Nursing Elites

1. A client with meningitis is being assessed by a healthcare provider. Which of the following findings should the provider expect?

• A. Negative Brudzinski’s sign.
• B. Flaccid neck muscles.
• C. Petechial rash.
• D. Hypoactive deep tendon reflexes.

Correct answer: C

Rationale: A petechial rash is a characteristic finding in clients with meningitis, indicating small, pinpoint hemorrhages under the skin. This rash results from the infection's impact on the blood vessels. Petechiae are important to recognize as they can help differentiate meningitis from other conditions with similar symptoms. Brudzinski’s sign, neck stiffness, and positive Kernig’s sign are more common physical exam findings in meningitis. Flaccid neck muscles and hypoactive deep tendon reflexes are not typically associated with meningitis.

2. A healthcare professional is preparing to insert an IV catheter for an older adult client. Which of the following actions should the professional take?

• A. Shave the hair at the insertion site.
• B. Insert the catheter at a 45-degree angle.
• C. Place the client’s arm in a dependent position.
• D. Use a tourniquet to dilate the veins.

Correct answer: C

Rationale: Placing the client’s arm in a dependent position is the correct action when preparing to insert an IV catheter in an older adult client. This position helps dilate the veins naturally by using gravity, making it easier to locate and access suitable veins for the IV catheter insertion. By positioning the arm in a dependent position, the healthcare professional can take advantage of gravity to increase venous distention, aiding in successful IV catheter insertion.

3. What is the primary purpose of the Health Insurance Portability and Accountability Act (HIPAA)?

• A. To provide health insurance coverage for all Americans.
• B. To ensure the confidentiality of health information.
• C. To reduce the cost of healthcare.
• D. To increase access to healthcare services.

Correct answer: B

Rationale: The primary purpose of the Health Insurance Portability and Accountability Act (HIPAA) is to ensure the confidentiality and security of health information. HIPAA establishes national standards to protect individuals' medical records and other personal health information. By safeguarding the privacy of health data, HIPAA aims to maintain the integrity and confidentiality of sensitive patient information, preventing unauthorized access and disclosure. This focus on privacy and security helps build trust between patients and healthcare providers, ensuring that personal health information is handled responsibly and ethically.

4. A healthcare professional is preparing to administer medications to a client who has an NG tube for continuous feedings. Which of the following actions should the healthcare professional take?

• A. Add crushed medications to the enteral feeding.
• B. Infuse each medication by gravity.
• C. Administer the medications through a syringe.
• D. Flush the NG tube with 5 mL of sterile water.

Correct answer: C

Rationale: Administering medications through a syringe is the correct action to take when a client has an NG tube for continuous feedings. This method ensures that each medication is delivered correctly and is not mixed with the enteral feeding, preventing drug interactions and ensuring proper administration of each medication. Adding crushed medications to the enteral feeding (Choice A) can lead to inaccurate dosing and potential drug interactions. Infusing each medication by gravity (Choice B) is not recommended as it may not ensure accurate delivery of the medication. Flushing the NG tube with sterile water (Choice D) is important but is not directly related to administering medications through the tube.

5. A client is receiving enteral feedings through an NG tube. Which of the following actions should be taken to prevent aspiration?

• A. Monitor gastric residuals every 4 hours.
• B. Position the client in a semi-Fowler's position.
• C. Check for tube placement by auscultating air after feeding.
• D. Warm the formula to body temperature before feeding.

Correct answer: A

Rationale: Monitoring gastric residuals every 4 hours is essential to assess the stomach's ability to empty properly, reducing the risk of aspiration. It helps in determining if the feedings are being tolerated by the client and if adjustments are needed in the feeding regimen. Positioning the client in a semi-Fowler's position helps prevent reflux and aspiration by promoting proper digestion and emptying of the stomach contents. Checking for tube placement by auscultating air after feeding confirms correct tube placement in the stomach. Warming the formula to body temperature before feeding enhances client comfort but does not directly prevent aspiration. Therefore, the correct answer is to monitor gastric residuals to prevent aspiration, as it directly assesses the stomach's ability to empty properly and the tolerance of the feedings.

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