Nursing Elites

1. A nurse has just inserted a nasogastric (NG) tube for a client. Which of the following findings should the nurse expect to confirm correct tube placement?

• A. The client reports relief of nausea.
• B. The tube aspirate has a pH less than 5.
• C. Bowel sounds are present on auscultation.
• D. An x-ray shows the end of the tube above the pylorus.

Correct answer: A

Rationale: The correct answer is A: The client reports relief of nausea. When the NG tube is correctly placed in the stomach, it can help alleviate feelings of nausea and discomfort. Choice B, a tube aspirate pH less than 5, is incorrect as it indicates gastric placement, not necessarily correct placement. Choice C, bowel sounds on auscultation, and Choice D, visualization of the tube on an x-ray above the pylorus, do not confirm correct NG tube placement; therefore, they are incorrect.

2. A nurse is considering employment at a long-term care facility that has a functional nursing delivery system. Knowing this, the nurse could expect that:

• A. Each RN would coordinate care for a group of clients.
• B. One RN would pass meds for all clients on a unit.
• C. Each RN would deliver total care to an assigned group of clients.
• D. One RN, one LPN, and one unlicensed assistive personnel would share responsibility for a group of clients.

Correct answer: B

Rationale: In a functional nursing delivery system, tasks are divided among the staff based on their roles. One of these roles is medication administration, where one RN may pass medications for all clients on a unit. Option A is incorrect because coordinating care for a group of clients is more aligned with team nursing. Option C is incorrect as it describes total care nursing, not functional nursing. Option D is incorrect as it reflects team nursing with a mix of different roles sharing responsibility.

3. Many patient classification systems have some type of shortcoming. Among these are:

• A. The client's condition changes before the next shift.
• B. The staffing needs are predicted on a short-term basis.
• C. The potential admissions cannot be accounted for.
• D. The staffing mix changes because of illness.

Correct answer: C

Rationale: Patient classification systems have limitations in accounting for changes in a client's condition, unexpected influx of new admissions, and changes in staffing due to illness. These systems often focus on short-term staffing needs rather than utilizing demand management, which considers client outcomes to predict staffing needs over a longer period. Not being able to account for potential admissions can lead to challenges in effectively managing staff allocation and resources. Choices A, B, and D are incorrect because they do not address the specific limitation of patient classification systems related to accounting for potential admissions.

4. A nurse is caring for a client who has an indwelling urinary catheter. Which of the following findings indicates that the catheter requires irrigation?

• A. Urine is positive for ketones
• B. Urine has an unusual odor
• C. Urine specific gravity is 1.035 (normal range: 1.010 to 1.025)
• D. Bladder scan shows 525 mL of urine

Correct answer: A

Rationale: The correct answer is A. Ketones in the urine may indicate infection or blockage in the urinary catheter, necessitating irrigation to ensure proper drainage. Choice B, an unusual odor in the urine, may suggest infection but does not directly indicate the need for catheter irrigation. Choice C, a high urine specific gravity, is indicative of concentrated urine but does not specifically point to the need for catheter irrigation. Choice D, a bladder scan showing 525 mL of urine, indicates urine retention, which may require catheterization or further assessment but not necessarily irrigation.

5. Which of the following best describes the concept of evidence-based practice (EBP)?

• A. Clinical expertise as the primary basis for decision making
• B. Research findings as the sole basis for decision making
• C. Combining clinical expertise with the best available research evidence
• D. Following institutional guidelines for patient care

Correct answer: C

Rationale: The correct answer is C: 'Combining clinical expertise with the best available research evidence.' Evidence-based practice (EBP) emphasizes integrating clinical expertise with the most current and relevant research evidence when making decisions about patient care. Choice A is incorrect because EBP does not rely solely on clinical expertise. Choice B is incorrect as EBP considers research evidence alongside clinical expertise, not as the sole basis. Choice D is incorrect because EBP is not about blindly following institutional guidelines, but rather about integrating research evidence with clinical judgment to provide the best possible care.

Similar Questions