Nursing Elites

1. A client has a nasogastric tube for gastric decompression. Which of the following actions should the nurse take?

• A. Check for the presence of bowel sounds every 8 hours.
• B. Flush the NG tube every 24 hours.
• C. Provide the client with sips of water every 2 hours.
• D. Keep the client's head of the bed elevated to 45 degrees.

Correct answer: D

Rationale: The correct answer is to keep the client's head of the bed elevated to 45 degrees. This position helps prevent aspiration in clients with a nasogastric tube for gastric decompression by reducing the risk of reflux and promoting proper drainage. Choice A is incorrect because checking for bowel sounds is not directly related to the care of a nasogastric tube. Choice B is incorrect as flushing the NG tube every 24 hours is not a standard nursing practice and may lead to complications. Choice C is incorrect because providing sips of water may interfere with the purpose of gastric decompression, which is to keep the stomach empty.

2. A client at 10 weeks of gestation reports frequent nausea and vomiting. Which of the following instructions should the nurse include?

• A. Eat high-protein foods.
• B. Lie down after meals.
• C. Drink water with meals.
• D. Eat dry carbohydrates before getting out of bed.

Correct answer: D

Rationale: During early pregnancy, nausea and vomiting are common. Instructing the client to eat dry carbohydrates like crackers before getting out of bed can help alleviate these symptoms. This recommendation helps prevent an empty stomach, which can worsen nausea. High-protein foods (Choice A) may be harder to digest and could exacerbate nausea. Lying down after meals (Choice B) may increase gastric reflux and worsen symptoms. Drinking water with meals (Choice C) may make the client feel fuller, potentially worsening nausea.

3. A client reports that the medication appears different than what they take at home. Which of the following responses should the nurse take?

• A. Did the healthcare provider discuss with you that there was a change in this medication?
• B. I recommend that you take this medication as prescribed.
• C. Do you know why this medication is being prescribed to you?
• D. I will call the pharmacist now to check on this medication.

Correct answer: D

Rationale: Contacting the pharmacist is the most appropriate action to ensure the correct medication is being administered. This response addresses the client's concern directly and prioritizes patient safety. The other options do not directly address the issue of the medication discrepancy. Option A focuses on the healthcare provider's discussion, not the medication itself. Option B assumes that the current medication is correct without verification. Option C addresses the reason for the prescription but does not verify the medication's correctness.

4. A client with preeclampsia and postpartum hemorrhage is being cared for by a nurse. The nurse should recognize that which of the following medications is contraindicated?

• A. Methylergonovine
• B. Misoprostol
• C. Dinoprostone
• D. Oxytocin

Correct answer: A

Rationale: The correct answer is A, Methylergonovine. Methylergonovine is contraindicated in clients with preeclampsia due to the risk of hypertension. Misoprostol (choice B), Dinoprostone (choice C), and Oxytocin (choice D) are appropriate medications for managing postpartum hemorrhage and are not contraindicated in clients with preeclampsia.

5. A nurse is providing dietary teaching to a client with irritable bowel syndrome (IBS). What recommendation should be included?

• A. Consume foods high in bran fiber.
• B. Increase intake of milk products.
• C. Sweeten foods with fructose corn syrup.
• D. Increase intake of foods high in gluten.

Correct answer: A

Rationale: The correct answer is A: Consume foods high in bran fiber. Bran fiber is recommended for clients with IBS as it promotes regularity and helps reduce symptoms. Choices B, C, and D are incorrect. Increasing milk products may exacerbate symptoms in some individuals with IBS due to lactose intolerance. Sweetening foods with fructose corn syrup can worsen symptoms as it is a type of sugar that can lead to gastrointestinal discomfort. Increasing intake of foods high in gluten is not recommended for individuals with IBS, especially those with gluten sensitivity, as it may trigger or worsen symptoms.

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