Nursing Elites

1. What action should the healthcare provider take for a patient with a chest tube?

• A. Strip the drainage tubing every 4 hours.
• B. Keep the drainage system below the level of the patient's chest.
• C. Clamp the chest tube when ambulating the patient.
• D. Ensure the water seal chamber is filled to the prescribed level.

Correct answer: D

Rationale: Ensuring the water seal chamber is filled to the prescribed level is essential for the chest tube's effective functioning. This maintains the integrity of the system, prevents air from entering the pleural space, and facilitates proper drainage. Stripping the drainage tubing, keeping the drainage system below the chest level, or clamping the chest tube during ambulation are not recommended practices and can lead to complications.

2. A healthcare professional is planning care for a client who has a new prescription for a high-protein diet. Which of the following foods should the healthcare professional recommend?

• A. Nuts
• B. Bananas
• C. Potatoes
• D. Apples

Correct answer: A

Rationale: Nuts are an excellent source of protein and are suitable for a high-protein diet. They provide essential nutrients and can help the client meet their increased protein requirements. Bananas, potatoes, and apples are not high-protein foods and are not the best choice when aiming to increase protein intake.

3. When should discharge planning begin for a client admitted to a long-term care facility for rehabilitation after a total hip arthroplasty?

• A. One week prior to the client's discharge
• B. Upon the client's admission to the care facility
• C. Once the discharge date is identified
• D. When the client addresses the topic with the nurse

Correct answer: B

Rationale: Discharge planning should begin upon the client's admission to the care facility. This early start allows the healthcare team to conduct assessments, set goals, and coordinate services for a smooth transition back home or to the community. Initiating discharge planning early ensures timely arrangements, leading to optimal outcomes and continuity of care. Choices A, C, and D are incorrect because waiting until one week before discharge, after the discharge date is identified, or until the client brings up the topic may lead to rushed decision-making, inadequate arrangements, and a less effective transition process.

4. A client with celiac disease is being taught about dietary management. Which statement by the client indicates an understanding of the teaching?

• A. I should avoid foods that contain gluten.
• B. I should increase my intake of foods high in gluten.
• C. I should avoid foods that contain lactose.
• D. I should increase my intake of foods high in lactose.

Correct answer: A

Rationale: The correct answer is A: 'I should avoid foods that contain gluten.' Celiac disease requires the avoidance of gluten-containing foods to manage symptoms and prevent complications. Gluten is found in wheat, barley, and rye. Choices B, C, and D are incorrect as they do not align with the dietary requirements for managing celiac disease. Increasing intake of foods high in gluten or lactose would be detrimental for someone with celiac disease.

5. During discharge instructions, a client with a new prescription for a metered-dose inhaler (MDI) states, 'I will shake the inhaler before each use.' Which of the following client statements indicates an understanding of the teaching?

• A. I will shake the inhaler before each use.
• B. I will use the inhaler immediately after meals.
• C. I will inhale the medication quickly.
• D. I will clean the mouthpiece with alcohol.

Correct answer: A

Rationale: The correct answer is A because shaking the inhaler before each use ensures that the medication is properly mixed, which is essential for effective administration. This action helps to disperse the medication evenly, enhancing its efficacy when inhaled. Proper mixing through shaking prevents inconsistent dosing and ensures that the client receives the correct amount of medication with each use.

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