Nursing Elites

1. An infant has just returned from surgery for placement of a gastrostomy tube as an initial treatment for tracheoesophageal fistula. The mother asks, 'When can the tube be used for feeding?' The nurse's best response would be which of these comments?

• A. "Feedings can begin in 5 to 7 days."
• B. "The use of the feeding tube can begin immediately."
• C. "The stomach contents and air must be drained first."
• D. "The incision healing must be complete before feeding."

Correct answer: C

Rationale: The correct answer is C: 'The stomach contents and air must be drained first.' Before starting feedings through a gastrostomy tube, it is essential to drain the stomach contents and air. This process helps prevent complications and ensures the proper functioning of the tube after placement. Choice A is incorrect because initiating feedings within 5 to 7 days may lead to complications if the stomach is not adequately prepared. Choice B is incorrect as feeding should not begin immediately to allow for proper preparation of the tube and the stomach. Choice D is incorrect because although incision healing is important, draining the stomach contents and air is a more immediate concern to prevent complications.

2. The home health care agency can expect to obtain Medicare reimbursement for which home visit performed by a registered nurse or a practical nurse?

• A. assessment of the speech pattern of a mobile adult who had a mild stroke last year
• B. safety teaching for an older male client whose wife complains that he uses an unsafe ladder while painting
• C. wound care for a client who had postoperative infection following abdominal surgery two weeks ago
• D. evaluation of crutch use by a 65-year-old client who broke his tibia while snow skiing

Correct answer: C

Rationale: The correct answer is C because wound care for a postoperative infection qualifies for Medicare reimbursement. Medicare typically covers skilled nursing care, like wound care, required due to a postoperative infection. Choices A, B, and D involve assessments, teaching, and evaluation, which may not always be eligible for Medicare reimbursement unless they are directly related to skilled nursing care for a specific medical condition.

3. A client with chronic renal failure is receiving erythropoietin (Epogen). The nurse should monitor the client for which of the following side effects?

• A. Hypertension
• B. Hypoglycemia
• C. Hyperkalemia
• D. Hypocalcemia

Correct answer: A

Rationale: The correct answer is A: Hypertension. Erythropoietin can lead to hypertension as a side effect due to its stimulation of red blood cell production, which can increase blood viscosity. This can result in elevated blood pressure. Choices B, C, and D are incorrect. Hypoglycemia is not a common side effect of erythropoietin. Hyperkalemia is more commonly associated with renal failure rather than erythropoietin use. Hypocalcemia is not a typical side effect of erythropoietin administration.

4. When a nurse from the surgical department is reassigned to the pediatric unit, the charge nurse should recognize that the child at highest risk for cardiac arrest and is the least likely to be assigned to this nurse is which child?

• A. Congenital cardiac defects
• B. An acute febrile illness
• C. Prolonged hypoxemia
• D. Severe multiple trauma

Correct answer: C

Rationale: The correct answer is C, 'Prolonged hypoxemia.' Prolonged hypoxemia is a critical condition that requires specialized pediatric care due to the high risk of cardiac arrest. The other choices, such as congenital cardiac defects, acute febrile illness, and severe multiple trauma, may also require attention, but prolonged hypoxemia poses the highest risk for cardiac arrest and demands specialized expertise in managing pediatric patients with this condition.

5. A public health nurse can say that she is beginning to achieve her goal of more optimal health for her community when:

• A. people learn self-care
• B. people become involved in determining health care policy
• C. all these indicators are present
• D. people assume responsibility for their own health

Correct answer: C

Rationale: Achieving optimal health for a community involves multiple factors and indicators. For a public health nurse to begin achieving this goal, it is essential that all relevant indicators are present, not just one or a few. While choices A, B, and D are important components of promoting community health, optimal health for a community encompasses a comprehensive approach where all indicators are considered and addressed. Therefore, the correct answer is C.

Similar Questions