Nursing Elites

1. Which nutrient deficiency is most likely to be seen in patients with chronic alcoholism?

• A. Vitamin C
• B. Vitamin D
• C. Vitamin B12
• D. Vitamin B1

Correct answer: D

Rationale: Patients with chronic alcoholism are most likely to develop a deficiency in Vitamin B1 (thiamine) due to poor dietary intake and impaired absorption. This deficiency can lead to conditions like Wernicke's encephalopathy and Korsakoff's syndrome. While deficiencies in other vitamins can also occur in chronic alcoholism, Vitamin B1 deficiency is more commonly associated with this condition, making it the most likely nutrient deficiency in these patients. Therefore, the correct answer is Vitamin B1 (Choice D). Deficiencies in Vitamin C (Choice A), Vitamin D (Choice B), and Vitamin B12 (Choice C) can also be seen in patients with chronic alcoholism, but they are not as commonly linked to this condition compared to Vitamin B1 deficiency.

2. The nurse is caring for the client one (1) day postoperative sigmoid colostomy operation. Which independent nursing intervention should the nurse implement?

• A. Change the infusion rate of the intravenous fluid
• B. Encourage the client to discuss his or her feelings
• C. Administer opioid narcotic medications for pain management
• D. Assist the client out of bed to sit in the chair twice daily

Correct answer: D

Rationale: Assisting the client to sit in a chair is a crucial nursing intervention postoperatively. It helps prevent complications such as thrombosis, pneumonia, and pressure ulcers by promoting circulation and aiding in recovery. Changing the infusion rate of the intravenous fluid would require a physician's order and is not within the nurse's independent scope of practice. Encouraging the client to discuss feelings and administering medications for pain management are important interventions but may not be as immediately necessary as assisting the client in mobilizing early postoperatively.

3. When palpating the client's neck for lymphadenopathy, where should the nurse position herself?

• A. At the client's back
• B. At the client's right side
• C. At the client's left side
• D. In front of a sitting client

Correct answer: D

Rationale: When palpating the client's neck for lymphadenopathy, the nurse should position herself in front of a sitting client. This positioning allows for easier access to the neck area and better visualization of any swelling or abnormalities in the lymph nodes. Placing oneself in front of the client ensures proper alignment and comfort for both the nurse and the client during the assessment. Choices A, B, and C are incorrect as positioning at the back or sides of the client may hinder proper assessment due to limited visibility and access to the neck area.

4. The nurse is administering a beta blocker to the client diagnosed with essential hypertension. Which data would cause the nurse to question administering the medication?

• A. The client’s BP is 110/70
• B. The client’s potassium level is 3.4 mEq/L
• C. The client has a barky cough
• D. The client’s apical pulse is 56

Correct answer: D

Rationale: The correct answer is D. A beta blocker should be withheld if the apical pulse is below 60, as it can further decrease the heart rate. Choice A is not a reason to question administering a beta blocker as the blood pressure is within normal range. Choice B is not directly related to the administration of a beta blocker. Choice C may indicate a potential adverse effect of another medication, but it does not specifically warrant questioning the administration of the beta blocker.

5. Which of the following is NOT one of the three basic areas of concern into which practical nurse management responsibilities can be categorized?

• A. Managing patients' legal affairs
• B. Managing the hypothalamus: The hypothalamus is a small area in the brain located just below the thalamus. It plays a crucial role in controlling various bodily functions, including temperature regulation, hunger, and thirst, sleep-wake cycles, and hormone regulation. The hypothalamus is also involved in the control of the autonomic nervous system and the release of hormones from the pituitary gland.
• C. Managing work center operations
• D. Managing personnel

Correct answer: A

Rationale: Managing patients' legal affairs is not a basic area of concern in practical nurse management responsibilities. The primary areas typically include managing work center operations, managing personnel, and overseeing patient care. Choice B, managing the hypothalamus, is irrelevant to nurse management responsibilities and is not a standard area of concern in this context. Choice C, managing work center operations, and Choice D, managing personnel, align more closely with the core responsibilities and concerns of practical nurse management roles.

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