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. Which of the following describes the concept of ratification?

• A. Contract administration
• B. Contract passage
• C. Contract denial
• D. Contract reorganization

Correct answer: B

Rationale: The correct answer is B: 'Contract passage.' Ratification refers to the approval or confirmation of a contract by a simple majority of members who vote to pass it. Choice A, 'Contract administration,' does not accurately describe ratification as it focuses more on the management of contracts rather than their approval. Choice C, 'Contract denial,' is incorrect as ratification implies acceptance or approval, not denial. Choice D, 'Contract reorganization,' is also incorrect as ratification does not involve restructuring or reorganizing a contract, but rather confirming its validity.

3. An RN is writing reminders for good documentation for the nurses on her staff. The purpose is to ensure nursing documentation is legally credible. Which of the following is a recommendation she should include in the reminders?

• A. Use shortcuts in documentation.
• B. Only use approved abbreviations.
• C. Documentation should be subjective.
• D. Document after care is provided.

Correct answer: B

Rationale: The correct recommendation that should be included in the reminders for ensuring legally credible nursing documentation is to 'Only use approved abbreviations.' Using shortcuts in documentation (Choice A) may lead to incomplete or vague information, compromising the credibility of documentation. Documentation should not be subjective (Choice C) but rather objective and based on factual information. While it is important to document after care is provided (Choice D), the immediate documentation following care provision is critical for accuracy and legal credibility.

4. A manager is working on the personnel budget for the year. The manager anticipates needing to replace 832 benefit hours. How many FTEs (Full-Time Equivalents) will be needed for replacement?

• A. 0.40 FTEs
• B. 17.0 FTEs
• C. 0.05 FTEs
• D. 1.0 FTEs

Correct answer: A

Rationale: To calculate the number of Full-Time Equivalents (FTEs) needed for replacement, divide the number of benefit hours (832) by the standard number of hours in a full-time work year (2,080). Therefore, 832 benefit hours ÷ 2,080 = 0.4 FTEs, which is equivalent to 0.40 FTEs. Choice B (17.0 FTEs) is incorrect as it is a significantly high number that does not align with the calculation. Choice C (0.05 FTEs) is incorrect because it is too low for the given number of benefit hours. Choice D (1.0 FTEs) is incorrect as it represents a full-time position, which is not the correct calculation for replacing 832 benefit hours.

5. Verbal interventions with an agitated patient may be calming. These interventions include:

• A. Holding and reassuring the patient
• B. Encouraging other staff to distract the patient
• C. Remaining calm and keeping an arm's distance
• D. Standing close to the patient while talking

Correct answer: C

Rationale: The correct answer is C: Remaining calm and keeping an arm's distance. Agitated individuals benefit from minimal verbal and physical stimulation. They respond to their environment based on how nurses interact with them. If an individual feels threatened or cornered, the response will generally be self-protective and reactive. Standing close to the patient (choice D) can be perceived as invasive and may escalate the situation. Holding and reassuring the patient (choice A) may not be effective if the patient perceives it as intrusive. Encouraging other staff to distract the patient (choice B) may introduce unnecessary stimulation. Therefore, the recommended approach is to remain calm and keep a safe distance to provide a non-threatening environment for the agitated patient.

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