The mean version of this puzzle requires you to figure out what order to perform the operations in, even! But experimentation will reveal that only one of them can be applied to INITIAL successfully: Add LUM (the scantily-clad invader girl from Urusei Yatsura) and anagram to get ILLUMINATI.
ILLUMINATI contains a word for diseased, ILL, and a urinary tract infection, UTI, that the second step needs to remove to give you MINA, a main cast member in Dracula.
Prepend RU for Russia and append TE for tellurium and get RUMINATE.
Replace the registered nurse, RN, with a lieutenant, LT, to get "LUMITATE," not a word, which only needs a little anagramming to yield the answer, ULTIMATE.