Nursing Elites

1. The nurse instructs a client 5 days after a lumbar laminectomy with spinal fusion about how to move from a supine position to standing at the left side of the bed with a walker. Which of the following directions by the nurse is BEST?

• A. Raise the head of the bed so you are sitting straight up, bend your knees, and swing your legs to the side and then to the floor
• B. Rock your body from side to side, going further each time until you build up enough momentum to be lying on your right side, and then raise your trunk toward your toes
• C. Reach over to the left side rail with your right hand, pull your body onto its side, bend your upper leg so the foot is on the bed, and push down to elevate your trunk
• D. Focus on using your arms, the left elbow as a pivot with the left hand grasping the mattress edge and the right hand pushing on the mattress above the elbow, then slide your legs over the side of the mattress

Correct answer: C

Rationale: Choice C is the best direction provided by the nurse. This method involves reaching over to the left side rail with the right hand, pulling the body onto its side, bending the upper leg so the foot is on the bed, and pushing down to elevate the trunk. This approach helps maintain spinal alignment while moving from a lying to a standing position, reducing strain on the back. Choices A, B, and D involve movements that are not suitable for a client recovering from a lumbar laminectomy with spinal fusion and could potentially cause harm or discomfort.

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

• A. Physician and nurse
• B. Physician and pharmacist
• C. Nurse and clinical dietitian
• D. Clinical dietitian and pharmacist

Correct answer: D

Rationale: Clinical dietitians and pharmacists are the key members of the healthcare team responsible for monitoring drug-nutrient interactions. Clinical dietitians assess patients' nutritional needs and develop appropriate diets that consider medication effects, while pharmacists provide expertise on medications and their interactions with nutrients. Physicians and nurses are essential healthcare providers but typically do not have the specialized knowledge required to manage drug-nutrient interactions, making choices A, B, and C incorrect.

3. A client who is postpartum and diagnosed with iron deficiency anemia is receiving education from a nurse. Which dietary recommendation should be included in the education plan?

• A. Yogurt and mozzarella
• B. Spinach and beef
• C. Fish and cottage cheese
• D. Turkey slices and milk

Correct answer: B

Rationale: The correct answer is B: Spinach and beef. Spinach is a good source of non-heme iron, while beef provides heme iron, both essential for treating iron deficiency anemia. Yogurt and mozzarella (choice A) are not significant sources of iron. Fish and cottage cheese (choice C) do not provide as much iron as spinach and beef. Turkey slices and milk (choice D) are also not as rich in iron compared to spinach and beef.

4. The nurse is teaching basic cardiopulmonary resuscitation (CPR) to individuals in the community. Which is the order of basic CPR?

• A. Ensure the scene is safe, assess responsiveness, call for help, begin CPR with compressions, airway, and breathing
• B. Give two (2) rescue breaths
• C. Look, listen, and feel for breathing
• D. Begin chest compressions

Correct answer: A

Rationale: The correct order of basic CPR is to first ensure the scene is safe to approach, then assess responsiveness. Next, call for help and start CPR with chest compressions, followed by checking the airway and giving rescue breaths. Choice B is incorrect as giving rescue breaths is usually done after the initial chest compressions. Choice C is incorrect as looking, listening, and feeling for breathing comes after starting compressions. Choice D is incorrect as chest compressions are usually the first step in basic CPR.

5. 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 'Educate personnel on UCMJ'?

• A. Accountability
• B. Personal/professional development
• C. Individual training
• D. Military appearance/physical condition

Correct answer: B

Rationale: The correct answer is B: Personal/professional development. Educating personnel on UCMJ falls under the category of personal/professional development as it involves enhancing their understanding of the Uniform Code of Military Justice. This category focuses on improving individuals' knowledge and skills related to their professional roles and responsibilities. Choices A, C, and D are not directly related to educating personnel on UCMJ. Accountability pertains to being answerable for one's actions, individual training focuses on specific skill development, and military appearance/physical condition relates to grooming standards and fitness rather than UCMJ education.

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