Nursing Elites

1. 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.

2. A nurse is preparing to remove a client’s clogged NG tube prior to re-inserting a new tube. Which of the following actions should the nurse take first?

• A. Assist the client to blow her nose.
• B. Ask the client to take a deep breath and hold it.
• C. Pinch the proximal end of the tube.
• D. Disconnect the tube from suction source.

Correct answer: D

Rationale: Disconnecting the tube from the suction source is the first step in safely removing a clogged NG tube.

3. A nurse is teaching a group of clients who are at risk for heart disease about decreasing saturated fats in their diet. Which of the following fats should the nurse recommend the clients use when cooking?

• A. Palm oil
• B. Peanut oil
• C. Canola oil
• D. Stick margarine

Correct answer: C

Rationale: Canola oil is lower in saturated fats and is a healthier option for clients at risk for heart disease.

4. A nurse is caring for a client who is receiving a continuous enteral tube feeding and reports cramping and abdominal distention. Which of the following actions should the nurse take?

• A. Check for gastric residual.
• B. Apply low intermittent suction.
• C. Increase the rate of the feeding.
• D. Request a higher-fat formula.

Correct answer: A

Rationale: Checking for gastric residual can help identify the cause of cramping and abdominal distention during enteral feedings.

5. A nurse is planning care for a client who has ascites secondary to liver disease. Which of the following interventions should the nurse include in the plan of care?

• A. Reduce complex carbohydrates to 30% of total calories.
• B. Restrict protein intake to less than 0.8 g/kg/day.
• C. Decrease daily caloric intake by 20%.
• D. Limit sodium to 2000 mg or less per day.

Correct answer: D

Rationale: Limiting sodium to 2000 mg or less per day helps manage fluid retention associated with ascites in liver disease.

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