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The client diagnosed with diabetes mellitus type 2 is admitted to the hospital with cellulitis of the right foot secondary to an insect bite. Which intervention should the nurse implement first?
- A. Administer intravenous antibiotics
- B. Apply warm moist packs every two hours
- C. Elevate the right foot on two pillows
- D. Teach the client about skin and foot care
Correct Answer: A
Rationale: Administering intravenous antibiotics is the priority intervention in this situation. Cellulitis is a bacterial infection that can spread rapidly, especially in individuals with diabetes. Immediate antibiotic therapy is crucial to prevent the infection from worsening and causing serious complications. Applying warm moist packs, elevating the foot, and teaching the client about skin and foot care are important interventions but should come after initiating antibiotic treatment to address the underlying infection.
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The client diagnosed with acute vein thrombosis is receiving a continuous heparin drip, an intravenous anticoagulant. The health care provider orders warfarin (Coumadin), an oral anticoagulant. Which action should the nurse take?
- A. Discontinue the heparin drip before initiating the Coumadin
- B. Check the client's INR before beginning Coumadin
- C. Clarify the order with the healthcare provider as soon as possible
- D. Administer the Coumadin along with the heparin drip as ordered
Correct Answer: D
Rationale: The correct answer is to administer the Coumadin along with the heparin drip as ordered. Heparin and warfarin are often given together initially because warfarin takes a few days to become effective. Discontinuing the heparin drip before initiating Coumadin can increase the risk of clot formation. Checking the client's INR before starting Coumadin is important but not the immediate action required. Clarifying the order with the healthcare provider is not necessary as both medications are commonly used together.
A healthcare provider is caring for a client who takes an antidepressant and oral contraceptives. Which herbal supplement should the healthcare provider educate the client about due to a drug-herb interaction?
- A. Iron supplement
- B. Garlic
- C. Green tea
- D. St. John's Wort
Correct Answer: D
Rationale: The correct answer is D, St. John's Wort. St. John's Wort can interact with antidepressants and oral contraceptives, potentially reducing their efficacy. Iron supplement, garlic, and green tea are not typically known to have significant interactions with antidepressants or oral contraceptives, making them less likely to impact the client's treatment.
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.
The Army Medical Department has four major functions. Three are prevention, treatment, and evacuation. What is the fourth?
- A. Preparation
- B. Training
- C. Mobilization
- D. Selection
Correct Answer: C
Rationale: The correct answer is C, 'Mobilization.' Mobilization is the fourth major function of the Army Medical Department. This involves preparing and organizing medical resources and personnel for deployment during military operations. Choices A, B, and D are incorrect because while they are important aspects in military healthcare, they do not represent the fourth major function of the Army Medical Department as specifically requested in the question.
The nurse is teaching basic cardiopulmonary resuscitation (CPR) to individuals in the community. Which is the order of basic CPR?
- A. Ensure the scene is safe, assess responsiveness, call for help, begin CPR with compressions, airway, and breathing
- B. Give two (2) rescue breaths
- C. Look, listen, and feel for breathing
- D. Begin chest compressions
Correct Answer: A
Rationale: The correct order of basic CPR is to first ensure the scene is safe to approach, then assess responsiveness. Next, call for help and start CPR with chest compressions, followed by checking the airway and giving rescue breaths. Choice B is incorrect as giving rescue breaths is usually done after the initial chest compressions. Choice C is incorrect as looking, listening, and feeling for breathing comes after starting compressions. Choice D is incorrect as chest compressions are usually the first step in basic CPR.