Nursing Elites

1. What teaching should be provided to a patient following an escharotomy for burn injuries?

• A. Monitor for infection
• B. Restrict fluid intake
• C. Avoid physical activity
• D. Limit phosphorus to 1,500 mg/day

Correct answer: A

Rationale: Following an escharotomy for burn injuries, patients should be taught to monitor for infection and care for the incision site. Choice A is the correct answer because infection is a common risk after a procedure involving incisions. Choices B, C, and D are incorrect. Restricting fluid intake is not typically advised after an escharotomy; avoiding physical activity may vary depending on the individual's condition and should be guided by healthcare providers; and limiting phosphorus to 1,500 mg/day is not directly related to post-escharotomy care.

2. What dietary recommendations should be given to a patient with GERD?

• A. Avoid mint and spicy foods
• B. Eat large meals before bed
• C. Increase fluid intake during meals
• D. Drink milk as a snack

Correct answer: A

Rationale: The correct dietary recommendation for a patient with GERD is to avoid mint and spicy foods. These foods can trigger symptoms of GERD and lead to acid reflux. Choice B is incorrect because eating large meals before bed can exacerbate GERD symptoms by increasing the likelihood of acid reflux during sleep. Choice C is incorrect as increasing fluid intake during meals can worsen GERD symptoms by distending the stomach, leading to increased pressure on the lower esophageal sphincter. Choice D is also incorrect because while milk may provide temporary relief for some individuals, it is not a recommended long-term solution for managing GERD.

3. What ECG changes are seen in hypokalemia?

• A. Flattened T waves on the ECG
• B. Elevated ST segments on the ECG
• C. Widened QRS complex
• D. Prominent U waves on the ECG

Correct answer: A

Rationale: The correct answer is A: Flattened T waves on the ECG. Flattened T waves are an early indicator of hypokalemia on an ECG. Choice B, Elevated ST segments, is not typically seen in hypokalemia but can be a sign of myocardial infarction. Choice C, Widened QRS complex, is more commonly associated with hyperkalemia. Choice D, Prominent U waves, is typically associated with hypokalemia, but flattened T waves are considered a more specific and early sign.

4. What is the priority action if a patient experiences abdominal cramping during enema administration?

• A. Lower the height of the solution container
• B. Increase the flow of the enema solution
• C. Stop the procedure and remove the tubing
• D. Continue the enema at a slower rate

Correct answer: A

Rationale: During enema administration, if a patient experiences abdominal cramping, the priority action is to lower the height of the solution container. This adjustment can help relieve abdominal cramping by reducing the flow rate of the enema, making it more comfortable for the patient. Increasing the flow of the enema solution (Choice B) can exacerbate the cramping. Stopping the procedure and removing the tubing (Choice C) may be necessary in some cases of severe discomfort or complications, but adjusting the height of the solution container should be the initial response. Continuing the enema at a slower rate (Choice D) may not address the immediate need to alleviate the cramping.

5. What intervention is needed for continuous bubbling in the chest tube water seal chamber?

• A. Tighten the connections of the chest tube system
• B. Clamp the chest tube
• C. Replace the chest tube system
• D. Continue monitoring the chest tube

Correct answer: A

Rationale: The correct intervention for continuous bubbling in the chest tube water seal chamber is to tighten the connections of the chest tube system. Continuous bubbling indicates an air leak in the system, and tightening the connections can help resolve this issue. Clamping the chest tube (Choice B) is not appropriate and can lead to complications by obstructing the drainage system. Similarly, replacing the entire chest tube system (Choice C) may not be necessary if the issue can be resolved by tightening the connections. Continuing to monitor the chest tube (Choice D) without taking action to address the continuous bubbling may delay necessary interventions to prevent complications.

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