Nursing Elites

1. In assessing the client's chest, which position best shows chest expansion as well as its movements?

• A. Sitting
• B. Prone
• C. Sidelying
• D. Supine

Correct answer: A

Rationale: The correct answer is A: Sitting. When the client is seated, their chest is in an optimal position for observing the full range of chest expansion during breathing. This position allows for easy visualization of chest movements and expansion as the client breathes in and out, providing a comprehensive assessment of respiratory function. Choice B, Prone, is incorrect as lying face down would not provide a clear view of chest expansion. Choice C, Sidelying, is also incorrect as this position may limit the visibility of chest movements. Choice D, Supine, is not the best position for assessing chest expansion as it may not offer a clear observation of chest movements during breathing.

2. A healthcare provider is caring for a client who takes an antidepressant and oral contraceptives. Which herbal supplement should the healthcare provider educate the client about due to a drug-herb interaction?

• A. Iron supplement
• B. Garlic
• C. Green tea
• D. St. John’s Wort

Correct answer: D

Rationale: The correct answer is D, St. John’s Wort. St. John’s Wort can interact with antidepressants and oral contraceptives, potentially reducing their efficacy. Iron supplement, garlic, and green tea are not typically known to have significant interactions with antidepressants or oral contraceptives, making them less likely to impact the client's treatment.

3. 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 'Know what your soldiers are doing during duty hours'?

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

Correct answer: A

Rationale: The correct answer is 'Accountability.' This choice is the most appropriate for the task 'Know what your soldiers are doing during duty hours' as it directly relates to being responsible for and knowing the actions and whereabouts of individuals under supervision. 'Personal/professional development' (choice B) focuses on growth and advancement, 'Individual training' (choice C) pertains to specific skill development, and 'Military appearance/physical condition' (choice D) deals with the physical presentation and health of soldiers, none of which directly address the task of knowing soldiers' activities during duty hours.

4. The nurse counsels a client diagnosed with iron deficiency anemia. The nurse determines that teaching is effective if the client selects which of the following menus?

• A. Roast beef, brown rice, green beans, carrot and raisin salad, and milk
• B. Cheese pizza, tossed green salad, oatmeal-raisin cookie, and lemonade
• C. Two scrambled eggs, bacon, white toast with strawberry jam, and coffee
• D. Corn flakes with milk, whole wheat toast, and orange juice

Correct answer: A

Rationale: The correct answer is A. Roast beef is high in heme iron, which is best absorbed and helps treat iron deficiency anemia. Choices B, C, and D do not contain significant amounts of heme iron or other iron-rich foods that would be beneficial in managing iron deficiency anemia. Cheese pizza, scrambled eggs, bacon, white toast, corn flakes, and whole wheat toast do not provide the necessary heme iron needed to address the client's condition.

5. The client diagnosed with thalassemia, a hereditary anemia, is to receive a transfusion of packed RBCs. The cross-match reveals the presence of antibodies that cannot be cross-matched. Which precaution should the nurse implement when initiating the transfusion?

• A. Start the transfusion at 10-15 mL per hour for 15-30 minutes
• B. Re-crossmatch the blood until the antibodies are identified
• C. Have the client sign a permit to receive uncrossmatched blood
• D. Have the unlicensed nursing assistant stay with the client

Correct answer: A

Rationale: Starting the transfusion slowly at 10-15 mL per hour for 15-30 minutes is the correct precaution to implement when the cross-match reveals the presence of antibodies that cannot be cross-matched. This allows the nurse to monitor for any adverse reactions due to the presence of antibodies. Re-crossmatching the blood until the antibodies are identified is not practical and may delay the transfusion, potentially compromising the patient's condition. Having the client sign a permit to receive uncrossmatched blood is not the best course of action as the focus should be on ensuring a safe transfusion. Having an unlicensed nursing assistant stay with the client does not address the specific precaution needed to manage a transfusion in the presence of antibodies.

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