Nursing Elites

1. The nurse supervises care of a client who is receiving enteral feeding via a nasogastric tube. The nurse determines that care is appropriate if which of the following is observed? (Select all that apply)

• A. The nursing assistant aspirates and measures the amount of gastric aspirate
• B. The nursing assistant elevates the head of the client’s bed 30 degrees
• C. The nursing assistant warms the formula to room temperature
• D. B, C

Correct answer: D

Rationale: The correct answer is D because elevating the head of the bed reduces the risk of aspiration, and warming the formula to room temperature helps prevent discomfort and complications. Choice A is incorrect as only licensed healthcare professionals should aspirate and measure the amount of gastric aspirate. Choice B is correct as it helps prevent aspiration. Choice C is correct as warming the formula can prevent discomfort.

2. 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 of 'Educate soldiers in the history and traditions of the service'?

• 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.' This category involves educating individuals in various aspects, including history and traditions. In this case, educating soldiers in the history and traditions of the service falls under personal/professional development rather than the other options provided. Choice A, 'Accountability,' focuses on responsibility and answerability, not education. Choice C, 'Individual training,' pertains more to specific skill development rather than broader education on history and traditions. Choice D, 'Military appearance/physical condition,' is related to maintaining physical standards and image, which is not directly relevant to educating soldiers in history and traditions.

3. Six hours after major abdominal surgery, a male client complains of severe abdominal pain; is pale and perspiring; has a thready, rapid pulse; and states he feels faint. The nurse checks the client’s medication administration record and determines that the client receives another injection of pain medication in an hour. What is the appropriate action by the nurse?

• A. Explain to the client that it is too early to have an injection for pain
• B. Call the practitioner, report the client’s symptoms, and obtain further orders
• C. Reposition the client for greater comfort and turn on the television as a distraction
• D. Prepare the injection and administer it to the client early because of the severe pain

Correct answer: B

Rationale: The correct action for the nurse to take in this situation is to call the practitioner, report the client’s symptoms, and obtain further orders. The client's symptoms, including severe abdominal pain, pallor, perspiration, thready rapid pulse, and feeling faint, are indicative of potential complications like internal bleeding, which require immediate medical evaluation. Explaining to the client that it is too early for pain medication or repositioning the client for comfort are not appropriate actions given the severity of the symptoms. Administering the injection early without consulting the practitioner can be dangerous and may worsen the client's condition.

4. People who use monoamine oxidase inhibitors for the treatment of depression need to avoid foods high in:

• A. Folate
• B. Tyramine
• C. Potassium
• D. Vitamin K

Correct answer: B

Rationale: The correct answer is B: Tyramine. When individuals taking monoamine oxidase inhibitors (MAOIs) consume foods high in tyramine, it can lead to a potentially dangerous increase in blood pressure known as a hypertensive crisis. Foods high in tyramine include aged cheeses, cured meats, and certain fermented foods. Choices A, C, and D are incorrect. Folate, potassium, and vitamin K are not typically contraindicated with the use of MAOIs.

5. The type of lipoprotein that carries cholesterol from tissues to the liver for excretion is:

• A. Very low-density lipoprotein
• B. Intermediate-density lipoprotein
• C. Low-density lipoprotein
• D. High-density lipoprotein

Correct answer: D

Rationale: The correct answer is D, High-density lipoprotein (HDL). HDL is known as the 'good' cholesterol and plays a crucial role in transporting cholesterol from tissues back to the liver for excretion. This process helps in reducing the buildup of cholesterol in the bloodstream, thus lowering the risk of heart diseases. Very low-density lipoprotein (Option A), Intermediate-density lipoprotein (Option B), and Low-density lipoprotein (Option C) are not responsible for carrying cholesterol back to the liver for excretion like HDL does. Instead, they are associated with different functions related to cholesterol transportation within the body.

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