Nursing Elites

1. The nurse teaches the mother of an infant how to care for her infant following repair of a cleft lip. It is MOST important for the nurse to include which of the following instructions?

• A. Feed the infant with a newborn nipple while holding him in the recumbent position
• B. Clean the suture site with a cotton-tipped swab soaked in Betadine
• C. Place the infant in the prone position after feeding
• D. Feed the infant with a rubber-tipped syringe and burp frequently

Correct answer: D

Rationale: The correct answer is D because feeding the infant with a rubber-tipped syringe reduces the risk of injury to the surgical site and prevents aspiration. Choice A is incorrect because feeding an infant with a cleft lip using a newborn nipple while in the recumbent position can increase the risk of aspiration. Choice B is incorrect as Betadine is not typically used on suture sites due to its cytotoxic effects. Choice C is incorrect because placing the infant in the prone position after feeding can also increase the risk of aspiration.

2. A patient with a history of peptic ulcer disease should avoid which medication?

• A. Acetaminophen
• B. Antacids
• C. Nonsteroidal anti-inflammatory drugs
• D. Antihistamines

Correct answer: C

Rationale: Patients with a history of peptic ulcer disease should avoid nonsteroidal anti-inflammatory drugs (NSAIDs) because they can worsen peptic ulcers. NSAIDs inhibit the production of prostaglandins, which help protect the stomach lining. Acetaminophen (Choice A) is a safer alternative for pain relief in patients with peptic ulcers. Antacids (Choice B) can actually help in symptom relief by neutralizing stomach acid. Antihistamines (Choice D) are not known to worsen peptic ulcers and are generally safe for use in patients with this condition.

3. What is a good source of potassium and can be related to increased excretion?

• A. Potassium
• B. Increased excretion
• C. Broccoli
• D. None of the above

Correct answer: C

Rationale: Broccoli is a good source of potassium and can contribute to increased excretion. While potassium itself is a mineral and increased excretion can be related to dietary intake, the specific relationship mentioned in the text is about broccoli being a good source of potassium and having a potential impact on excretion.

4. The nurse on the postsurgical unit received a client that was transferred from the post-anesthesia care unit (PACU) and is planning care for this client. The nurse understands that staff should begin planning for this client’s discharge at which point during the hospitalization?

• A. Is admitted to the surgical unit
• B. Is transferred from the PACU to the postsurgical unit
• C. Is able to perform activities of daily living independently
• D. Has been assessed by the healthcare provider for the first time after surgery

Correct answer: A

Rationale: Discharge planning should begin as soon as the patient is admitted to the surgical unit to ensure a smooth transition. Option A is the correct choice because it marks the initial point in the hospitalization process where discharge planning should start. Options B, C, and D are not the ideal points to begin discharge planning. Option B only signifies a transfer within the hospital, while Option C relates to the patient's independence in activities of daily living, which is not directly linked to discharge planning. Option D, having the patient assessed by the healthcare provider for the first time after surgery, is unrelated to the timing of discharge planning.

5. The nurse is caring for the client recovering from intestinal surgery. Which assessment finding would require immediate intervention?

• A. Presence of thin pink drainage in the Jackson Pratt
• B. Guarding when the nurse touches the abdomen
• C. Tenderness around the surgical site during palpation
• D. Complaints of chills and feeling feverish

Correct answer: D

Rationale: Complaints of chills and feeling feverish may indicate infection, which requires immediate intervention. This finding suggests a systemic response to infection, which can be life-threatening if not promptly addressed. Options A, B, and C are common postoperative findings and may not necessarily require immediate intervention unless accompanied by other concerning signs or symptoms.

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