Nursing Elites

1. When caring for a patient with a nasogastric (NG) tube, what is the most appropriate intervention to prevent aspiration?

• A. Flush the NG tube with water before each feeding.
• B. Check the placement of the NG tube before each feeding.
• C. Elevate the head of the bed to 30-45 degrees.
• D. Provide the patient with oral care every 4 hours.

Correct answer: C

Rationale: Elevating the head of the bed to 30-45 degrees is the most appropriate intervention to prevent aspiration in a patient with an NG tube. This position helps reduce the risk of regurgitation and aspiration by promoting the proper flow of contents through the gastrointestinal tract and minimizing the chances of stomach contents entering the airway. Flushing the NG tube with water before each feeding may not directly prevent aspiration. Checking the placement of the NG tube is important but does not specifically address the prevention of aspiration. Providing oral care every 4 hours is essential for maintaining oral hygiene but is not directly related to preventing aspiration in a patient with an NG tube.

2. A healthcare provider notices a discrepancy in the narcotics log. What is the appropriate response?

• A. Correct the narcotics log and move on.
• B. Report the discrepancy to the supervisor.
• C. Confront the provider responsible for the discrepancy.
• D. Dispose of the medication and ignore the discrepancy.

Correct answer: B

Rationale: When a healthcare provider notices a discrepancy in the narcotics log, the appropriate response is to report the issue to the supervisor. Reporting discrepancies is crucial to maintain accountability and prevent potential misuse. Choice A is incorrect because simply correcting the log without addressing the underlying issue does not ensure accountability. Choice C is inappropriate as confronting the provider directly may not be the best approach and could lead to a confrontational situation. Choice D is highly inappropriate as ignoring the discrepancy and disposing of medication without proper documentation can lead to serious consequences.

3. A client with hypertension is receiving teaching from a healthcare provider. Which statement demonstrates comprehension of the instruction?

• A. I will limit my daily salt intake to 3g
• B. I will discontinue my medication when I start feeling better
• C. I will adhere to a consistent daily medication schedule
• D. I will engage in 60 minutes of exercise every day

Correct answer: C

Rationale: Choice C is the correct answer because taking hypertension medication at the same time each day ensures its effectiveness in managing blood pressure. Consistency in medication intake is crucial to control hypertension. Option A focuses on dietary management, which is essential but not directly related to medication adherence. Option B is incorrect as stopping hypertension medication abruptly can lead to complications. Option D addresses the importance of exercise, which is beneficial for hypertension but not directly related to medication adherence.

4. A healthcare provider is assessing a client who has been using beclomethasone for 2 weeks to manage her asthma. What is the priority to report to the provider?

• A. Sore throat
• B. Cough
• C. Chest tightness
• D. Bronchospasms

Correct answer: D

Rationale: The correct answer is D: Bronchospasms. Bronchospasms can indicate worsening asthma and are considered a severe side effect that requires immediate attention. While sore throat, cough, and chest tightness are also possible side effects of beclomethasone, bronchospasms are of higher concern due to their association with significant respiratory distress and potential exacerbation of asthma symptoms.

5. A nurse is caring for a client who had a total thyroidectomy and has a serum calcium level of 7.6 mg/dL. Which of the following findings should the nurse expect?

• A. Shortened QT intervals
• B. Hypoactive deep tendon reflexes
• C. Tingling of the extremities
• D. Constipation

Correct answer: C

Rationale: The correct answer is C: Tingling of the extremities. Tingling is a common symptom of hypocalcemia, which is expected with low calcium levels after a thyroidectomy. Option A, shortened QT intervals, is associated with hypercalcemia rather than hypocalcemia. Option B, hypoactive deep tendon reflexes, is not typically related to hypocalcemia. Option D, constipation, is not a common finding associated with low calcium levels.

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