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 nurse is teaching a client about how to use her new hearing aids. Which of the following statements should the nurse identify as an indication that the client needs further instruction?

• A. I will not use hairspray if I am wearing the hearing aids
• B. I will clean the hearing aids with alcohol wipes
• C. I will change the batteries once a week
• D. I will expect the hearing aids to whistle when I cup my hand over them

Correct answer: B

Rationale: The correct answer is B because cleaning the hearing aids with alcohol wipes can damage them. It is important to use specialized cleaning tools or follow specific cleaning instructions provided by the manufacturer to prevent harm to the hearing aids. Choices A, C, and D demonstrate good understanding and appropriate care for hearing aids, indicating that the client does not need further instruction in those areas.

3. A patient has a DNR (do-not-resuscitate) order but their family insists on resuscitation if necessary. What should the nurse do?

• A. Follow the family's wishes to resuscitate.
• B. Explain that the nurse must follow the DNR order.
• C. Ask the provider for clarification on the DNR.
• D. Call the ethics committee to discuss the situation.

Correct answer: B

Rationale: The correct answer is B. The nurse must follow the legal DNR order, even if the family insists on resuscitation. Respecting the patient's wishes is crucial in providing ethical care. Choice A is incorrect because the nurse should prioritize the patient's documented wishes over the family's requests. Choice C may cause unnecessary delays in care as the DNR order is a legal document. Choice D is not the initial action to take in this situation; the nurse should first address the conflict between the family's wishes and the patient's DNR order.

4. What is the definition of malpractice in the context of professional negligence?

• A. Failure to follow personal standards of care
• B. Failure to act in a reasonable and prudent manner by a professional
• C. Harm caused by a healthcare team due to miscommunication
• D. Failure to document patient care properly

Correct answer: B

Rationale: The correct definition of malpractice in the context of professional negligence is the failure to act in a reasonable and prudent manner by a professional. This choice is correct because malpractice occurs when a professional does not meet the standard of care expected in their field, leading to harm or injury to the client. Choices A, C, and D are incorrect because malpractice is specifically about the failure to meet professional standards of care, rather than personal standards, miscommunication within a healthcare team, or inadequate documentation of patient care.

5. A client had a left hip arthroplasty. Which of the following interventions should the nurse use to prevent dislocation?

• A. Maintain foam wedge between legs
• B. Monitor for shortening of the affected leg
• C. Encourage use of elastic stockings
• D. Avoid flexing the hips more than 60 degrees

Correct answer: A

Rationale: The correct answer is to maintain a foam wedge between the legs. This intervention helps prevent hip dislocation by maintaining proper leg alignment after surgery. Monitoring for shortening of the affected leg (choice B) is not directly related to preventing dislocation. Encouraging the use of elastic stockings (choice C) is more related to preventing deep vein thrombosis rather than dislocation. Avoiding flexing the hips more than 60 degrees (choice D) is important post-surgery, but it is not the most direct intervention to prevent dislocation.

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