physician assistants. Choice C, 'Combat medic,' is incorrect as they usually provide immediate medical care but may not be the first to make medically substantiated decisions. Choice D, 'Combat lifesaver,' is incorrect as they are trained to provide basic life-saving interventions but may not have the specialized medical training to make complex medical decisions.

3. The system used at the division level and forward is comprised of six basic modules. Which module is composed of a dental officer, dental specialist, x-ray specialist, laboratory specialist, and needed equipment?

• A. Treatment squad
• B. Area support squad
• C. Medical service squad
• D. Dental squad

Correct answer: D

Rationale: The correct answer is D, Dental squad. The Dental squad is composed of a dental officer, dental specialist, x-ray specialist, laboratory specialist, and necessary equipment. This module specifically focuses on dental care and services. Choices A, B, and C are incorrect as they do not include the specific specialists mentioned in the question or focus on dental services.

4. Which laboratory data indicate the client’s pancreatitis is improving?

• A. The amylase and lipase serum levels are decreased
• B. The white blood cell count (WBC) is decreased
• C. The conjugated and unconjugated bilirubin levels are decreased
• D. The blood urea nitrogen (BUN) serum level is decreased

Correct answer: A

Rationale: The correct answer is A. Amylase and lipase are specific markers for pancreatitis. A decrease in their serum levels indicates improvement in pancreatitis. Choice B, a decreased white blood cell count (WBC), is more indicative of an improvement in infection rather than pancreatitis. Choices C and D, decreased bilirubin levels and blood urea nitrogen (BUN) levels respectively, are not specific markers for pancreatitis improvement.

5. Which potential complication should the nurse assess for in the client with infective endocarditis who has embolization of vegetative lesions from the mitral valve?

• A. Pulmonary embolism
• B. Decreased urine output
• C. Hemoptysis
• D. Deep vein thrombosis

Correct answer: B

Rationale: The correct answer is 'Decreased urine output.' Embolization of vegetative lesions from the mitral valve can cause renal infarction, leading to a decrease in urine output. This complication is due to the obstruction of blood flow to the kidneys. Choices A, C, and D are incorrect because embolization from the mitral valve typically does not directly cause pulmonary embolism, hemoptysis, or deep vein thrombosis.

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