Nursing Elites

1. Your client has a doctor's order that reads 'advance diet as tolerated'. This client has returned from the recovery room after an appendectomy and he states, 'I am hungry'. What would you offer this client to consume?

• A. Cheese and crackers
• B. Apple sauce
• C. Chicken broth
• D. A peanut butter sandwich

Correct answer: C

Rationale: Chicken broth is a suitable option for a post-appendectomy patient beginning to tolerate oral intake. It is clear liquid and easily digestible, making it a gentle choice for someone who has just returned from surgery. Cheese and crackers, apple sauce, and a peanut butter sandwich are not ideal options for an individual who needs to start with a light and easily digestible diet.

2. The doctor has ordered 1,000 cc of intravenous fluid every 8 hours. You will be using intravenous tubing that delivers 20 cc/drop. At what rate will you adjust the intravenous fluid flow? _____ gtts per minute.

• A. 38 gtts/min
• B. 42 gtts/min
• C. 50 gtts/min
• D. 40 gtts/min

Correct answer: D

Rationale: To calculate the rate: 1000 cc/8 hours = 125 cc/hour. 125 cc/hour * 1 drop/20 cc * 1 hour/60 minutes = 40 gtts/min. Therefore, the correct answer is 40 gtts/min. Choice A (38 gtts/min) is incorrect as it doesn't match the calculation result. Choice B (42 gtts/min) is incorrect as it is not the calculated rate. Choice C (50 gtts/min) is incorrect as it is not the calculated rate either.

3. Serge, who has diabetes mellitus, is taking oral agents and is scheduled for a diagnostic test that requires him to be NPO. What is the best plan of action for the nurse regarding Serge's oral medications?

• A. Administer the oral agents immediately after the test.
• B. Notify the diagnostic department and request orders.
• C. Notify the physician and request orders.
• D. Administer the oral agents with a sip of water before the test.

Correct answer: C

Rationale: The best plan of action for the nurse is to notify the physician and request orders regarding Serge's oral medications. By involving the physician, the nurse ensures that appropriate instructions are obtained, considering Serge's medical condition and the need for NPO status for the diagnostic test. Administering the medications without medical guidance (choice A) can be risky, as it may affect the test results. Notifying the diagnostic department (choice B) is not the most direct and appropriate action; the physician is the primary healthcare provider responsible for medication orders. Administering the medications with water before the test (choice D) is not advisable when the patient is supposed to be NPO, as it can interfere with the test requirements.

4. A nurse manager is reviewing isolation guidelines with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates understanding of isolation guidelines?

• A. I will have a client who is on airborne precautions wear a mask when out of their room.
• B. I will wear an N95 respirator mask for a client who is on droplet precautions.
• C. I will place a client who has compromised immunity in a negative-pressure airflow room.
• D. I will instruct visitors to wear a mask when visiting a client who is on contact precautions.

Correct answer: A

Rationale: The correct answer is A. Having a client on airborne precautions wear a mask when out of their room is appropriate to prevent the spread of infection. Choice B is incorrect because the healthcare provider, not the client, wears an N95 respirator mask for a client on droplet precautions. Choice C is incorrect because negative-pressure airflow rooms are used for clients with airborne infections, not compromised immunity. Choice D is incorrect because visitors, not clients, should wear a mask when visiting a client on contact precautions.

5. Select the criteria that is accurately paired with its indication of birth weight or gestational age.

• A. Low birth weight: The neonate's weight is less than 1,500 g at the time of delivery.
• B. Appropriate for gestational age: The neonate's weight ranges from the 10th to the 90th percentile.
• C. Large for gestational age: The neonate's weight is above the 99th percentile.
• D. Small for gestational age: The neonate's weight is below the 20th percentile.

Correct answer: B

Rationale: Appropriate for gestational age (AGA) indicates a neonate's weight ranging from the 10th to the 90th percentile. This range signifies that the baby's weight is within the normal range for their gestational age. Choices A, C, and D provide inaccurate information about the criteria and do not correctly correspond to the indicated birth weight or gestational age. Low birth weight typically refers to a weight below 2,500 g, large for gestational age above the 90th percentile, and small for gestational age below the 10th percentile.

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