Nursing Elites

1. Neomycin may decrease absorption of which nutrient?

• A. Iron, copper, and zinc
• B. Protein and amino acids
• C. Fat-soluble vitamins
• D. Water-soluble vitamins

Correct answer: C

Rationale: The correct answer is C: Fat-soluble vitamins. Neomycin is known to interfere with the absorption of fat-soluble vitamins. This is because neomycin can disrupt the normal gut flora responsible for the absorption of these vitamins. Choices A, B, and D are incorrect because neomycin primarily affects the absorption of fat-soluble vitamins, not minerals, proteins, amino acids, or water-soluble vitamins.

2. 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.

3. In assessing the client's chest, which position best shows chest expansion as well as its movements?

• A. Sitting
• B. Prone
• C. Sidelying
• D. Supine

Correct answer: A

Rationale: The position that best shows chest expansion as well as its movements is when the client is sitting. When the client is seated, their chest is in an optimal position for observing the full range of chest expansion during breathing. This position allows for easy visualization of chest movements and expansion as the client breathes in and out, providing a comprehensive assessment of respiratory function. Choice B (Prone) and Choice D (Supine) involve positions where the chest's movements and expansion are less visible and may not provide an accurate representation of respiratory function. Choice C (Sidelying) can also limit the visibility of chest expansion compared to the sitting position.

4. 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.

5. Which nutrient deficiency is most likely to be seen in patients with chronic alcoholism?

• A. Vitamin C
• B. Vitamin D
• C. Vitamin B12
• D. Vitamin B1

Correct answer: D

Rationale: In patients with chronic alcoholism, the most likely nutrient deficiency is Vitamin B1 (thiamine), not Vitamin B12. Chronic alcoholism often leads to Vitamin B1 deficiency, causing conditions like Wernicke's encephalopathy. While other vitamin deficiencies can also occur in chronic alcoholism, such as Vitamin C and Vitamin D, Vitamin B1 deficiency is more commonly associated with alcoholism.

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