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. Through the client’s health history, you gather that Mr. Dizon smokes and drinks coffee. When taking the blood pressure of a client who recently smoked or drank coffee, how long should the nurse wait before taking the client’s blood pressure for accurate reading?

• A. 15 minutes
• B. 30 minutes
• C. 1 hour
• D. 5 minutes

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

3. Toilet training occurs in the anal stage of Freud’s psychosexual development. This is equivalent to Erikson’s:

• A. Trust vs. Mistrust
• B. Autonomy vs. Shame and Doubt
• C. Initiative vs. Guilt
• D. Industry vs. Inferiority

Correct answer: A

Rationale: The correct answer is A: Trust vs. Mistrust. In Freud's psychosexual development theory, the anal stage is where toilet training occurs, focusing on issues of control and independence. This stage is parallel to Erikson's Trust vs. Mistrust stage, where infants learn to trust or mistrust their caregivers based on the consistency of care they receive. Choices B, C, and D are incorrect as they correspond to different stages in Erikson's psychosocial development theory, not related to toilet training or the anal stage of Freud's theory.

4. Substance abuse is different from substance dependence in that, substance dependence:

• A. includes characteristics of adverse consequences and repeated use
• B. requires long term treatment in a hospital based program
• C. produces less severe symptoms than that of abuse
• D. includes characteristics of tolerance and withdrawal

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

5. The client is discussing sources of carbohydrates with a nurse recently diagnosed with diabetes. Which food(s) identified by the client indicate understanding? (SATA)

• A. Starch
• B. Fiber
• C. Sugar
• D. All of the above

Correct answer: D

Rationale: The correct answer is D because starch, fiber, and sugar are all sources of carbohydrates. Starchy foods like bread, rice, and potatoes contain starch; fruits, vegetables, and whole grains provide fiber; and sugars are found in sweet foods like fruits, honey, and desserts. Fatty acids and amino acids are not sources of carbohydrates, so choices A, B, and C are correct while choices A and B are incorrect.

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