Nursing Elites

1. Which client is most likely to need regular injections of vitamin B12?

• A. The client with malabsorption syndrome.
• B. The client following a vegan eating pattern.
• C. The client whose stomach does not produce intrinsic factors.
• D. The client with alcoholism.

Correct answer: C

Rationale: The correct answer is C. The client whose stomach does not produce intrinsic factors is most likely to need regular injections of vitamin B12. Intrinsic factor is essential for the absorption of vitamin B12. Without intrinsic factor, the client cannot absorb vitamin B12 from food, necessitating the need for regular injections. Choices A, B, and D do not directly impact the production of intrinsic factors in the stomach, so they are less likely to result in the need for vitamin B12 injections.

2. Each statement is true of vitamin K, except one. Which is the exception?

• A. Vitamin K is produced in the gut.
• B. Vitamin K functions as a catalyst for the synthesis of blood-clotting factors.
• C. Vitamin K maintains prothrombin levels.
• D. Vitamin K absorption increases with high levels of vitamin E supplementation.

Correct answer: D

Rationale: The correct answer is D. Vitamin K absorption decreases with high levels of vitamin E supplementation because in larger amounts, vitamin E acts as an anticoagulant. Vitamin K is not produced in the gut but can be obtained from food sources or supplements. Vitamin K is essential for the synthesis of blood-clotting factors and is crucial in maintaining prothrombin levels, which is vital for proper blood clotting. The incorrect choice, D, is misleading as high levels of vitamin E supplementation hinder vitamin K absorption due to its anticoagulant properties. Dental hygienists should be aware of the importance of vitamin K in blood clotting, especially when treating patients who are on anticoagulant medications for conditions like stroke prevention.

3. Cancers that arise from epithelial tissues are known as:

• A. Leukemias
• B. Myelomas
• C. Carcinomas
• D. Sarcomas

Correct answer: C

Rationale: The correct answer is C: Carcinomas. Carcinomas are cancers that originate from epithelial tissues, which are the tissues lining the surfaces of organs and structures in the body. Leukemias (choice A) are cancers of the blood-forming cells, not epithelial tissues. Myelomas (choice B) are cancers that develop in plasma cells in the bone marrow, not epithelial tissues. Sarcomas (choice D) are cancers that arise from connective tissues like bone, cartilage, or muscle, not epithelial tissues. Therefore, choices A, B, and D are incorrect in the context of cancers originating from epithelial tissues.

4. A nurse is planning a menu for a client with a folic acid deficiency anemia. Which food should the nurse recommend that is high in folate?

• A. 4 slices of roast beef
• B. ½ cup of asparagus
• C. 1 cup part-skim mozzarella cheese
• D. ¼ cup of olives

Correct answer: B

Rationale: The correct answer is B: ½ cup of asparagus. Asparagus is high in folate, making it a suitable recommendation for clients with folic acid deficiency anemia. Folate is essential in the production of red blood cells, which is crucial in managing anemia. Choices A, C, and D do not contain as much folate as asparagus and are not the best options for addressing a folic acid deficiency anemia.

5. An appropriate nursing diagnosis for clients in the acute manic phase of bipolar disorder is:

• A. Risk for injury directed to self
• B. Risk for injury directed to others
• C. Impaired nutrition less than body requirements
• D. Ineffective individual coping

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

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