Nursing Elites

1. A client who is 1 day postpartum plans to breastfeed. Which statement indicates an understanding of the teaching provided by the nurse?

• A. I will breastfeed every 4 hours.
• B. I will feed my baby from each breast for 5 minutes.
• C. I will use both breasts at each feeding.
• D. I will pump my breasts if my baby does not wake up to feed.

Correct answer: C

Rationale: The correct answer is C. Using both breasts at each feeding helps ensure adequate milk production and consumption. Option A is incorrect because breastfeeding should be done on demand rather than following a strict schedule. Option B is incorrect as limiting feeding time to 5 minutes per breast may not provide the baby with enough milk. Option D is also incorrect as pumping should not replace direct breastfeeding unless there is a specific medical reason to do so.

2. A nurse is providing dietary teaching to a client who is at 8 weeks of gestation and has a body mass index (BMI) of 24. Which of the following instructions should the nurse include?

• A. You should increase your caloric intake by 600 calories per day.
• B. You should increase your caloric intake by 300 calories per day.
• C. You should maintain your prepregnancy caloric intake during the first trimester.
• D. You should increase your caloric intake by 150 calories per day.

Correct answer: B

Rationale: During the first trimester, it is recommended to increase caloric intake by 300 calories per day to support fetal growth and development. Choice A suggesting an increase of 600 calories is excessive and unnecessary. Choice C advising to maintain prepregnancy caloric intake could lead to inadequate nutrition for the developing fetus. Choice D recommending an increase of 150 calories is insufficient to meet the increased energy demands of pregnancy.

3. What is the best intervention for a patient with respiratory distress?

• A. Administer oxygen
• B. Reposition the patient
• C. Provide bronchodilators
• D. Provide humidified air

Correct answer: A

Rationale: Administering oxygen is the best intervention for a patient with respiratory distress because it helps improve oxygenation levels and alleviates respiratory distress directly. Providing oxygen addresses the primary issue of inadequate oxygen supply, which is crucial in managing respiratory distress. Repositioning the patient, while important for airway clearance, may not address the immediate need for oxygen. Providing bronchodilators and humidified air can be beneficial in certain respiratory conditions, but when a patient is in respiratory distress, ensuring adequate oxygenation through oxygen administration takes precedence.

4. What lab value should a healthcare provider monitor for a patient on warfarin therapy?

• A. Potassium
• B. PT/INR
• C. Sodium
• D. Calcium

Correct answer: B

Rationale: The correct answer is B: PT/INR. When a patient is on warfarin therapy, healthcare providers monitor the PT/INR levels to evaluate the effectiveness of the treatment and assess the risk of bleeding. Monitoring potassium, sodium, or calcium levels is not directly related to warfarin therapy and would not provide the necessary information needed to manage the medication effectively.

5. How should a healthcare provider care for a patient with a tracheostomy?

• A. Clean the tracheostomy site daily
• B. Change the tracheostomy ties daily
• C. Suction the tracheostomy regularly
• D. Provide humidified oxygen

Correct answer: C

Rationale: Suctioning the tracheostomy regularly is crucial in caring for a patient with a tracheostomy as it helps keep the airway clear of secretions, preventing blockages and potential complications. Cleaning the tracheostomy site daily is important for hygiene but not as critical as regular suctioning. Changing the tracheostomy ties daily may not be necessary unless soiled or loose. Providing humidified oxygen may be part of the care plan but is not as directly related to maintaining the tracheostomy patency as suctioning.

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