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. The two members of the health care team who work closely to monitor drug-nutrient interactions are the:

• A. physician and nurse
• B. physician and pharmacist
• C. nurse and clinical dietitian
• D. clinical dietitian and pharmacist

Correct answer: D

Rationale: The correct answer is D: clinical dietitian and pharmacist. Clinical dietitians and pharmacists work closely together to monitor and manage drug-nutrient interactions. While physicians and nurses play essential roles in patient care, they are not typically the primary professionals involved in monitoring drug-nutrient interactions. Therefore, choices A, B, and C are incorrect.

3. What happens when Mrs. Guevarra, a nurse, delegates aspects of the client's care to the nurse-aide, an unlicensed staff member?

• A. Mrs. Guevarra makes the assignment to instruct the staff member
• B. Mrs. Guevarra is assigning the responsibility to the aide but not the accountability for those tasks
• C. Mrs. Guevarra does not need to directly supervise or evaluate the aide
• D. Mrs. Guevarra must know how to perform the task being delegated

Correct answer: C

Rationale: The correct answer is C. While it is true that Mrs. Guevarra is delegating tasks to the nurse-aide, she does not necessarily have to directly supervise or evaluate the aide. She still retains the overall accountability for the care of the client, but direct supervision of the aide is not a requirement for delegation. Choice A is incorrect because the primary purpose of delegation is not instruction. Choice B is also incorrect because although Mrs. Guevarra is delegating tasks, she still retains accountability for those tasks. Finally, choice D is incorrect because the ability to perform the task being delegated is not a requirement for the delegator; the delegatee should have the necessary skills and knowledge to perform the delegated tasks.

4. What is the primary function of a written nursing care plan?

• A. Evaluates whether nursing care goals have been achieved
• B. Ensures the provision of quality nursing care
• C. Assists in selecting the appropriate nursing interventions
• D. Facilitates the creation of a nursing diagnosis

Correct answer: D

Rationale: A written nursing care plan fundamentally serves to facilitate the development of a nursing diagnosis. This procedure involves analyzing patient data and identifying health problems that nurses can address independently. This analysis then aids in determining the most appropriate nursing interventions for the identified health issues. Although evaluating the achievement of nursing care goals is an important aspect, it is not the primary function of a nursing care plan. Similarly, while delivering quality nursing care is crucial, it is a broader concept that includes many other facets beyond just the initial nursing diagnosis and interventions.

5. If a person could not make bile, what would happen?

• A. experience fatigue, as the body would not be able to make lipid carriers to deliver fat to body cells for energy
• B. have less cholesterol being made by the liver
• C. need to consume higher levels of fat
• D. be unable to absorb most lipids, and fat would be excreted in the feces

Correct answer: D

Rationale: The correct answer is D. Bile is essential for emulsifying fats in the small intestine, allowing them to be absorbed. Without bile, most fats would not be absorbed and would be excreted in the feces. Choices A, B, and C are incorrect because the primary role of bile is in the digestion and absorption of fats, rather than affecting lipid carriers, cholesterol production, or dietary fat consumption.

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