Nursing Elites

1. A nurse is caring for a client who is receiving enteral nutrition via a nasogastric tube. Which of the following actions should the nurse take to reduce the risk of aspiration?

• A. Position the client supine during feedings.
• B. Administer the feedings over 10 minutes.
• C. Elevate the head of the bed during feedings.
• D. Place the client in a lateral position after feedings.

Correct answer: C

Rationale: The correct action to reduce the risk of aspiration in clients receiving enteral feedings is to elevate the head of the bed during feedings. This position helps prevent regurgitation and aspiration of the feeding. Positioning the client supine (Choice A) increases the risk of aspiration as it promotes reflux. Administering feedings over 10 minutes (Choice B) does not directly reduce the risk of aspiration. Placing the client in a lateral position after feedings (Choice D) does not address the risk of aspiration during the feeding process.

2. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following laboratory values indicates the TPN is effective?

• A. Albumin 3.5 g/dL
• B. Hemoglobin 8 g/dL
• C. WBC count 15,000/mm3
• D. Blood glucose 110 mg/dL

Correct answer: D

Rationale: The correct answer is D. A blood glucose level of 110 mg/dL indicates that the TPN is effective in maintaining normal glucose levels. Hemoglobin level (choice B) is related to anemia and not directly indicative of TPN effectiveness. Albumin level (choice A) is a marker of nutritional status over a longer term and may not reflect immediate TPN effectiveness. White blood cell count (choice C) is related to infection or inflammation and is not a direct indicator of TPN effectiveness.

3. A nurse is providing discharge teaching to a client who has a new diagnosis of diabetes mellitus. Which of the following client statements indicates a need for further teaching?

• A. I will check my blood glucose level once a week.
• B. I will eat a snack if my blood glucose level is above 200 mg/dL.
• C. I will take my insulin as prescribed, even when I am feeling well.
• D. I will avoid physical activity if my blood glucose level is below 100 mg/dL.

Correct answer: B

Rationale: The correct answer is B. Clients should eat a snack when their blood glucose level is low, typically below 70-100 mg/dL, not when it is high. Eating a snack when the blood glucose level is above 200 mg/dL can exacerbate hyperglycemia. Choice A is correct as checking blood glucose levels regularly is important in managing diabetes. Choice C is also correct as adherence to prescribed insulin therapy is crucial. Choice D is incorrect as physical activity can help lower blood glucose levels, especially when they are above the target range.

4. A client with heart failure is prescribed furosemide. What finding should the nurse report to the provider?

• A. Sodium 140 mEq/L
• B. Heart rate of 82/min
• C. Potassium level of 2.8 mEq/L
• D. Oxygen saturation 95%

Correct answer: C

Rationale: The correct answer is C. A potassium level of 2.8 mEq/L is low and should be reported to the provider. Furosemide can cause potassium depletion, leading to hypokalemia. Low potassium levels can result in cardiac dysrhythmias, which is a serious concern in clients with heart failure. Choices A, B, and D are within normal ranges and do not require immediate reporting. Sodium level of 140 mEq/L, heart rate of 82/min, and oxygen saturation of 95% are all acceptable findings.

5. A nurse is caring for a client who has acute pancreatitis. Which of the following laboratory results should the nurse expect to be elevated?

• A. Serum creatinine.
• B. Amylase.
• C. Hemoglobin.
• D. Blood glucose.

Correct answer: B

Rationale: The correct answer is B: Amylase. Amylase is typically elevated in clients with acute pancreatitis due to inflammation of the pancreas. Elevated serum creatinine levels are more indicative of kidney dysfunction rather than pancreatitis. Hemoglobin levels are not directly related to pancreatitis. While blood glucose levels can be affected by pancreatitis, they are not typically the primary laboratory result expected to be elevated in this condition.

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