Nursing Elites

1. What are sheets/forms that provide an efficient and time-saving way to record information that must be obtained repeatedly at regular and/or short intervals of time? This does not replace progress notes; instead, it records information on vital signs, intake and output, treatment, postoperative care, postpartum care, and diabetic regimen, etc. These are used whenever specific measurements or observations need to be documented repeatedly. What is this?

• A. Nursing Kardex
• B. Graphic Flow Sheets
• C. Discharge Summary
• D. Medicine and Treatment Record

Correct answer: A

Rationale: The correct answer is A, Nursing Kardex. Nursing Kardex is a tool used for documenting essential patient information that needs to be recorded repeatedly at regular intervals. It includes vital signs, intake and output, treatment details, postoperative care, postpartum care, and diabetic regimen. This tool is efficient and time-saving for healthcare professionals. Choice B, Graphic Flow Sheets, may be used for visual representation of patient data but is not specifically designed for repeated documentation of essential information. Choice C, Discharge Summary, is a document outlining the patient's care and condition at the time of discharge, not for repeated recording of ongoing data. Choice D, Medicine and Treatment Record, focuses more on specific medications and treatments rather than a comprehensive recording of various patient data needed at regular intervals.

2. After bronchoscopy, the nurse's priority is to check which of the following before feeding?

• A. Gag reflex
• B. Wearing off of anesthesia
• C. Swallowing reflex
• D. Peristalsis

Correct answer: A

Rationale: After a bronchoscopy procedure, the nurse's priority is to check the patient's gag reflex before allowing them to eat to prevent aspiration. The gag reflex helps protect the airway by triggering a cough or gag response if something touches the back of the throat. This is crucial to ensure that the patient can protect their airway and prevent food or fluids from entering the lungs, especially when the throat may be sensitive or compromised post-bronchoscopy. Checking for the wearing off of anesthesia, swallowing reflex, or peristalsis are important assessments but not the immediate priority before feeding in this context.

3. What is the term for a barrier that prevents the normal emptying of stomach contents into the duodenum?

• A. Dumping syndrome
• B. Gastritis
• C. Gastric outlet obstruction
• D. Hypochlorhydria

Correct answer: C

Rationale: Gastric outlet obstruction refers to a condition where the opening between the stomach and the duodenum is blocked, preventing the normal passage of food. This is why choice 'C' is correct. 'A: Dumping syndrome' is incorrect because it is a condition where stomach contents move too quickly through the small intestine, not a barrier preventing emptying. 'B: Gastritis' is inflammation of the stomach lining, not a blockage of the outlet. 'D: Hypochlorhydria' refers to low stomach acid, which may affect digestion but does not create a physical barrier blocking the outlet of the stomach.

4. A client who is in her second trimester of pregnancy should increase her caloric intake by how many calories during this trimester?

• A. 110 cal/day
• B. 225 cal/day
• C. 340 cal/day
• D. 450 cal/day

Correct answer: C

Rationale: During the second trimester of pregnancy, it is recommended that a client increases their caloric intake by around 340 calories per day to support the growing needs of both the mother and the developing fetus. This additional intake helps ensure the proper nutrition and energy levels required during this crucial stage of pregnancy. Option A (110 cal/day) is too low to meet the increased demands. Option B (225 cal/day) is also below the recommended amount. Option D (450 cal/day) is higher than necessary and could lead to excessive weight gain, which is not ideal during pregnancy.

5. A healthcare professional has just inserted an NG tube for a client who is to start enteral tube feedings. Which of the following actions should the healthcare professional take to verify tube placement?

• A. Measure the tube length.
• B. Obtain an abdominal x-ray.
• C. Flush the tube with 20 mL of water.
• D. Auscultate the client’s lungs.

Correct answer: B

Rationale: Obtaining an abdominal x-ray is the most accurate method to verify the correct placement of an NG tube. Measuring the tube length is not a reliable method to confirm placement as it may vary among individuals. Flushing the tube with water and auscultating the client's lungs are not definitive methods to ensure proper NG tube placement.

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