Nursing Elites

1. How should a healthcare professional manage a patient with a chest tube?

• A. Ensuring the chest tube is secured properly and functioning
• B. Checking for air leaks and ensuring drainage is working
• C. Ensuring chest tube drainage is below chest level
• D. Ensuring proper documentation of chest tube output

Correct answer: D

Rationale: Proper documentation of chest tube output is crucial in the care of a patient with a chest tube. While ensuring the chest tube is secured and functioning, checking for air leaks, and maintaining drainage below chest level are important aspects of care, documentation of output is essential for monitoring the patient's condition, assessing the effectiveness of treatment, and ensuring appropriate interventions if needed.

2. A client just had a flexible bronchoscopy. Which of the following nursing actions is appropriate?

• A. Irrigate the client's throat every 4 hours
• B. Withhold food and liquids until the client's gag reflex returns
• C. Suction the client's oropharynx frequently
• D. Have the client refrain from talking for 24 hours

Correct answer: B

Rationale: After a flexible bronchoscopy, it is essential to withhold food and liquids until the client's gag reflex returns. This precaution helps prevent aspiration, as the gag reflex protects the airway from foreign material. Irrigating the client's throat every 4 hours (Choice A) is unnecessary and may increase the risk of aspiration. Suctioning the client's oropharynx frequently (Choice C) can cause trauma and is not indicated unless there is a specific medical reason for it. Having the client refrain from talking for 24 hours (Choice D) is not necessary after a flexible bronchoscopy.

3. A patient is receiving enteral feedings through a nasogastric (NG) tube. What is the most appropriate nursing intervention?

• A. Flush the NG tube with water before and after each feeding.
• B. Check the placement of the NG tube before each feeding.
• C. Administer medications through the NG tube every 4 hours.
• D. Increase the feeding rate if the patient is tolerating well.

Correct answer: B

Rationale: Checking the placement of the NG tube before each feeding is crucial as it ensures the tube is correctly positioned, reducing the risk of complications such as aspiration or improper delivery of feedings. Flushing the NG tube with water before and after each feeding can disrupt the feeding schedule and is not a standard procedure. Administering medications through the NG tube every 4 hours may not be necessary for all patients and should be based on specific medication requirements. Increasing the feeding rate without proper assessment and monitoring can lead to feeding intolerance or complications, making it an inappropriate intervention.

4. Which intervention is most effective for managing a patient with constipation?

• A. Increase the patient's fluid intake.
• B. Administer a stool softener as prescribed.
• C. Provide the patient with a high-fiber diet.
• D. Teach the patient to perform Valsalva maneuvers.

Correct answer: B

Rationale: The most effective intervention for managing constipation in a patient is to administer a stool softener as prescribed. Stool softeners help relieve constipation by making the stool easier to pass, especially in postoperative patients. Increasing fluid intake can be beneficial but may not address the underlying cause of constipation. While a high-fiber diet is important for bowel health, it may not provide immediate relief for constipation. Teaching a patient to perform Valsalva maneuvers is not recommended for managing constipation as it can lead to adverse effects like increasing intra-abdominal pressure.

5. A healthcare provider is assessing a patient with chronic pain. Which finding is most concerning?

• A. The patient reports a pain level of 6 on a scale of 0 to 10.
• B. The patient is lying still and refuses to move.
• C. The patient's pain persists despite medication.
• D. The patient reports feeling anxious and restless.

Correct answer: C

Rationale: In the context of chronic pain management, the most concerning finding is when the patient's pain persists despite medication. This suggests inadequate pain control or the need for a re-evaluation of the treatment plan. Choices A, B, and D are not as concerning in this scenario. A pain level of 6 on a scale of 0 to 10 is moderate and may be manageable with appropriate interventions. Patients with chronic pain can sometimes lie still due to pain or other reasons, and anxiety and restlessness are common in individuals with pain conditions but may not necessarily indicate a critical issue like uncontrolled pain.

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