Nursing Elites

1. Mario listens to Richard’s bilateral sounds and finds that congestion is in the upper lobes of the lungs. The appropriate position to drain the anterior and posterior apical segments of the lungs when Mario does percussion would be:

• A. Client lying on his back then flat on his abdomen on Trendelenburg position
• B. Client seated upright in bed or on a chair then leaning forward in sitting position then flat on his back and on his
• C. Client lying flat on his back and then flat on his abdomen
• D. Client lying on his right then left side on Trendelenburg position

Correct answer: A

Rationale: Proper patient positioning is essential for maximizing lung expansion and promoting the drainage of secretions. Postural drainage techniques rely on gravity to help clear different lung segments, which is critical in preventing complications such as atelectasis or pneumonia in immobilized patients.

2. For patients with anemia, which vitamin is crucial for the absorption of iron?

• A. Vitamin A
• B. Vitamin C
• C. Vitamin D
• D. Vitamin E

Correct answer: B

Rationale: The correct answer is Vitamin C. Vitamin C enhances the absorption of non-heme iron, which is crucial for patients with anemia. Vitamin A (Choice A) is not directly involved in iron absorption. Vitamin D (Choice C) helps with calcium absorption, not iron. Vitamin E (Choice D) does not have a significant role in iron absorption.

3. Which of the following is the least likely reason that osteoporosis is more prevalent in women?

• A. women have smaller bodies
• B. women have lower bone mass
• C. women consume less calcium
• D. bone loss begins later in women

Correct answer: D

Rationale: The correct answer is D. Contrary to the statement, bone loss begins earlier in women, particularly after menopause, due to the decrease in estrogen levels. This drop in estrogen accelerates bone loss, contributing to the higher prevalence of osteoporosis in women. Choices A, B, and C are more likely reasons for the increased prevalence of osteoporosis in women. Women generally have smaller bodies, lower bone mass compared to men, and may consume less calcium, all of which are significant factors contributing to the higher incidence of osteoporosis in women.

4. During the first 24 hours after the thermal injury, you should assess Sergio for:

• A. hypokalemia and hypernatremia
• B. hypokalemia and hyponatremia
• C. hyperkalemia and hyponatremia
• D. hyperkalemia and hypernatremia

Correct answer: D

Rationale: During the initial phase after a thermal injury, the major concern is the release of potassium due to cell damage, leading to hyperkalemia. Hypernatremia is not typically a primary concern in the immediate post-injury phase. Hyponatremia is less likely to occur initially after a burn injury. Therefore, the correct assessment for Sergio during the first 24 hours after the thermal injury would be hyperkalemia and hypernatremia.

5. Intrinsic factor from the stomach is needed for the absorption of which vitamin?

• A. vitamin B12
• B. folate
• C. niacin
• D. vitamin B6

Correct answer: A

Rationale: The correct answer is A: vitamin B12. Intrinsic factor is a glycoprotein produced by the stomach that is necessary for the absorption of vitamin B12 in the small intestine. Vitamin B12 binds to intrinsic factor in the stomach, forming a complex that is then absorbed in the ileum. This absorption process is crucial for preventing vitamin B12 deficiency. Choices B, C, and D are incorrect because they do not require intrinsic factor for absorption. Folate is absorbed in the small intestine through a different mechanism, niacin can be absorbed in the small intestine without the need for intrinsic factor, and vitamin B6 does not rely on intrinsic factor for absorption.

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