Nursing Elites

1. A healthcare provider is planning care for a client who is receiving total parenteral nutrition (TPN). Which of the following actions should the healthcare provider include?

• A. Administer 0.9% sodium chloride with the TPN.
• B. Change the TPN tubing every 24 hours.
• C. Weigh the client every 72 hours.
• D. Flush the TPN line with heparin.

Correct answer: B

Rationale: The correct action the healthcare provider should include is changing the TPN tubing every 24 hours to decrease the risk of infection. Administering 0.9% sodium chloride with TPN is not typically recommended as it can cause chemical instability. Weighing the client every 72 hours is important but not directly related to TPN administration. Flushing the TPN line with heparin is not a standard practice and not recommended as it can increase the risk of complications.

2. A client is receiving radiation therapy to the head and neck. Which of the following interventions should the nurse include?

• A. Instruct the client to use an alcohol-free mouthwash.
• B. Apply heat packs to the radiation site.
• C. Provide a diet low in carbohydrates.
• D. Avoid exposure to direct sunlight during treatment.

Correct answer: D

Rationale: The correct intervention for a client receiving radiation therapy to the head and neck is to avoid exposure to direct sunlight. Direct sunlight should be avoided to protect the skin from further irritation and damage caused by the radiation therapy. Instructing the client to use an alcohol-free mouthwash is important to prevent irritation and maintain oral hygiene, making choice A incorrect. Applying heat packs to the radiation site is contraindicated as heat can further aggravate the skin, making choice B incorrect. Providing a diet low in carbohydrates is not directly related to radiation therapy to the head and neck, so choice C is also incorrect.

3. A nurse is teaching at a community health fair about electrical fire prevention. Which of the following information should the nurse include in the teaching?

• A. Use three-pronged grounded plugs
• B. Cover extension cords with a rug
• C. Check for tingling sensations around the cord to ensure the electricity is working
• D. Remove the plug from the socket by pulling the cord

Correct answer: A

Rationale: The correct answer is A: 'Use three-pronged grounded plugs.' This is important in preventing electrical fires as it provides a grounded connection, reducing the risk of electrical malfunctions. Choice B is incorrect because covering extension cords with a rug can lead to overheating and increase the risk of fire. Choice C is also incorrect as tingling sensations around a cord indicate an electrical hazard, not proper functioning. Choice D is incorrect as pulling the cord to remove a plug can damage the cord, leading to potential electrical dangers.

4. How should a healthcare professional assess for infection in a patient post-surgery?

• A. Check the surgical site
• B. Check for fever
• C. Check for abnormal breath sounds
• D. Check the patient's skin color

Correct answer: A

Rationale: When assessing for infection in a patient post-surgery, checking the surgical site is crucial. Changes in the appearance of the surgical site, such as redness, swelling, warmth, or drainage, can indicate an infection. While checking for fever (Choice B) is also important as it can be a sign of infection, it is a more general symptom and may not always be present. Checking for abnormal breath sounds (Choice C) and skin color (Choice D) are not typically direct indicators of infection in a post-surgery patient.

5. A client has a nasogastric tube and is receiving intermittent enteral feedings. Which of the following actions should the nurse take to prevent aspiration?

• A. Administer a bolus feeding over 10 minutes.
• B. Elevate the head of the bed to 45 degrees during feedings.
• C. Flush the tube with 10 mL of sterile water before feedings.
• D. Position the client on the left side during feedings.

Correct answer: B

Rationale: To prevent aspiration in clients with a nasogastric tube receiving intermittent enteral feedings, the nurse should elevate the head of the bed to 45 degrees during feedings. This position helps reduce the risk of regurgitation and aspiration of the feeding contents. Administering a bolus feeding over 10 minutes (choice A) may not prevent aspiration as effectively as elevating the head of the bed. Flushing the tube with sterile water before feedings (choice C) is important for tube patency but does not directly prevent aspiration. Positioning the client on the left side during feedings (choice D) is not the recommended action to prevent aspiration; elevating the head of the bed is more effective.

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