Nursing Elites

1. How should a healthcare provider respond to a patient refusing a blood transfusion for religious reasons?

• A. Respect the patient's beliefs
• B. Educate the patient on the importance of the transfusion
• C. Notify the healthcare provider
• D. Persuade the patient to accept the transfusion

Correct answer: A

Rationale: When a patient refuses a blood transfusion for religious reasons, the healthcare provider should respect the patient's beliefs. It is crucial to uphold the patient's autonomy and right to make decisions about their care, even if the provider disagrees. Educating the patient on the importance of the transfusion may be appropriate in some cases, but the initial response should always be to respect the patient's decision. Notifying the healthcare provider is not necessary as the decision lies with the patient. Persuading the patient to accept the transfusion goes against the principle of respecting the patient's autonomy and beliefs.

2. What is the most important assessment for a patient post-op to monitor for complications?

• A. Monitor vital signs
• B. Monitor the surgical site
• C. Check blood glucose levels
• D. Check for abnormal breath sounds

Correct answer: A

Rationale: The correct answer is to monitor vital signs. Post-operative patients need close monitoring of their vital signs to detect early signs of complications such as changes in blood pressure, heart rate, temperature, and respiratory rate. While monitoring the surgical site is also important for signs of infection, assessing vital signs takes precedence as it provides immediate information about the patient's overall condition. Checking blood glucose levels may be essential for specific patients but is not the primary assessment for monitoring post-op complications. Checking for abnormal breath sounds is important but falls secondary to monitoring vital signs as it indicates respiratory issues rather than providing a comprehensive assessment of the patient's condition.

3. A client with hypertension is receiving discharge teaching from a nurse on managing blood pressure at home. Which of the following instructions should the nurse include?

• A. Take medication at bedtime.
• B. Check blood pressure once a week.
• C. Use a blood pressure cuff that fits snugly around the arm.
• D. Stop taking medication once blood pressure is within the normal range.

Correct answer: C

Rationale: The correct answer is C: 'Use a blood pressure cuff that fits snugly around the arm.' Using a properly fitting cuff is essential for accurate blood pressure measurements. Choice A is incorrect because the timing of medication administration should be individualized and not specified in the question. Choice B is incorrect as checking blood pressure once a week may not provide sufficient monitoring for a client with hypertension. Choice D is incorrect because stopping medication abruptly once blood pressure is normal can lead to rebound hypertension and complications.

4. A nurse is planning care for a client who has a nasogastric tube for enteral feedings. Which of the following interventions should the nurse include to prevent aspiration?

• A. Flush the tube with 30 mL of sterile water before each feeding.
• B. Check for gastric residuals every 4 hours.
• C. Elevate the head of the bed to 45 degrees during feedings.
• D. Place the client in the left lateral position during feedings.

Correct answer: C

Rationale: Elevating the head of the bed to 45 degrees during feedings is the correct intervention to prevent aspiration in clients with a nasogastric tube. This position helps reduce the risk of regurgitation and subsequent aspiration of stomach contents into the lungs. Flushing the tube with water before feedings (Choice A) is not necessary for preventing aspiration. Checking for gastric residuals (Choice B) helps monitor feeding tolerance but does not directly prevent aspiration. Placing the client in the left lateral position (Choice D) is not specifically indicated for preventing aspiration in a client with a nasogastric tube.

5. A nurse is preparing an in-service for a group of nurses about malpractice issues in nursing. Which of the following examples should the nurse include in the teaching?

• A. Leaving a nasogastric tube clamped after administering oral medication.
• B. Documenting communication with a provider in the progress notes of the client's medical records.
• C. Administering potassium via IV bolus.
• D. Placing a yellow bracelet on a client who is at risk for falls.

Correct answer: C

Rationale: Administering potassium via IV bolus is a malpractice issue due to the risk of cardiac complications. Option A is incorrect as leaving a nasogastric tube clamped after administering oral medication can lead to complications but is not directly linked to malpractice. Option B is incorrect as documenting communication with a provider in the progress notes is a necessary part of nursing practice. Option D is incorrect as placing a yellow bracelet on a client at risk for falls is a safety measure to prevent falls and is not related to malpractice issues.

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