Nursing Elites

1. When performing nasotracheal suctioning on a client with a respiratory infection, what technique should be used?

• A. Apply intermittent suction when withdrawing the catheter.
• B. Apply continuous suction during insertion of the catheter.
• C. Apply suction only during insertion of the catheter.
• D. Insert the catheter while the client is exhaling.

Correct answer: A

Rationale: The correct technique for nasotracheal suctioning is to apply intermittent suction when withdrawing the catheter. This method helps prevent damage to the mucosa and is the recommended approach. Continuous suction during insertion (choice B) can cause trauma to the airway lining. Applying suction only during insertion (choice C) is not sufficient for effective removal of secretions. Inserting the catheter while the client is exhaling (choice D) does not follow the standard procedure for nasotracheal suctioning.

2. A client with difficulty self-feeding due to rheumatoid arthritis should be referred to which member of the interprofessional care team to use adaptive devices?

• A. Social worker
• B. Certified nursing assistant
• C. Registered dietitian
• D. Occupational therapist

Correct answer: D

Rationale: The correct answer is D, Occupational therapist. Occupational therapists specialize in assisting clients with adaptive devices to enhance their ability to perform daily activities like self-feeding. They evaluate client needs and provide interventions to promote independence in activities of daily living. Choice A, Social worker, focuses on psychosocial support and community resources, not directly addressing the physical aspect of self-feeding difficulty. Choice B, Certified nursing assistant, is involved in direct patient care but lacks specialized training in adaptive devices. Choice C, Registered dietitian, primarily focuses on nutrition-related issues and may not have the expertise in adaptive devices and functional rehabilitation necessary for this client's self-feeding challenges.

3. A client with a terminal illness and approaching death has noisy respirations and is short of breath. Which of the following actions should the nurse take?

• A. Elevate the head of the client's bed
• B. Administer an opioid medication
• C. Perform oral suctioning
• D. Place the client in a prone position

Correct answer: A

Rationale: Elevating the head of the client's bed is the most appropriate action in this situation. It helps reduce noisy respirations and improves comfort for clients with terminal illnesses by facilitating better air exchange. Administering an opioid medication may not address the immediate issue of noisy respirations and shortness of breath caused by secretions in the airway. Performing oral suctioning without proper assessment and indication can be uncomfortable for the client and may not be necessary. Placing the client in a prone position can further compromise breathing and is not recommended for a client with respiratory distress.

4. During an initial history and physical assessment of a 3-month-old brought into the clinic for spitting up and excessive gas, what would the nurse expect to find?

• A. Increased temperature and lethargy
• B. Restlessness and increased mucus production
• C. Increased sleeping and listlessness
• D. Diarrhea and poor skin turgor

Correct answer: B

Rationale: Restlessness and increased mucus production are common signs of gastrointestinal issues or reflux in infants, which could explain the symptoms of spitting up and excessive gas. Increased temperature and lethargy (Choice A) are more indicative of an infection rather than gastrointestinal issues. Increased sleeping and listlessness (Choice C) are not typical signs associated with the symptoms described. Diarrhea and poor skin turgor (Choice D) are not directly related to the symptoms of spitting up and gas in this scenario.

5. To use proper body mechanics while making an occupied bed for a client on bed rest, the nurse should:

• A. Place the bed in a high horizontal position
• B. Use a low bed position
• C. Bend at the waist
• D. Keep the bed flat and at a comfortable working height

Correct answer: A

Rationale: When making an occupied bed for a client on bed rest, the nurse should place the bed in a high horizontal position to promote better body mechanics. This positioning helps reduce strain on the nurse's back and promotes proper alignment while working. Using a low bed position can lead to awkward bending and increased risk of musculoskeletal injuries. Bending at the waist is discouraged as it can strain the back. Keeping the bed flat and at a comfortable working height may not provide the optimal ergonomic setup needed to prevent injury.

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