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. Because of increasing cases of fluorosis, low levels of fluoride are added to commercial infant formula. Breast milk provides low levels of fluoride.

• A. Both statements are true
• B. 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: D

Rationale: The first statement is false; fluoride is not added to infant formulas due to the risk of fluorosis. The second statement is true; breast milk contains low levels of fluoride.

3. Vitamin deficiencies, especially the B-complex vitamins, seldom occur in isolation. Folate, a B-complex vitamin, is the exception because it functions separately from other vitamins.

• A. Both statements are true.
• B. 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: C

Rationale: The first statement is true; the second is false. If a deficiency of one vitamin is suspected, symptoms of other vitamin B deficiencies also may be present. Folate deficiencies usually occur with other nutrient deficiencies. Specifically, folate functions in conjunction with vitamins B12 and C in maintaining normal levels of mature red blood cells.

4. A nurse is caring for an 8-month-old infant who screams when the parent leaves the room. The parent begins to cry and says, 'I don't understand why my child is so upset. I've never seen my child act this way around others before.' Which of the following statements should the nurse make?

• A. This is a normal, expected reaction for a child of this age.
• B. This is a response to an overstimulating environment.
• C. This is a common reaction to an overexposure to caregivers.
• D. This is a typical reaction for a child who is sick.

Correct answer: A

Rationale: The correct answer is 'This is a normal, expected reaction for a child of this age.' Separation anxiety typically peaks around 8-10 months of age, leading to distress when separated from caregivers. Choice B is incorrect because the infant's behavior is more likely due to separation anxiety rather than overstimulation. Choice C is incorrect as the infant's behavior is not related to overexposure to caregivers but rather a natural developmental stage. Choice D is incorrect as the infant's behavior is not indicative of illness but rather a normal emotional response.

5. What activities best describe the work of the placenta during pregnancy?

• A. surrounding and cushioning the fetus
• B. combining maternal and fetal blood stores to exchange nutrients
• C. producing hormones that maintain the pregnancy
• D. absorbing vitamins and minerals that can be transferred to the fetus

Correct answer: C

Rationale: The placenta plays a crucial role in producing hormones that are necessary for maintaining pregnancy, supporting fetal development, and preparing the mother's body for childbirth. Choices A, B, and D are incorrect because the placenta's primary function is not to surround and cushion the fetus, combine blood stores for nutrient exchange, or absorb vitamins and minerals. While the placenta does facilitate the exchange of nutrients and oxygen between the mother and fetus, its hormone production is the most critical function during pregnancy.

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