Nursing Elites

1. A patient asks a nurse the following question: Exposure to TB can be best identified with which of the following procedures?

• A. Chest x-ray
• B. Mantoux test
• C. Breath sounds examination
• D. Sputum culture for Mycobacterium tuberculosis

Correct answer: B

Rationale: The Mantoux test, also known as the tuberculin skin test, is the most appropriate and accurate test to identify exposure to TB. This test involves injecting a small amount of PPD tuberculin under the top layer of the skin, and a positive reaction indicates exposure to the TB bacteria. Choice A, a chest x-ray, is useful for detecting active TB disease but not exposure. Choice C, a breath sounds examination, is not a specific test for TB exposure. Choice D, a sputum culture for Mycobacterium tuberculosis, is used to diagnose active TB infection rather than exposure.

2. Which of the following should be included in a diet rich in iron?

• A. peaches, eggs, beef
• B. cereals, kale, cheese
• C. red beans, enriched breads, squash
• D. legumes, green beans, eggs

Correct answer: A

Rationale: The correct answer is peaches, eggs, beef. These are good sources of heme iron, which is more easily absorbed by the body compared to nonheme iron. Heme iron is mainly found in animal-based foods like meat, poultry, and fish. Peaches, eggs, and beef are rich in iron and can help prevent iron deficiency anemia. Choices B, C, and D are incorrect because they do not include significant sources of heme iron. Cereals, kale, cheese, red beans, enriched breads, squash, legumes, and green beans are sources of nonheme iron, which is not as efficiently absorbed by the body as heme iron. It is important to include heme iron sources in the diet for optimal iron absorption.

3. Herbal therapy has several indications for use. Primarily, herbal therapy is:

• A. used to treat many common complaints and diseases.
• B. used to promote certain types of low-carb diets.
• C. used as an adjunct to medications.
• D. used to create a diet without salt and carbohydrates.

Correct answer: A

Rationale: The correct answer is A: 'used to treat many common complaints and diseases.' Herbal therapy is commonly used to address a variety of health issues and ailments by utilizing natural remedies derived from plants. Choices B, C, and D are incorrect because herbal therapy's primary purpose is not to promote specific diets, act as an adjunct to medications, or create specific dietary restrictions, but rather to provide alternative treatment options for various health conditions.

4. Signs of impaired breathing in infants and children include all of the following except:

• A. nasal flaring
• B. grunting
• C. seesaw breathing
• D. quivering lips

Correct answer: D

Rationale: Signs of impaired breathing in infants and children can manifest in various ways. Nasal flaring, grunting, and seesaw breathing are all indicative of respiratory distress in pediatric patients. Nasal flaring is the widening of the nostrils with breathing effort, grunting is a sound made during exhalation to try to keep the airways open, and seesaw breathing involves the chest moving in the opposite direction of the abdomen. However, quivering lips are not typically associated with impaired breathing in this context. Lip quivering is a distracter and not a common sign of respiratory distress in infants and children. Therefore, the correct answer is 'quivering lips.'

5. One drug can alter the absorption of another drug. One drug increases intestinal motility. Which effect does this have on the second drug?

• A. None; absorption of the second drug is not affected.
• B. The increased gut motility decreases the absorption of the second drug.
• C. The absorption of the second drug cannot be predicted.
• D. Less of the second drug is absorbed.

Correct answer: D

Rationale: When one drug increases intestinal motility, it accelerates the movement of the second drug through the system. Since most oral medications are absorbed in the intestine, the faster transit time decreases the absorption of the second drug. Therefore, less of the second drug is absorbed. Choice A is incorrect because the increased gut motility does affect the absorption of the second drug. Choice C is incorrect as the effect of increased intestinal motility on drug absorption can be predicted based on pharmacokinetic principles. Choice B is incorrect as increased gut motility would not increase but decrease the absorption of the second drug.

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