Nursing Elites

1. Which client is most likely to need regular injections of vitamin B12?

• A. The client with malabsorption syndrome.
• B. The client following a vegan eating pattern.
• C. The client whose stomach does not produce intrinsic factors.
• D. The client with alcoholism.

Correct answer: C

Rationale: The correct answer is C. The client whose stomach does not produce intrinsic factors is most likely to need regular injections of vitamin B12. Intrinsic factor is essential for the absorption of vitamin B12. Without intrinsic factor, the client cannot absorb vitamin B12 from food, necessitating the need for regular injections. Choices A, B, and D do not directly impact the production of intrinsic factors in the stomach, so they are less likely to result in the need for vitamin B12 injections.

2. A nurse is initiating continuous enteral feedings for a client who has a new gastrostomy tube. Which of the following actions should the nurse take?

• A. Measure the client’s gastric residual every 12 hours.
• B. Obtain the client’s electrolyte levels every 4 hours.
• C. Keep the client’s head elevated at 15° during feedings.
• D. Flush the client’s tube with 30 mL of water every 4 hours.

Correct answer: D

Rationale: Flushing the client’s tube with 30 mL of water every 4 hours is essential to maintain tube patency and prevent blockages. This action helps ensure the continuous flow of enteral feedings without obstruction. Measuring the client’s gastric residual every 12 hours (Choice A) is important but not the priority when initiating enteral feedings. Obtaining the client’s electrolyte levels every 4 hours (Choice B) is unnecessary and not directly related to tube feeding initiation. Keeping the client’s head elevated at 15° during feedings (Choice C) is a good practice to prevent aspiration, but tube flushing is more crucial to prevent tube occlusion.

3. A healthcare professional is preparing to remove a client’s clogged NG tube prior to re-inserting a new tube. Which of the following actions should the healthcare professional take first?

• A. Assist the client in blowing their nose.
• B. Ask the client to take a deep breath and hold it.
• C. Pinch the proximal end of the tube.
• D. Disconnect the tube from the suction source.

Correct answer: D

Rationale: Correct Answer: Disconnecting the tube from the suction source is the first step in safely removing a clogged NG tube. This action helps prevent any suction-related complications and ensures a smooth transition when removing the tube. Choice A, assisting the client to blow their nose, is not necessary in this situation. Choice B, asking the client to take a deep breath and hold it, is unrelated to the process of removing a clogged NG tube. Choice C, pinching the proximal end of the tube, should only be done after disconnecting the tube from the suction source to prevent the contents from leaking.

4. According to the DASH Eating Plan, Carmen's daily sodium intake should not exceed how many milligrams to ensure the plan's effectiveness?

• A. 1000 milligrams
• B. 2500 milligrams
• C. 3000 milligrams
• D. 1500 milligrams

Correct answer: D

Rationale: The DASH Eating Plan is designed to lower blood pressure and is most effective when daily sodium intake is limited to 1500 milligrams or less. Therefore, choice D is the correct answer. Choices A (1000 milligrams), B (2500 milligrams), and C (3000 milligrams) are incorrect because they either fall below or exceed the recommended daily sodium intake for the DASH Eating Plan.

5. The use of the Standards of Nursing Practice is important in the hospital. Which of the following statements best describes what it is?

• A. These are statements that describe the maximum or highest level of acceptable performance in nursing practice
• B. It refers to the scope of nursing practice as defined in Republic Act 9173
• C. It is a license issued by the Professional Regulation Commission to protect the public from substandard nursing
• D. The Standards of Care includes the various steps of the nursing process and the standards of professional

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

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