Nursing Elites

1. When preparing to administer a medication through a nasogastric (NG) tube, what is the first action the nurse should take?

• A. Check the placement of the NG tube
• B. Flush the tube with saline
• C. Position the client in a semi-Fowler's position
• D. Administer the medication slowly

Correct answer: A

Rationale: The correct first action when preparing to administer a medication through a nasogastric (NG) tube is to check the placement of the NG tube. This step is essential to ensure that the tube is correctly positioned in the stomach and not in the lungs, preventing potential complications. Flushing the tube with saline may be required, but it should follow the verification of tube placement. Positioning the client in a semi-Fowler's position is necessary for comfort during the procedure but is not the initial step. Administering the medication can only be done safely after confirming the correct placement of the NG tube.

2. What is the primary purpose of administering Rho(D) immune globulin (RhoGAM) to an Rh-negative mother after childbirth?

• A. To prevent Rh sensitization in future pregnancies
• B. To treat anemia in the newborn
• C. To increase the mother's white blood cell count
• D. To prevent infection in the newborn

Correct answer: A

Rationale: The correct answer is A: To prevent Rh sensitization in future pregnancies. RhoGAM is given to an Rh-negative mother to prevent the development of antibodies against Rh-positive blood cells. This prevents Rh sensitization, which could lead to hemolytic disease in future Rh-positive pregnancies. Choices B, C, and D are incorrect because RhoGAM is not used to treat anemia in the newborn, increase the mother's white blood cell count, or prevent infection in the newborn.

3. Which vitamin deficiency is most associated with night blindness?

• A. Vitamin A
• B. Vitamin B12
• C. Vitamin C
• D. Vitamin D

Correct answer: A

Rationale: The correct answer is Vitamin A. Vitamin A deficiency leads to night blindness because this vitamin is crucial for the formation of rhodopsin, a photopigment in the retina. Rhodopsin is essential for vision in low-light conditions. Vitamin B12 deficiency can lead to anemia and neurological issues but is not directly related to night blindness. Vitamin C deficiency can cause scurvy, affecting connective tissues, but not night vision. Vitamin D deficiency can lead to bone disorders but is not primarily associated with night blindness.

4. Which of the following is an appropriate intervention for a patient experiencing a hypertensive crisis?

• A. Placing the patient in a supine position
• B. Administering a beta-blocker intravenously
• C. Encouraging the patient to drink fluids
• D. Applying a cold compress to the forehead

Correct answer: B

Rationale: Administering a beta-blocker intravenously is the correct intervention for a patient experiencing a hypertensive crisis. Beta-blockers help quickly reduce blood pressure and prevent complications such as stroke or heart attack. Placing the patient in a supine position can worsen the condition by reducing venous return and increasing the workload of the heart. Encouraging the patient to drink fluids is not recommended as it can exacerbate hypertension by increasing fluid volume. Applying a cold compress to the forehead does not address the underlying cause of the hypertensive crisis and is unlikely to provide significant benefit.

5. At the first dressing change, the PN tells the client that her mastectomy incision is healing well, but the client refuses to look at the incision and refuses to talk about it. Which response by the PN to the client's silence is best?

• A. You will feel better when you see that the incision is not as bad as you may think.
• B. It's OK if you don't want to look or talk about the mastectomy. I will be available when you're ready.
• C. Part of recovery is accepting your new body image, and you will need to look at your incision.
• D. Would you like me to call another nurse to be here while I show you the wound?

Correct answer: B

Rationale: Acknowledging the client's feelings and providing emotional support without pressuring them to look at the incision is important. Choice B is the best response as it respects the client's emotional readiness to confront their body image changes. The client's autonomy and emotional needs are prioritized in this response. Choice A may invalidate the client's feelings by assuming the incision is not as bad as they think, potentially dismissing their emotions. Choice C is insensitive as it imposes a particular view of recovery on the client, disregarding their current emotional state. Choice D may escalate the situation by suggesting the need for another nurse, which could make the client feel uncomfortable and pressured.

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