Nursing Elites

1. The nurse supervises care of a client who is receiving enteral feeding via a nasogastric tube. The nurse determines that care is appropriate if which of the following is observed? (Select all that apply)

• A. The nursing assistant aspirates and measures the amount of the gastric aspirate
• B. The nursing assistant elevates the head of the client’s bed 30 degrees
• C. The nursing assistant warms the formula to room temperature
• D. B, C

Correct answer: D

Rationale: Elevating the head of the bed to 30 degrees reduces the risk of aspiration by promoting proper digestion and preventing reflux. Warming the formula to room temperature is essential to prevent discomfort and complications. Aspirating and measuring the gastric aspirate is not a recommended nursing action for monitoring enteral feeding via a nasogastric tube, as it can introduce the risk of introducing contaminants into the feeding tube. Therefore, choices A and B are incorrect, making choice D the correct answer.

2. A patient with diabetes should be advised to avoid which type of carbohydrate?

• A. Simple carbohydrates
• B. Complex carbohydrates
• C. Fiber-rich carbohydrates
• D. All carbohydrates

Correct answer: A

Rationale: A patient with diabetes should be advised to avoid simple carbohydrates. Simple carbohydrates can cause rapid spikes in blood glucose levels due to their quick absorption, which can be challenging to manage for individuals with diabetes. Complex carbohydrates and fiber-rich carbohydrates are generally better choices for individuals with diabetes as they are absorbed more slowly, leading to more stable blood glucose levels. Avoiding all carbohydrates is not necessary or recommended, as carbohydrates are an essential source of energy and nutrients in a balanced diet.

3. Patients with gallbladder disease should reduce their intake of:

• A. Protein
• B. Sodium
• C. Cholesterol
• D. Fat

Correct answer: D

Rationale: Patients with gallbladder disease should reduce their intake of fat because high-fat foods can trigger gallbladder symptoms such as pain and indigestion. While proteins, sodium, and cholesterol may also need to be moderated for overall health, reducing fat intake is particularly crucial for managing gallbladder issues.

4. Which of the following drugs contribute to peptic ulcers?

• A. Antacids
• B. Certain antibiotics
• C. Cholesterol-lowering medications
• D. Nonsteroidal anti-inflammatory drugs

Correct answer: D

Rationale: The correct answer is D: Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs are known to contribute to peptic ulcers by affecting the gastric mucosa. Choice A, Antacids, actually help to alleviate symptoms of peptic ulcers by neutralizing stomach acid. Choice B, Certain antibiotics, are used to treat H. pylori infections, a common cause of peptic ulcers. Choice C, Cholesterol-lowering medications, do not contribute to peptic ulcers.

5. Participating in the development of long-term and preventive health goals with the patient and their family is part of which of the following steps for determining and fulfilling the nursing care needs of the patient?

• A. Evaluation
• B. Planning
• C. Implementation
• D. Assessment

Correct answer: B

Rationale: The correct answer is B: Planning. Planning in nursing care involves setting long-term and preventive goals for the patient in collaboration with the patient and their family. This step ensures that a comprehensive and individualized care plan is developed. Choice A, Evaluation, comes after the interventions have been implemented to assess their effectiveness. Choice C, Implementation, is the step where the care plan is put into action. Choice D, Assessment, is the initial step that involves collecting data to identify the patient's needs, which is done before planning the care.

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