Nursing Elites

1. Which vitamin deficiency is commonly associated with prolonged antibiotic use?

• A. Vitamin A
• B. Vitamin B6
• C. Vitamin C
• D. Vitamin K

Correct answer: D

Rationale: The correct answer is Vitamin K. Prolonged antibiotic use can disrupt the gut flora, leading to Vitamin K deficiency and an increased risk of bleeding. Vitamin A deficiency is not commonly associated with antibiotic use. Similarly, Vitamin B6 and Vitamin C deficiencies are not typically linked to prolonged antibiotic use.

2. A client is transferred from the emergency department to the locked psychiatric unit after attempting suicide by taking 200 acetaminophen (Tylenol) tablets. The client is now awake and alert but refuses to speak with the nurse. In this situation, the nurse’s first priority is to:

• A. Establish a rapport to foster trust
• B. Place the client in full restraints
• C. Try to communicate with the client in writing
• D. Ensure safety by initiating suicide precautions

Correct answer: D

Rationale: In this scenario, the nurse's highest priority should be to ensure the client's safety by initiating suicide precautions. Given the history of a suicide attempt by taking a large number of acetaminophen tablets, there is a high risk of further self-harm. Placing the client in full restraints without assessing the situation properly may escalate anxiety and hinder therapeutic communication. Trying to communicate with the client in writing could be an option but ensuring immediate safety takes precedence. Establishing rapport is essential for building trust and therapeutic relationship, but safety concerns must be addressed first in this critical situation.

3. What is the primary goal of care for a client diagnosed with sickle cell anemia?

• A. The client will call the healthcare provider if feeling ill.
• B. The client will be compliant with the medical regimen.
• C. The client will live as normal a life as possible.
• D. The client will verbalize understanding of treatments.

Correct answer: C

Rationale: The correct answer is C: 'The client will live as normal a life as possible.' For a client with sickle cell anemia, the primary goal of care is to promote a good quality of life by managing symptoms, preventing crises, and enhancing overall well-being. Option A is incorrect as it focuses on a specific action rather than the overall goal of care. Option B is important but not the primary goal; compliance is a means to achieve better health outcomes. Option D is also important but does not address the holistic approach of helping the client maintain a normal lifestyle despite their condition.

4. What is the most crucial and most difficult management skill required of the M6 practical nurse?

• A. Preparing time schedules and task assignment rosters
• B. Inspecting equipment for damage and proper function
• C. Preparing reports and maintaining records
• D. Effectively managing personnel

Correct answer: D

Rationale: Correct. Effectively managing personnel is indeed the most crucial and difficult management skill required of a practical nurse. This skill involves supervising, motivating, and coordinating the work of other healthcare staff, ensuring optimal patient care. Choices A, B, and C are important tasks but do not necessarily involve the same level of complexity and interpersonal skills required for managing personnel in a healthcare setting.

5. The nurse is analyzing laboratory values for the assigned clients. Which finding, based on the client's medical history, indicates the need for immediate follow-up?

• A. Client with chronic kidney disease and serum creatinine of 1.6 mg/dL
• B. Client with diabetes mellitus and a glycosylated hemoglobin A1c (HbA1c) of 7.0%
• C. Client with heart failure and a B-type natriuretic peptide (BNP) of 140 pg/mL
• D. Client who is male and has anemia with hemoglobin of 16.5 g/dL and hematocrit of 45%

Correct answer: B

Rationale: An HbA1c of 7.0% in a client with diabetes mellitus indicates poor long-term glucose control, necessitating immediate follow-up. Choice A, chronic kidney disease with a serum creatinine of 1.6 mg/dL, though concerning, does not indicate an immediate need for follow-up. Choice C, heart failure with a BNP of 140 pg/mL, may require monitoring but not immediate follow-up. Choice D, a male client with anemia and normal hemoglobin and hematocrit levels, does not warrant immediate attention based on the provided information.

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