Nursing Elites

1. A nurse is preparing to administer medications to a client who is NPO and is receiving enteral feedings through an NG tube. Which of the following prescriptions should the nurse clarify with the provider?

• A. Metoprolol ER 50 mg via NG tube BID
• B. Acetaminophen 650 mg PO BID
• C. Lisinopril 10 mg PO daily
• D. Ondansetron 4 mg IV push PRN

Correct answer: B

Rationale: The nurse should clarify prescription B, Acetaminophen 650 mg PO BID, with the provider. When a patient is NPO and receiving enteral feedings through an NG tube, medications administered orally may be contraindicated due to the risk of aspiration. Therefore, Acetaminophen should be confirmed for safety in this situation. The other options (Metoprolol ER 50 mg via NG tube BID, Lisinopril 10 mg PO daily, Ondansetron 4 mg IV push PRN) are appropriate and do not need clarification in this scenario.

2. A client who has undergone vein ligation and stripping to treat varicose veins should be instructed to do which of the following activities during discharge teaching?

• A. Remain sedentary for 2-3 days
• B. Walk for 1-2 hours each day
• C. Wear compression stockings only at night
• D. Elevate legs while sitting

Correct answer: B

Rationale: The correct answer is B: 'Walk for 1-2 hours each day.' After vein ligation and stripping, walking helps promote circulation and aids in the recovery process. Option A is incorrect as remaining sedentary for 2-3 days can lead to decreased circulation and potentially increase the risk of complications. Option C is incorrect because compression stockings should typically be worn during the day to support circulation. Option D is incorrect as elevating the legs while sitting is beneficial, but walking is more effective in promoting circulation and recovery in this case.

3. A nurse is teaching a client who has ulcerative colitis about dietary recommendations. Which of the following instructions should the nurse include?

• A. Avoid high-fiber foods
• B. Increase intake of spicy foods
• C. Consume foods high in fiber
• D. Eat large, infrequent meals

Correct answer: C

Rationale: The correct answer is C: 'Consume foods high in fiber.' Consuming high-fiber foods helps manage symptoms of ulcerative colitis by promoting regular bowel movements. Choices A, B, and D are incorrect. Avoiding high-fiber foods can worsen symptoms as fiber is beneficial for digestive health. Increasing the intake of spicy foods can exacerbate inflammation in the digestive tract, leading to more discomfort. Eating large, infrequent meals can put more strain on the digestive system, which is not ideal for managing ulcerative colitis.

4. What are the key steps in administering oral medications to a patient with dysphagia?

• A. Crush medications and mix with food
• B. Use a straw to facilitate swallowing
• C. Encourage the patient to drink thickened liquids
• D. Have the patient lie flat during administration

Correct answer: A

Rationale: The correct answer is A: Crush medications and mix with food. When administering oral medications to a patient with dysphagia, crushing the medications and mixing them with food is a common method to aid in swallowing. Choice B is incorrect because using a straw could pose a choking hazard for patients with dysphagia. Choice C is incorrect as thickened liquids may not always be suitable for all medications. Choice D is incorrect because having the patient lie flat can increase the risk of aspiration, which is not recommended for patients with dysphagia.

5. A client diagnosed with dementia wanders the halls of the locked nursing unit during the day. To ensure the client's safety while walking in the halls, the nurse should do which of the following?

• A. Administer PRN haloperidol (Haldol) to decrease the need to walk
• B. Assess the client's gait for steadiness
• C. Restrain the client in a geriatric chair
• D. Administer PRN lorazepam (Ativan) to provide sedation

Correct answer: B

Rationale: Assessing the client's gait for steadiness is the most appropriate action to ensure the safety of a client with dementia while walking. This allows the nurse to identify any issues that may increase the risk of falls or accidents. Administering PRN haloperidol or lorazepam is not indicated as the first-line approach in managing wandering behavior and can have adverse effects like increased risk of falls, confusion, or oversedation. Restraint use should be avoided whenever possible, as it can lead to physical and psychological harm to the client.

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