Nursing Elites

1. A nurse is providing dietary teaching to a client who has a new diagnosis of celiac disease. Which of the following foods should the nurse instruct the client to avoid?

• A. Rice
• B. Barley soup
• C. Cornbread
• D. Potatoes

Correct answer: B

Rationale: The correct answer is B: Barley soup. Barley contains gluten, which is harmful to individuals with celiac disease. Therefore, the nurse should instruct the client to avoid barley-containing foods like barley soup. Choices A, C, and D are safe options for individuals with celiac disease as they do not contain gluten. Rice, cornbread, and potatoes are gluten-free and can be included in the client's diet.

2. Which lab value should be monitored in a patient on digoxin?

• A. Monitor potassium levels
• B. Monitor calcium levels
• C. Monitor digoxin levels
• D. Monitor sodium levels

Correct answer: C

Rationale: The correct answer is to monitor digoxin levels in a patient on digoxin. Digoxin is a medication commonly used to treat heart conditions, and monitoring its levels in the blood is crucial to ensure that the patient is within the therapeutic range and to prevent toxicity. Monitoring potassium levels (Choice A) is important due to the potential of digoxin-induced hypokalemia, but the primary focus should be on monitoring digoxin levels. Monitoring calcium levels (Choice B) and sodium levels (Choice D) are not directly related to digoxin therapy and are not the primary lab values of concern when administering digoxin.

3. A nurse is providing teaching to a client who has a new prescription for digoxin. Which of the following instructions should the nurse include?

• A. Avoid taking this medication with antacids.
• B. Contact your provider if you experience visual changes.
• C. Increase your intake of foods high in potassium.
• D. You may experience increased urination while taking this medication.

Correct answer: B

Rationale: The correct answer is B: 'Contact your provider if you experience visual changes.' Visual changes, such as blurred or yellow vision, can indicate digoxin toxicity and should be reported immediately to the healthcare provider for further evaluation and management. Choice A is incorrect because digoxin can be taken with antacids. Choice C is incorrect because increasing potassium intake can lead to hyperkalemia when taking digoxin. Choice D is incorrect because increased urination is not a common side effect of digoxin.

4. A nurse is caring for a client who is receiving continuous enteral nutrition through a nasogastric tube. Which of the following actions should the nurse take?

• A. Administer the feeding using a large-bore syringe
• B. Check the placement of the tube every 8 hours
• C. Flush the tube with 5 mL of water every 6 hours
• D. Maintain the client in an upright position

Correct answer: B

Rationale: The correct action for the nurse to take is to check the placement of the nasogastric tube every 8 hours. This is crucial to ensure that the tube is correctly positioned in the stomach, reducing the risk of complications such as aspiration. Administering the feeding using a large-bore syringe (Choice A) is not recommended for enteral nutrition. Flushing the tube with water every 6 hours (Choice C) is not necessary for continuous enteral nutrition. Maintaining the client in an upright position (Choice D) is generally preferred to reduce the risk of aspiration, but it is not the most critical action compared to verifying tube placement.

5. How should pain be assessed in a non-verbal patient?

• A. Observe facial expressions
• B. Use the Wong-Baker faces scale
• C. Assess heart rate
• D. Ask the patient to rate their pain

Correct answer: A

Rationale: Observing facial expressions is essential in assessing pain levels in non-verbal patients. Non-verbal cues, such as facial grimacing, furrowed brows, or clenched jaws, can provide valuable information about the patient's pain experience. Using the Wong-Baker faces scale or assessing heart rate may not be as effective in non-verbal patients as they are unable to communicate their pain through these methods. Asking the patient to rate their pain is also not suitable for non-verbal patients as they may not have the ability to verbally communicate their pain levels.

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