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. The UAP reports to the nurse that a client refused to bathe for the third consecutive day. Which action is best for the nurse to take?

• A. Explain the importance of good hygiene to the client
• B. Ask family members to encourage the client to bathe
• C. Reschedule the bath for the following day
• D. Ask the client why the bath was refused

Correct answer: D

Rationale: The correct action for the nurse to take is to ask the client why the bath was refused. Understanding the client's reason for refusal is crucial in identifying and addressing any underlying concerns or issues that may be contributing to the refusal. This approach promotes open communication, client-centered care, and helps in developing a plan of care that is tailored to the client's needs and preferences. Choices A, B, and C do not directly address the root cause of the refusal and may not effectively resolve the situation.

3. Inspiratory and expiratory stridor may be heard in a client who:

• A. Is experiencing an exacerbation of goiter
• B. Is experiencing an acute asthmatic attack
• C. Has aspirated a piece of meat
• D. Has severe laryngotracheitis

Correct answer: D

Rationale: Inspiratory and expiratory stridor are high-pitched, wheezing sounds caused by disrupted airflow due to airway obstruction. Severe laryngotracheitis, involving inflammation and swelling of the larynx and trachea, leads to airway obstruction and can produce both inspiratory and expiratory stridor. Exacerbation of goiter, an acute asthmatic attack, and aspiration of a piece of meat are not typically associated with both inspiratory and expiratory stridor. Therefore, choices A, B, and C are incorrect.

4. Which of the following factors increases the risk of developing a pressure ulcer?

• A. High-protein diet
• B. Frequent repositioning
• C. Immobility
• D. Active range of motion exercises

Correct answer: C

Rationale: Immobility is a significant risk factor for pressure ulcers because it leads to prolonged pressure on specific areas of the body, reducing blood flow and leading to tissue breakdown. Choices A, B, and D are incorrect. A high-protein diet can actually aid in wound healing and tissue repair. Frequent repositioning helps relieve pressure on bony prominences, reducing the risk of pressure ulcers. Active range of motion exercises can improve circulation and prevent muscle atrophy, thereby reducing the risk of pressure ulcers.

5. When caring for a child with sickle cell disease, the PN expects that the child will most likely describe which symptom when experiencing a sickle cell crisis?

• A. Decreased hemoglobin
• B. Joint pain
• C. Fatigue
• D. Infection

Correct answer: B

Rationale: During a sickle cell crisis, a child with sickle cell disease is most likely to describe joint pain. Sickle cell disease leads to the blockage of blood flow by sickled red blood cells, causing ischemia and pain, often felt in the joints and other body parts. Fatigue (choice C) is a nonspecific symptom that can occur in various conditions but is not a characteristic symptom of a sickle cell crisis. While decreased hemoglobin (choice A) can be observed in sickle cell disease, it is not a symptom typically described by a child during a sickle cell crisis. Infection (choice D) can trigger a sickle cell crisis but is not the symptom most likely to be described by the child during the crisis.

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