The nurse is analyzing laboratory values for the assigned clients. Which finding, based on the client's medical history, indicates the need for immediate follow-up?
- A. Client with chronic kidney disease and serum creatinine of 1.6 mg/dL
- B. Client with diabetes mellitus and a glycosylated hemoglobin A1c (HbA1c) of 7.0%
- C. Client with heart failure and a B-type natriuretic peptide (BNP) of 140 pg/mL
- D. Client who is male and has anemia with hemoglobin of 16.5 g/dL and hematocrit of 45%
Correct Answer: B
Rationale: An HbA1c of 7.0% in a client with diabetes mellitus indicates poor long-term glucose control, necessitating immediate follow-up. Choice A, chronic kidney disease with a serum creatinine of 1.6 mg/dL, though concerning, does not indicate an immediate need for follow-up. Choice C, heart failure with a BNP of 140 pg/mL, may require monitoring but not immediate follow-up. Choice D, a male client with anemia and normal hemoglobin and hematocrit levels, does not warrant immediate attention based on the provided information.
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Before administering an MMR (measles, mumps, and rubella) vaccine to a 15-month-old, which question should the nurse ask the mother of the child?
- A. "Has your child had any sore throats?"
- B. "Has your child been eating properly?"
- C. "Is your child allergic to any antibiotics?"
- D. "Has your child been exposed to any infections?"
Correct Answer: C
Rationale: The correct question the nurse should ask the mother before administering an MMR vaccine to a 15-month-old is whether the child is allergic to any antibiotics. This is crucial because vaccines like MMR contain components that the child could be allergic to, such as neomycin. Checking for antibiotic allergies is essential to prevent adverse reactions to the vaccine. The other options are less relevant in this context. Asking about sore throats, eating habits, or exposure to infections does not directly impact the administration of the MMR vaccine.
The unlicensed nursing assistant is applying elastic compression stockings to the client. Which action by the assistant warrants immediate intervention by the nurse?
- A. The assistant is putting the stockings on while the client is in the chair
- B. The assistant inserted two (2) fingers under the proximal end of the stocking
- C. The assistant elevated the feet while lying down to put on the stockings
- D. The assistant made sure the toes were warm after putting the stockings on
Correct Answer: A
Rationale: The correct answer is A. Compression stockings should be applied while the client is lying down to prevent pooling of blood in the legs, which can occur when the client is sitting or standing. Choice B is incorrect as inserting two fingers under the proximal end of the stocking helps ensure proper fit. Choice C is incorrect as elevating the feet while lying down is a correct technique for applying compression stockings. Choice D is incorrect as ensuring the toes are warm after putting the stockings on is a good practice for client comfort.
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: Norepinephrine is indeed secreted by the adrenal medulla, making choice C the correct answer. The adrenal medulla is part of the adrenal glands, located on top of the kidneys. Norepinephrine is involved in the body's 'fight or flight' response, helping to prepare the body to react to stress. Choices A, B, and D are incorrect as norepinephrine is not secreted by the pancreas, adrenal cortex, or the anterior pituitary gland.
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.
Which of the following is a nonmedical member of a unit who receives additional training in providing care beyond basic first aid procedures?
- A. Area support squad leader
- B. ATLS specialist
- C. Tactical lifesaver
- D. Combat lifesaver
Correct Answer: D
Rationale: The correct answer is D, Combat lifesaver. A Combat Lifesaver is a nonmedical member of a unit who receives specialized training in advanced first aid procedures, beyond basic first aid care. This training equips them to provide crucial medical assistance in emergency situations where immediate medical personnel may not be available. Choices A, B, and C are incorrect as they do not specifically refer to nonmedical members trained in advanced first aid care beyond basic procedures.