Nursing Elites

1. 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 B: Decreased urine output. When vegetative lesions from the mitral valve embolize, they can block blood flow to the kidneys, leading to renal infarction. This can result in decreased urine output. Choices A, C, and D are incorrect. Pulmonary embolism involves a blockage of an artery in the lungs, not directly related to embolization from the mitral valve. Hemoptysis is the coughing up of blood from the respiratory tract, which is not a direct consequence of embolization from the mitral valve. Deep vein thrombosis is the formation of a blood clot in a deep vein, unrelated to embolization from the mitral valve.

2. In managing cystic fibrosis, which nutrition therapy is crucial for patients with pancreatic insufficiency?

• A. A low-fat diet to prevent steatorrhea
• B. A low-sodium diet to normalize fluid status
• C. A high-fiber diet to normalize bowel function
• D. Pancreatic enzyme replacement therapy to help digestion

Correct answer: D

Rationale: In cystic fibrosis patients with pancreatic insufficiency, pancreatic enzyme replacement therapy is vital for aiding digestion. This therapy helps compensate for the decreased production of digestive enzymes by the pancreas, enabling the proper breakdown and absorption of nutrients. Options A, B, and C are not the primary focus of nutrition therapy for cystic fibrosis patients with pancreatic insufficiency.

3. Which situation(s) are classified as natural disasters?

• A. Blizzards
• B. Blizzards, Volcanic eruptions
• C. Volcanic eruptions
• D. Structural collapse

Correct answer: B

Rationale: Blizzards and volcanic eruptions are classified as natural disasters because they are caused by natural forces beyond human control. In contrast, structural collapses are typically a result of man-made factors, making them not classified as natural disasters. Therefore, the correct answer is B.

4. 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 Physician Assistant is the first individual in the combat health support chain to make medically substantiated decisions based on their military occupational specialty-specific medical training. While physicians are highly trained medical professionals, in the context of combat health support, the Physician Assistant is typically the frontline provider who directly applies their specific military medical training to make decisions. Combat medics and combat lifesavers may provide critical care in the field, but they do not have the same level of training and scope of practice as a Physician Assistant in this context, making them less likely to be the first to make medically substantiated decisions.

5. During a physical assessment of a newborn, what finding should the nurse prioritize reporting?

• A. Head circumference of 40 cm
• B. Chest circumference of 32 cm
• C. Acrocyanosis and edema of the scalp
• D. Heart rate of 160 bpm and respirations of 40/min

Correct answer: A

Rationale: The correct answer is A because a head circumference of 40 cm is unusually large for a newborn, which may indicate hydrocephalus or other abnormalities. Reporting this finding is crucial for further evaluation and intervention. Choices B, C, and D are not as concerning during a newborn physical assessment. A chest circumference of 32 cm is within the normal range for a newborn. Acrocyanosis and edema of the scalp are common findings in newborns and usually resolve without intervention. While a heart rate of 160 bpm and respirations of 40/min should be monitored, they are not as critical as an unusually large head circumference.

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