Nursing Elites

1. A nurse is caring for four clients. The nurse should plan to administer total parenteral nutrition for which of the following clients?

• A. A client who is postoperative following a laminectomy and is receiving IV PCA
• B. A client who has dysphagia and does not recognize his family
• C. A client who has COPD and is going home with oxygen
• D. A client who has colon cancer and will undergo a hemicolectomy

Correct answer: D

Rationale: Total parenteral nutrition (TPN) is essential for clients undergoing significant surgical procedures like a hemicolectomy to ensure they receive adequate nutrition when oral intake is not possible.

2. A nurse is caring for a client who follows the dietary laws of Orthodox Judaism. Which of the following meal choices should the nurse request for the client?

• A. Turkey and cheese sandwich
• B. Spaghetti with tomato sauce
• C. Pork chop and applesauce
• D. Scrambled eggs and bacon

Correct answer: B

Rationale: Spaghetti with tomato sauce adheres to the kosher dietary laws followed by Orthodox Jews, which prohibit mixing meat and dairy and consuming pork.

3. A nurse is reviewing the laboratory findings of a client who has heart failure. Which of the following findings indicates that the client is experiencing fluid volume excess?

• A. BUN 8 mg/dL
• B. Hgb 15 g/dL
• C. Creatinine 0.8 mg/dL
• D. Sodium 140 mEq/L

Correct answer: A

Rationale: A BUN level of 8 mg/dL is indicative of fluid volume excess, which is common in clients with heart failure.

4. A nurse is initiating continuous enteral feedings for a client who has a new gastrostomy tube. Which of the following actions should the nurse take?

• A. Measure the client’s gastric residual every 12 hr.
• B. Obtain the client’s electrolyte levels every 4 hr.
• C. Keep the client’s head elevated at 15* during feedings.
• D. Flush the client’s tube with 30 mL of water every 4 hr.

Correct answer: D

Rationale: Flushing the client's tube with 30 mL of water every 4 hours helps maintain tube patency and prevent blockages.

5. A nurse is preparing to administer a gavage feeding via 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 forehead.
• B. Remove supplemental oxygen during the feeding.
• C. Measure the stomach aspirate prior to the feeding.
• D. Place the newborn on her left side for 30 min after the feeding.

Correct answer: C

Rationale: Measuring the stomach aspirate prior to the feeding is essential to ensure proper placement and function of the NG tube.

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