Nursing Elites

1. Larry, 55 years old, who is suspected of having colorectal cancer, is admitted to the CI. After taking the history and vital signs the physician does which test as a screening test for colorectal cancer.

• A. Barium enema
• B. Carcinoembryonic antigen
• C. Annual digital rectal examination
• D. Proctosigmoidoscopy

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

2. A nurse is initiating continuous enteral feedings for a client who has a new gastrostomy tube. Which of the following actions should the nurse take?

• A. Measure the client’s gastric residual every 12 hours.
• B. Obtain the client’s electrolyte levels every 4 hours.
• C. Keep the client’s head elevated at 15° during feedings.
• D. Flush the client’s tube with 30 mL of water every 4 hours.

Correct answer: D

Rationale: Flushing the client’s tube with 30 mL of water every 4 hours is essential to maintain tube patency and prevent blockages. This action helps ensure the continuous flow of enteral feedings without obstruction. Measuring the client’s gastric residual every 12 hours (Choice A) is important but not the priority when initiating enteral feedings. Obtaining the client’s electrolyte levels every 4 hours (Choice B) is unnecessary and not directly related to tube feeding initiation. Keeping the client’s head elevated at 15° during feedings (Choice C) is a good practice to prevent aspiration, but tube flushing is more crucial to prevent tube occlusion.

3. During the first 24 hours after the thermal injury, you should assess Sergio for:

• A. hypokalemia and hypernatremia
• B. hypokalemia and hyponatremia
• C. hyperkalemia and hyponatremia
• D. hyperkalemia and hypernatremia

Correct answer: D

Rationale: During the initial phase after a thermal injury, the major concern is the release of potassium due to cell damage, leading to hyperkalemia. Hypernatremia is not typically a primary concern in the immediate post-injury phase. Hyponatremia is less likely to occur initially after a burn injury. Therefore, the correct assessment for Sergio during the first 24 hours after the thermal injury would be hyperkalemia and hypernatremia.

4. Which food provides a 1-ounce serving of grains for a preschool child?

• A. 1 cup of ready-to-eat cereal flakes
• B. 1⁄2 slice of whole wheat bread
• C. 1⁄2 of a 6-inch flour tortilla
• D. 1 cup of cooked rice

Correct answer: A

Rationale: The correct answer is A: 1 cup of ready-to-eat cereal flakes. For a preschool child, 1 cup of ready-to-eat cereal flakes provides a 1-ounce serving of grains, meeting the requirement. Choice B, 1⁄2 slice of whole wheat bread, is not the correct answer as it does not constitute a 1-ounce serving of grains. Similarly, choice C, 1⁄2 of a 6-inch flour tortilla, does not offer a 1-ounce serving of grains. Choice D, 1 cup of cooked rice, also does not provide a 1-ounce serving of grains for a preschool child, making it an incorrect choice.

5. A nurse is teaching a group of clients who are at risk for heart disease about decreasing saturated fats in their diet. Which of the following fats should the nurse recommend the clients use when cooking?

• A. Palm oil
• B. Peanut oil
• C. Canola oil
• D. Stick margarine

Correct answer: C

Rationale: Canola oil is lower in saturated fats compared to palm oil, peanut oil, and stick margarine, making it a healthier option for clients at risk for heart disease. Palm oil is high in saturated fats, peanut oil has a moderate amount of saturated fats, and stick margarine is also high in saturated fats and trans fats, which are not heart-healthy choices.

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