Nursing Elites

1. When preparing for a change of shift, which document or tools should a healthcare provider use to communicate?

• A. SBAR
• B. SOAP
• C. PIE
• D. DAR

Correct answer: A

Rationale: The correct answer is A: SBAR (Situation, Background, Assessment, Recommendation) is a structured method for communicating information during shift changes. SBAR provides a clear and concise way for healthcare providers to communicate important details about a patient's condition, ensuring that essential information is effectively transferred between providers. Choice B, SOAP (Subjective, Objective, Assessment, Plan), is a method primarily used for documentation in patient charts, not for shift change communication. Choice C, PIE (Problem, Intervention, Evaluation), is a nursing process format for organizing nursing care that focuses on individualized patient care plans, not shift handoff communication. Choice D, DAR (Data, Action, Response), is not a standard format for provider-to-provider handoff communication and is less commonly used in healthcare settings compared to SBAR.

2. An elderly male client who is unresponsive following a cerebral vascular accident (CVA) is receiving bolus enteral feedings through a gastrostomy tube. What is the best client position for the administration of bolus tube feedings?

• A. Prone.
• B. Fowler's.
• C. Sims'.
• D. Supine.

Correct answer: B

Rationale: The correct answer is Fowler's position. Placing the client in Fowler's position, with the head of the bed elevated to 45-60 degrees, reduces the risk of aspiration during bolus enteral feedings by facilitating the flow of the feeding into the stomach. Prone position (choice A) is lying face down, which is not suitable for feeding. Sims' position (choice C) is a side-lying position used for rectal examinations or enemas, not for feeding. Supine position (choice D) is lying flat on the back and is not optimal for reducing the risk of aspiration during bolus tube feedings.

3. A healthcare professional is assessing postoperative circulation of the lower extremities for a client who had knee surgery. The healthcare professional should test which of the following?

• A. Range of motion
• B. Skin color
• C. Edema
• D. Skin temperature

Correct answer: B

Rationale: Corrected Rationale: Assessing skin color is crucial to evaluate perfusion and circulation postoperatively. Skin color changes can indicate compromised circulation, such as pallor or cyanosis. Edema may suggest fluid retention but is not a direct indicator of circulation status. Range of motion is more related to joint function and mobility, not specifically circulation.

4. 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.

5. A client is being taught about medications at discharge. Which statement should the nurse identify as an indication that the client understands the instructions?

• A. I can open the time-release capsule with the beads in it and sprinkle them on my oatmeal.
• B. If I am having difficulty swallowing, I will add the liquid medication to a prepared package of pudding.
• C. I can crush the enteric-coated pill if needed.
• D. I will eat two crackers with the pain pills.

Correct answer: B

Rationale: The correct answer is B. Adding liquid medication to pudding can help with swallowing difficulties, demonstrating understanding of the instructions. Options A and C are incorrect as altering time-release capsules and enteric-coated pills is not recommended in medication administration. Option A is incorrect as time-release capsules should not be opened and sprinkled on food, affecting their efficacy. Option C is incorrect as crushing enteric-coated pills can affect their absorption. Option D is unrelated to medication administration and does not demonstrate understanding of the instructions.

Similar Questions