Nursing Elites

1. A healthcare professional is preparing to insert an NG tube for a client admitted with bowel obstruction. Which of the following should the healthcare professional do first?

• A. Explain the procedure to the client
• B. Measure the length of the NG tube
• C. Lubricate the NG tube
• D. Place the client in a high Fowler’s position

Correct answer: A

Rationale: Explaining the procedure to the client is the initial and most important step that the healthcare professional should take before inserting an NG tube. By explaining the procedure, the healthcare professional ensures the client's understanding, obtains informed consent, and fosters cooperation. Measuring the length of the NG tube, lubricating the tube, and positioning the client in a high Fowler's position are essential steps in the NG tube insertion process but should come after the client has been informed and consented to the procedure.

2. The nurse is caring for a client with chronic obstructive pulmonary disease (COPD). Which instruction should the LPN/LVN reinforce to the client to help manage their condition?

• A. Increase fluid intake to thin secretions.
• B. Practice pursed-lip breathing to improve oxygenation.
• C. Avoid physical activity to prevent dyspnea.
• D. Use a peak flow meter to monitor lung function.

Correct answer: B

Rationale: Practicing pursed-lip breathing is an essential technique to help manage COPD as it can improve oxygenation by promoting better gas exchange. This technique helps to keep the airways open longer during exhalation, preventing air trapping and improving breathing efficiency. Increasing fluid intake can help thin secretions, which is beneficial, but it is not the primary instruction for managing COPD. Avoiding physical activity is not recommended as it can lead to deconditioning and worsen dyspnea in COPD patients. Using a peak flow meter is more commonly associated with monitoring asthma rather than COPD, so it is not the most relevant instruction for managing COPD.

3. A client is receiving chemotherapy for breast cancer. Which laboratory value would be most important for the nurse to monitor?

• A. White blood cell count
• B. Hemoglobin level
• C. Serum creatinine
• D. Blood glucose level

Correct answer: A

Rationale: The correct answer is to monitor the white blood cell count. Chemotherapy can lead to neutropenia, which is a decrease in white blood cells, particularly neutrophils. Neutropenia increases the risk of infections, making it crucial to monitor the white blood cell count during chemotherapy. Monitoring hemoglobin level is important but not as critical as white blood cell count in this scenario. Serum creatinine and blood glucose levels are not directly impacted by chemotherapy for breast cancer, making them less relevant to monitor in this situation.

4. A client with a terminal illness is being educated by a healthcare provider about declining resuscitation in a living will. The client asks, “What would happen if I arrived at the ED and I had difficulty breathing?”

• A. We would give you oxygen through a tube in your nose.
• B. We would initiate full resuscitation efforts.
• C. We would consult the living will and provide comfort care.
• D. We would not provide any medical intervention.

Correct answer: C

Rationale: In the scenario described, the client has a living will that declines resuscitation. Therefore, if the client arrives at the emergency department with difficulty breathing, healthcare providers would consult the living will to understand the client's wishes. Providing comfort care, which may include oxygen therapy to alleviate symptoms, aligns with the client's preferences. Option A incorrectly suggests an intervention that goes against the client's wishes. Option B is incorrect because full resuscitation efforts are not in line with the client's choice to decline resuscitation. Option D is also incorrect as it does not consider the client's living will and the need to provide care according to the documented preferences of the client.

5. The healthcare provider is teaching a patient about contact lens care. Which instructions will the healthcare provider include in the teaching session?

• A. Use tap water to clean soft lenses.
• B. Wash and rinse the lens storage case daily.
• C. Reuse storage solution for no longer than a week.
• D. Keep the lenses in a cool, dry place when not in use.

Correct answer: B

Rationale: The correct answer is B. Washing and rinsing the lens storage case daily is essential to prevent contamination and infections. Choice A is incorrect as tap water should not be used to clean soft lenses due to the risk of introducing harmful microorganisms. Choice C is incorrect as the storage solution should not be reused for longer than recommended to maintain its effectiveness and prevent eye infections. Choice D is incorrect because lenses should be stored in a clean, disinfected case, not just in a cool, dry place, to avoid contamination.

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