Nursing Elites

1. Listed below are five categories that identify the responsibilities of the practical nurse manager in personnel management. Which of these categories is most appropriate for the task 'Conduct physical training'?

• A. Accountability
• B. Personal/professional development
• C. Individual training
• D. Military appearance/physical condition

Correct answer: D

Rationale: The correct answer is D because 'Military appearance/physical condition' typically involves conducting physical training to ensure personnel meet certain physical standards. Choices A, B, and C are incorrect. Accountability deals with being answerable for one's actions, personal/professional development focuses on individual growth and advancement, and individual training refers to specific skill development rather than physical training.

2. The client has been diagnosed with hemorrhoids. Which statement from the client indicates that further teaching is needed?

• A. “I should increase fruits, bran, and fluids in my diet.”
• B. “I will use warm compresses and take sitz baths daily.”
• C. “I must take a laxative every night and have a stool daily.”
• D. “I can use an analgesic ointment or suppository for pain.”

Correct answer: C

Rationale: Choice C indicates that further teaching is needed because taking a laxative every night and aiming to have a stool daily can lead to dependence and is not recommended for managing hemorrhoids. Choices A, B, and D are appropriate self-care measures for hemorrhoids, such as increasing fiber intake, using warm compresses/sitz baths, and using analgesic ointments or suppositories for pain relief.

3. The client diagnosed with thalassemia, a hereditary anemia, is to receive a transfusion of packed RBCs. The cross-match reveals the presence of antibodies that cannot be cross-matched. Which precaution should the nurse implement when initiating the transfusion?

• A. Start the transfusion at 10-15 mL per hour for 15-30 minutes
• B. Re-crossmatch the blood until the antibodies are identified
• C. Have the client sign a permit to receive uncrossmatched blood
• D. Have the unlicensed nursing assistant stay with the client

Correct answer: A

Rationale: Starting the transfusion slowly at 10-15 mL per hour for 15-30 minutes is essential when the cross-match reveals the presence of antibodies that cannot be cross-matched. This precaution allows the nurse to monitor for any adverse reactions due to the antibodies. Re-crossmatching the blood until the antibodies are identified (choice B) may delay the transfusion process and put the client at risk. Having the client sign a permit to receive uncrossmatched blood (choice C) is not a standard practice and does not address the immediate need for precautions during transfusion. Having the unlicensed nursing assistant stay with the client (choice D) is unrelated to the safe initiation of the transfusion and is not a precaution specific to managing antibodies in blood products.

4. Which vitamin deficiency is commonly associated with prolonged antibiotic use?

• A. Vitamin A
• B. Vitamin B6
• C. Vitamin C
• D. Vitamin K

Correct answer: D

Rationale: The correct answer is Vitamin K. Prolonged antibiotic use can disrupt the gut flora, leading to Vitamin K deficiency and an increased risk of bleeding. Vitamin A deficiency is not commonly associated with antibiotic use. Similarly, Vitamin B6 and Vitamin C deficiencies are not typically linked to prolonged antibiotic use.

5. The nurse is caring for a client whose religious background is Seventh Day Adventist (Church of GOD). Which nursing action(s) are most appropriate in terms of providing for the dietary needs of this client? Select all that apply.

• A. Providing snacks between meals
• B. Excluding caffeine and pork from the client's diet
• C. Removing coffee from the breakfast tray
• D. Ensuring that there is no pork on the dinner tray

Correct answer: B

Rationale: The correct answer is B. Seventh Day Adventists typically avoid caffeine and pork due to religious dietary restrictions. Providing snacks between meals (choice A) is not specifically related to the dietary needs of this client. While removing coffee from the breakfast tray (choice C) aligns with the client's dietary restrictions, ensuring no pork on the dinner tray (choice D) is redundant as it is already covered in the correct answer. Therefore, choices C and D are not necessary to include as separate options.

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