Nursing Elites

1. Which of the following is a critical nursing action when managing a patient with a chest tube?

• A. Keep the chest tube clamped at all times.
• B. Ensure the chest tube is connected to a closed drainage system.
• C. Empty the chest tube drainage system every 2 hours.
• D. Disconnect the chest tube when the patient is ambulating.

Correct answer: B

Rationale: The correct answer is B: "Ensure the chest tube is connected to a closed drainage system." This is a critical nursing action when managing a patient with a chest tube because it is essential for proper drainage and to prevent complications such as air leaks or infections. Option A is incorrect because keeping the chest tube clamped at all times would prevent proper drainage and could lead to complications. Option C is incorrect as emptying the chest tube drainage system should be done based on assessment findings rather than a fixed time interval. Option D is incorrect because disconnecting the chest tube when the patient is ambulating can lead to complications like a pneumothorax.

2. A healthcare professional is preparing to insert an indwelling urinary catheter. What is the most important action to prevent infection?

• A. Use sterile gloves during the procedure.
• B. Clean the catheter insertion site with alcohol.
• C. Insert the catheter as quickly as possible.
• D. Use a smaller catheter size to minimize trauma.

Correct answer: A

Rationale: Using sterile gloves during catheter insertion is crucial to prevent infection. Sterile gloves help maintain asepsis during the procedure, reducing the risk of introducing microorganisms into the urinary tract. Cleaning the insertion site with alcohol, as mentioned in choice B, is important but not as critical as using sterile gloves. Choice C, inserting the catheter as quickly as possible, is not recommended as it can lead to errors and increase the risk of contamination. Choice D, using a smaller catheter size to minimize trauma, is not directly related to preventing infection but rather focuses on patient comfort and reducing tissue damage.

3. A nurse is preparing medications for a client via nasogastric tube. What should the nurse do before administering the medications?

• A. Flush the tube with water and administer all medications at once
• B. Administer medications one after the other without flushing
• C. Crush all medications and mix them together for administration
• D. Administer medications in liquid form only

Correct answer: B

Rationale: Before administering medications through a nasogastric tube, the nurse should administer them one after the other without flushing. Flushing the tube with water should be done before and after each medication to prevent any interactions and ensure each medication is delivered effectively. The correct answer is not to administer all medications at once (choice A) as this can lead to potential drug interactions. Crushing all medications and mixing them together (choice C) is incorrect as each medication should be given separately to maintain their individual efficacy. Administering medications in liquid form only (choice D) is limiting and may not be suitable for all types of medications that need to be administered.

4. After a case manager completes a history and physical assessment for a client with COPD, which of the following actions should the case manager take next?

• A. Call the provider with a list of client concerns.
• B. Identify the client's current health needs.
• C. Compile a list of community resources for the client.
• D. Refer the client to a COPD support group.

Correct answer: A

Rationale: After completing a history and physical assessment for a client with COPD, the next step for the case manager should be to call the provider with a list of client concerns. This is crucial as the provider needs to be informed about any issues or changes in the client's health status to ensure appropriate management. Identifying the client's current health needs, as mentioned in option B, is important but would typically follow after communicating the client's concerns to the provider. Compiling a list of community resources (option C) and referring the client to a COPD support group (option D) are also valuable actions but are not the immediate next steps after completing the assessment.

5. What should be done to manage a patient with contact precautions?

• A. Wear a mask, gown, and gloves for all patient interactions.
• B. Ensure that visitors wear protective equipment.
• C. Dedicate all patient care equipment to that patient.
• D. Disinfect shared equipment before use.

Correct answer: C

Rationale: When managing a patient with contact precautions, it is essential to dedicate all patient care equipment to that specific patient. This practice helps minimize the risk of spreading infections to other patients. Choice A, wearing protective gear for all patient interactions, is a general precaution but not specific to managing a patient with contact precautions. Choice B, ensuring visitors wear protective equipment, is important for infection control but not directly related to managing the patient with contact precautions. Choice D, disinfecting shared equipment before use, is a good practice for infection control in general but does not address the specific needs of a patient under contact precautions.

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