Nursing Elites

1. A nurse is caring for a client following an appendectomy. The nurse verifies the postoperative prescription which reads, 'Discontinue NPO status; advance diet as tolerated.' Which of the following are appropriate for the nurse to offer the client? (SATA)

• A. Wheat toast
• B. Applesauce
• C. Applesauce, Chicken broth
• D. Chicken broth

Correct answer: C

Rationale: The correct answer is C: Applesauce and chicken broth. After an appendectomy, patients are typically started on a clear liquid diet before advancing to more solid foods. Applesauce and chicken broth are part of a low-residue diet that is easily digestible and gentle on the digestive system, making them suitable choices for a client following surgery. Wheat toast may be too heavy and fibrous initially, while other solid foods should be introduced gradually to prevent gastrointestinal upset.

2. In a patient with chronic kidney disease, which dietary modification is recommended?

• A. Increase protein intake
• B. Reduce potassium intake
• C. Increase sodium intake
• D. Reduce fiber intake

Correct answer: B

Rationale: Reducing potassium intake is important for patients with chronic kidney disease to prevent hyperkalemia.

3. _____ neutralizes stomach acid in the small intestine:

• A. saliva
• B. gastric mucus
• C. bicarbonate ions
• D. enzymes

Correct answer: C

Rationale: The correct answer is C: bicarbonate ions. Bicarbonate ions, secreted by the pancreas, neutralize the acidic chyme entering the small intestine from the stomach, creating a more suitable environment for digestive enzymes. Saliva (choice A) helps in the initial breakdown of food in the mouth, not in neutralizing stomach acid. Gastric mucus (choice B) protects the stomach lining from the acidic environment but does not neutralize the acid in the small intestine. Enzymes (choice D) facilitate chemical reactions in digestion but do not neutralize stomach acid.

4. A nurse is teaching a group of adults about nutrition. The nurse should include which of the following amounts as an appropriate daily intake of fiber for adult women?

• A. 5 to 10 g
• B. 10 to 15 g
• C. 20 to 35 g
• D. 40 to 50 g

Correct answer: C

Rationale: The correct answer is 20 to 35 g. This range is the recommended daily intake of fiber for adult women. Fiber is essential for maintaining a healthy digestive system and overall well-being. Option A (5 to 10 g) is too low and may not provide sufficient fiber intake. Option B (10 to 15 g) is also below the recommended range. Option D (40 to 50 g) is too high and can lead to gastrointestinal discomfort and other complications if consumed in excess.

5. A nurse is preparing to administer a gavage feeding via a nasogastric tube to a preterm newborn who is receiving supplemental oxygen. Which of the following actions should the nurse take?

• A. Stabilize the tube with tape to the newborn’s cheek.
• B. Remove supplemental oxygen during the feeding.
• C. Measure the stomach aspirate prior to the feeding.
• D. Place the newborn on their left side for 30 minutes after the feeding.

Correct answer: C

Rationale: Measuring the stomach aspirate prior to the feeding is crucial to ensure the correct placement and function of the nasogastric tube. This step helps prevent complications such as aspiration or improper feeding. Choice A is incorrect as stabilizing the tube with tape to the newborn’s cheek can cause discomfort and skin irritation. Choice B is incorrect because removing supplemental oxygen during the feeding may compromise the newborn's respiratory status. Choice D is incorrect because placing the newborn on their left side for 30 minutes after the feeding is not a standard practice and is unnecessary for administering gavage feeding.

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