Nursing Elites

1. What type of cells create exocrine secretions?

• A. alpha cells
• B. beta cells
• C. acinar cells
• D. plasma cells

Correct answer: C

Rationale: Acinar cells are responsible for creating exocrine secretions, such as enzymes and digestive juices. Alpha cells are found in the pancreas and are responsible for producing glucagon, beta cells produce insulin, and plasma cells are a type of white blood cell involved in immune responses. Therefore, the correct answer is acinar cells, as they specifically produce exocrine secretions.

2. Which of the following infant behaviors demonstrates the concept of object permanence?

• A. The infant cries when his mother leaves the room.
• B. The infant looks at the floor to find a toy that he was playing with and dropped.
• C. The infant picks up another toy after the one he was playing with rolls under the couch.
• D. The infant participates in a game of patty-cake.

Correct answer: B

Rationale: Object permanence occurs when the infant learns that something or someone still exists even though they might not be able to see it or them. This typically develops between 9 and 10 months of age. The correct answer, 'The infant looks at the floor to find a toy that he was playing with and dropped,' demonstrates object permanence as the infant understands that the toy still exists even though it is temporarily out of sight. Choices A and C do not directly relate to object permanence as the behaviors described do not necessarily indicate an understanding of objects existing when out of sight. Choice D is incorrect as participating in a game of patty-cake does not involve demonstrating object permanence. Peek-a-boo is a more suitable example of a game that demonstrates object permanence, as the infant continues to look for the hidden face, understanding that it still exists even though temporarily unseen.

3. The LPN is preparing to ambulate a client post total knee replacement. Which of the following actions should the nurse perform prior to ambulating the client?

• A. Assist the client to a sitting position at the edge of the bed
• B. Have the client march in place for 30 seconds
• C. Have the client raise his arms above his head
• D. Ask the client the last time he fell

Correct answer: A

Rationale: The correct action to perform before ambulating a client post total knee replacement is to assist the client to a sitting position at the edge of the bed. This step is crucial to prevent orthostatic hypotension and ensure the client is ready to stand and walk safely. Having the client march in place or raise his arms above his head are not necessary preparations for ambulation. While knowing about the client's fall history is important for safety reasons, it is not the priority action immediately before ambulating the client.

4. The nurse is caring for a client following an appendectomy. The client reports nausea and complains of surgical site pain at a 6 on a 0 to 10 scale. The client's employer is present in the room and states he is paying for the insurance and wants to know what pain medication has been prescribed by the physician. Which of the following is the appropriate nurse response?

• A. Answer any questions the employer may have as he pays for the insurance.
• B. Tell the employer his question is inappropriate and that the information is none of his business.
• C. Explain to the employer that you cannot release private information and ask the employer to step out while you conduct your assessment of the client.
• D. Ask the employer to leave and wait until the client returns home to visit.

Correct answer: C

Rationale: The appropriate nurse response is to explain to the employer that private information cannot be released and ask the employer to step out while conducting the assessment. This approach respects the client's privacy while still acknowledging the employer. The employer's payment for insurance does not grant rights to confidential information. Sharing information without permission violates the client's right to privacy under HIPAA. Option A is incorrect as it compromises the client's confidentiality by sharing private medical information. Option B is inappropriate and unprofessional as it does not address the situation respectfully. Option D is incorrect as it does not prioritize the client's immediate needs and assumes the client's consent without proper communication.

5. Which of the following diseases or conditions is least likely to be associated with an increased potential for bleeding?

• A. metastatic liver cancer
• B. gram-negative septicemia
• C. pernicious anemia
• D. iron-deficiency anemia

Correct answer: C

Rationale: Pernicious anemia is least likely to be associated with an increased potential for bleeding. Pernicious anemia results from vitamin B12 deficiency due to a lack of intrinsic factor, leading to faulty absorption from the gastrointestinal tract. While pernicious anemia can lead to other health issues, bleeding tendencies are not a primary concern. Metastatic liver cancer (choice A) can cause liver dysfunction leading to decreased synthesis of clotting factors, increasing the risk of bleeding. Gram-negative septicemia (choice B) can lead to disseminated intravascular coagulation (DIC) causing excessive bleeding. Iron-deficiency anemia (choice D) can result in microcytic hypochromic red blood cells, which can impair oxygen transport and lead to tissue hypoxia, but it is not directly associated with a significant potential for bleeding.

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