Nursing Elites

1. When reviewing the health history of an older adult with a hip fracture, what should a nurse identify as a risk factor for developing pressure injuries?

• A. Malnutrition
• B. Poor hygiene
• C. Urinary incontinence
• D. Immobility

Correct answer: C

Rationale: Urinary incontinence is a risk factor for skin breakdown, which can lead to the development of pressure injuries. While malnutrition, poor hygiene, and immobility are important considerations in overall patient care, they are not specifically identified as significant risk factors for pressure injuries in this scenario.

2. A client with a new diagnosis of diabetes mellitus is being taught about foot care. What instruction should the nurse include?

• A. Apply lotion between the toes after bathing
• B. Wear shoes at all times
• C. Cut toenails in a rounded shape
• D. Inspect the feet weekly

Correct answer: B

Rationale: The correct answer is to wear shoes at all times. This instruction is vital for clients with diabetes mellitus as it helps protect the feet and reduces the risk of injury. Option A is incorrect as applying lotion between the toes can increase moisture and the risk of fungal infections. Option C is incorrect as cutting toenails in a rounded shape may lead to ingrown toenails. Option D is also incorrect as inspecting the feet weekly is not sufficient for proper foot care in clients with diabetes mellitus.

3. A nurse is planning to administer several medications to a client through a nasogastric (NG) tube. What action should the nurse take?

• A. Dissolve crushed tablet medications in tap water
• B. Administer all medications together
• C. Flush the NG tube with 60 mL of water before each medication
• D. Dissolve medications separately and flush with sterile water

Correct answer: D

Rationale: The correct action for the nurse to take when administering medications through a nasogastric (NG) tube is to dissolve medications separately and flush the tube with sterile water. This is important to prevent interactions between medications and ensure accurate administration. Option A is incorrect because tap water may not be sterile and could lead to contamination. Option B is incorrect as it increases the risk of drug interactions and may affect the effectiveness of each medication. Option C is incorrect as 60 mL of water before each medication may not be enough to ensure proper medication delivery and prevent interactions.

4. A client who has recently developed fever, confusion, and a decreased level of consciousness is being admitted by a nurse. What should the nurse do first after obtaining the client's history and assessment?

• A. Administer prescribed antibiotics
• B. Initiate seizure precautions
• C. Identify the client's needs
• D. Place the client in isolation

Correct answer: C

Rationale: The correct answer is to identify the client's needs first. This allows the nurse to prioritize interventions based on the assessment findings. Administering prescribed antibiotics (choice A) should be based on a medical prescription and the identified infection. Initiating seizure precautions (choice B) is important but not the immediate priority in this case. Placing the client in isolation (choice D) is premature as the nurse needs to first assess and address the client's condition.

5. A nurse is preparing to administer medications to a client through a nasogastric (NG) tube. Which action should the nurse take?

• A. Crush all the medications and mix them together in water
• B. Flush the NG tube with 10 mL of air before each medication
• C. Dissolve each medication separately and flush with water between medications
• D. Administer all medications at the same time

Correct answer: C

Rationale: The correct action for the nurse to take when administering medications through an NG tube is to dissolve each medication separately and flush with water between medications. This practice helps prevent interactions between medications and ensures that each medication is delivered effectively. Option A is incorrect as mixing all medications together can lead to chemical interactions or alter the effectiveness of the medications. Option B is incorrect because flushing the NG tube with air is not recommended and may cause harm. Option D is incorrect as administering all medications at the same time does not allow for proper absorption and interaction control.

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