Nursing Elites

1. A nurse is initiating continuous enteral feedings for a client who has a new gastrostomy tube. Which of the following actions should the nurse take?

• A. Measure the client’s gastric residual every 12 hr.
• B. Obtain the client’s electrolyte levels every 4 hr.
• C. Keep the client’s head elevated at 15* during feedings.
• D. Flush the client’s tube with 30 mL of water every 4 hr.

Correct answer: D

Rationale: Flushing the client's tube with 30 mL of water every 4 hours helps maintain tube patency and prevent blockages.

2. A home health nurse is conducting an initial visit with an older adult client. The client lives alone and has difficulty preparing his own meals. Which of the following actions should the nurse take first?

• A. Discuss nutritional requirements with the client.
• B. Refer the client to a senior citizen center.
• C. Arrange for a home-delivered meal program.
• D. Perform a nutrition screening.

Correct answer: D

Rationale: Performing a nutrition screening first allows the nurse to assess the client's nutritional status and identify specific needs.

3. A nurse is caring for a client who follows the dietary laws of Orthodox Judaism. Which of the following meal choices should the nurse request for the client?

• A. Turkey and cheese sandwich
• B. Spaghetti with tomato sauce
• C. Pork chop and applesauce
• D. Scrambled eggs and bacon

Correct answer: B

Rationale: Spaghetti with tomato sauce adheres to the kosher dietary laws followed by Orthodox Jews, which prohibit mixing meat and dairy and consuming pork.

4. A nurse is providing teaching to an obese client who has gestational diabetes and is at 25 weeks of gestation. Which of the following statements made by the client indicates a need for further teaching?

• A. This does not mean that my baby will have this disease.
• B. This means that I will have diabetes for the rest of my life.
• C. If I feel dizzy, I should drink six ounces of a non-diet soda.
• D. Being obese might be one reason why I developed diabetes.

Correct answer: B

Rationale: The belief that gestational diabetes results in lifelong diabetes is incorrect; it often resolves after pregnancy, though it does indicate a higher risk for developing type 2 diabetes in the future.

5. A nurse is planning care for a client who reports increasing difficulty swallowing food. Which of the following interventions should the nurse plan to take?

• A. Turn on the client’s television during meals.
• B. Place the client into a semi-reclining position for meals.
• C. Encourage the client to rest prior to mealtimes.
• D. Encourage the client to use a straw when drinking liquids.

Correct answer: C

Rationale: Encouraging the client to rest prior to mealtimes can help reduce fatigue and improve the ability to swallow.

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