Nursing Elites

1. How should a healthcare provider care for a patient with a nasogastric (NG) tube?

• A. Check tube placement and assess for signs of aspiration
• B. Flush the tube with water regularly to maintain patency
• C. Monitor for bowel sounds and administer medications
• D. Administer medications through the tube

Correct answer: A

Rationale: When caring for a patient with a nasogastric (NG) tube, it is crucial to check the tube placement and assess for signs of aspiration. This ensures that the tube is correctly positioned and that the patient is not at risk of complications such as aspiration pneumonia. Choice B is incorrect as flushing the tube with water regularly is not a standard practice and may not be appropriate for all patients. Choice C is incorrect as monitoring for bowel sounds is not directly related to NG tube care, and administering medications is not the primary focus of caring for the tube itself. Choice D is incorrect because administering medications through the NG tube is a specific action that may be taken based on a healthcare provider's order, not a general care guideline for the NG tube.

2. A client with a serum albumin level of 3 g/dL has a pressure ulcer. What should the nurse do first?

• A. Monitor the client's fluid and electrolyte balance
• B. Consult a dietitian to improve the client's nutritional status
• C. Administer a protein supplement
• D. Administer an anti-inflammatory medication

Correct answer: B

Rationale: The correct first action for a client with a serum albumin level of 3 g/dL and a pressure ulcer is to consult a dietitian to improve the client's nutritional status. Adequate nutrition is essential for wound healing. Monitoring fluid and electrolyte balance is important but not the first priority in this situation. Administering a protein supplement can be considered after dietary evaluation. Administering an anti-inflammatory medication is not the primary intervention for addressing a pressure ulcer related to low albumin levels.

3. During an initial assessment of a client, a nurse notices a discrepancy between the client's current IV infusion and the information received during the shift report. Which of the following actions should the nurse take?

• A. Complete an incident report and place it in the client's medical record.
• B. Compare the current infusion with the prescription in the client's medication record.
• C. Contact the charge nurse to see if the prescription was changed.
• D. Submit a written warning for the nurse involved in the incident.

Correct answer: B

Rationale: The correct action for the nurse to take when noticing a discrepancy between the client's current IV infusion and the information received during the shift report is to compare the current infusion with the prescription in the client's medication record. This step is crucial to ensure the accuracy of the prescribed treatment and to prevent any potential harm to the client. Option A is incorrect because completing an incident report should only be done after verifying the discrepancy. Option C is incorrect as contacting the charge nurse should come after confirming the details. Option D is incorrect as submitting a written warning is not appropriate without verifying the information first.

4. What are the early signs of sepsis in a patient?

• A. Increased heart rate and fever
• B. Low blood pressure and confusion
• C. Elevated blood sugar and sweating
• D. Increased urine output and abdominal pain

Correct answer: A

Rationale: The correct answer is A: Increased heart rate and fever. These are early signs of sepsis and indicate a systemic infection. It is crucial to identify these signs promptly to initiate appropriate treatment. Choice B is incorrect because low blood pressure and confusion are more indicative of severe sepsis or septic shock rather than early signs. Choice C is incorrect as elevated blood sugar and sweating are not typical early signs of sepsis. Choice D is also incorrect as increased urine output and abdominal pain are not early signs of sepsis.

5. How should a healthcare provider assess a patient for fluid overload?

• A. Monitor weight and assess for shortness of breath
• B. Auscultate lung sounds and monitor blood pressure
• C. Assess for edema in the extremities
• D. Assess for jugular venous distension

Correct answer: A

Rationale: Correctly, the answer is to monitor weight and assess for shortness of breath when assessing a patient for fluid overload. Weight monitoring is crucial as sudden weight gain can indicate fluid retention. Shortness of breath can be a sign of fluid accumulation in the lungs. While auscultating lung sounds and monitoring blood pressure are important assessments in overall patient care, they may not be specific to fluid overload. Assessing for edema in the extremities is relevant, but it is not as sensitive as monitoring weight for detecting fluid overload. Assessing for jugular venous distension is more specific to assessing fluid status in heart failure rather than a general assessment for fluid overload.

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