Nursing Elites

1. A nurse is preparing to administer a gavage feeding via nasogastric tube to a preterm newborn who is receiving supplemental oxygen. Which of the following actions should the nurse take?

• A. Stabilize the tube with tape to the newborn’s forehead.
• B. Remove supplemental oxygen during the feeding.
• C. Measure the stomach aspirate prior to the feeding.
• D. Place the newborn on her left side for 30 min after the feeding.

Correct answer: C

Rationale: Measuring the stomach aspirate prior to the feeding is essential to ensure proper placement and function of the NG tube.

2. A nurse is preparing to remove a client’s clogged NG tube prior to re-inserting a new tube. Which of the following actions should the nurse take first?

• A. Assist the client to blow her nose.
• B. Ask the client to take a deep breath and hold it.
• C. Pinch the proximal end of the tube.
• D. Disconnect the tube from suction source.

Correct answer: D

Rationale: Disconnecting the tube from the suction source is the first step in safely removing a clogged NG tube.

3. 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.

4. A nurse is planning care for a client who has ascites secondary to liver disease. Which of the following interventions should the nurse include in the plan of care?

• A. Reduce complex carbohydrates to 30% of total calories.
• B. Restrict protein intake to less than 0.8 g/kg/day.
• C. Decrease daily caloric intake by 20%.
• D. Limit sodium to 2000 mg or less per day.

Correct answer: D

Rationale: Limiting sodium to 2000 mg or less per day helps manage fluid retention associated with ascites in liver disease.

5. A nurse is evaluating the meal choices of a client who has major depressive disorder and a prescription of Phenelzine. Which of the following selections should the nurse identify as appropriate?

• A. Cheddar cheese
• B. Smoked salmon
• C. Strawberry yogurt
• D. Pepperoni pizza

Correct answer: C

Rationale: Strawberry yogurt is appropriate as it does not contain high levels of tyramine, which can interact negatively with Phenelzine.

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