Nursing Elites

1. The nurse knows that after receiving the blood from the blood bank, it should be administered within:

• A. 1 hour
• B. 2 hours
• C. 4 hours
• D. 6 hours

Correct answer: D

Rationale: Blood transfusions need to be administered promptly after receiving the blood from the blood bank to ensure patient safety and effectiveness. Waiting too long can lead to complications such as bacterial growth in the blood product, which can be harmful when infused. Administering the blood within 6 hours is crucial to prevent such risks. Choices A, B, and C are incorrect because waiting for 1, 2, or 4 hours respectively can increase the likelihood of complications associated with delayed transfusion.

2. 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.

3. 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.

4. Which food is a reliable source of B12 for a pregnant vegan client?

• A. Soybeans
• B. Algae
• C. Fortified soy milk
• D. Sea vegetables

Correct answer: C

Rationale: Fortified soy milk is a reliable source of vitamin B12 for pregnant vegan clients as it is usually enriched with this vitamin. The other options, while nutritious, are not reliable sources of B12 for vegans. Soybeans may not provide enough B12, algae contains B12 analogs that the human body cannot utilize, and the B12 content in sea vegetables can fluctuate, potentially not providing the necessary daily intake.

5. Has Healthy People (HP 2020), issued by the U.S. Department of Health and Human Services, resulted in a reduction of deaths from cardiovascular disease, stroke, and some cancers, as well as decreased dental caries in children aged 2 to 4 years and adults aged 53 to 44 years?

• A. Yes, both statements are true.
• B. No, both statements are false.
• C. The first statement is true; the second is false.
• D. The first statement is false; the second is true.

Correct answer: B

Rationale: Both statements are false. While Healthy People (HP 2020) has contributed to a reduction in deaths from cardiovascular disease, stroke, and some cancers, it did not result in decreased dental caries in children aged 2 to 4 years and adults aged 53 to 44 years. Therefore, the correct answer is B. Choice A is incorrect because the second statement is false. Choice C is incorrect as the first statement is also false. Choice D is incorrect as the second statement is false.

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