Nursing Elites

1. Membership dropout generally occurs in group therapy after a member:

• A. Accomplishes his goal in joining the group
• B. Discovers that his feelings are shared by the group members
• C. Experiences feelings of frustration in the group
• D. Discusses personal concerns with group members

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

2. A nurse is initiating continuous enteral feedings for a client who has a new gastrostomy tube. Which of the following actions should the nurse take?

• A. Measure the client’s gastric residual every 12 hours.
• B. Obtain the client’s electrolyte levels every 4 hours.
• C. Keep the client’s head elevated at 15° during feedings.
• D. Flush the client’s tube with 30 mL of water every 4 hours.

Correct answer: D

Rationale: Flushing the client’s tube with 30 mL of water every 4 hours is essential to maintain tube patency and prevent blockages. This action helps ensure the continuous flow of enteral feedings without obstruction. Measuring the client’s gastric residual every 12 hours (Choice A) is important but not the priority when initiating enteral feedings. Obtaining the client’s electrolyte levels every 4 hours (Choice B) is unnecessary and not directly related to tube feeding initiation. Keeping the client’s head elevated at 15° during feedings (Choice C) is a good practice to prevent aspiration, but tube flushing is more crucial to prevent tube occlusion.

3. Why are blood glucose levels high in type 1 diabetes?

• A. The urinary excretion of glucose is impaired
• B. The lean body mass is metabolized to produce glucose via gluconeogenesis
• C. The absorption of glucose from the gastrointestinal tract is more efficient
• D. There is insufficient insulin to facilitate the transport of glucose into the cells

Correct answer: D

Rationale: In type 1 diabetes, the body's immune system destroys the beta cells in the pancreas that produce insulin. This leads to an insufficient amount of insulin, which is required to facilitate the transport of glucose into the cells. Consequently, blood glucose levels remain high. The other options are incorrect. Option A is incorrect because urinary excretion of glucose does not directly contribute to blood glucose levels. Option B is incorrect because, while gluconeogenesis does produce glucose, it is not the cause of high glucose levels in type 1 diabetes. Option C is incorrect because absorption efficiency of glucose from the gastrointestinal tract does not affect the amount of insulin available to transport glucose into cells.

4. A child with ear problem should be assessed for the following, EXCEPT:

• A. is there any fever?
• B. Ear discharge
• C. If discharge is present for how long?
• D. Ear pain

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

5. What type of drug would most likely be given to a patient following a myocardial infarction?

• A. antiemetic
• B. anticoagulant
• C. anticonvulsant
• D. antibiotic

Correct answer: B

Rationale: Anticoagulants are the most suitable choice for a patient following a myocardial infarction. These medications are essential in preventing further blood clots from forming in the arteries, reducing the risk of complications such as strokes or recurrent heart attacks. Antiemetics are used to control nausea and vomiting, not directly related to myocardial infarction. Anticonvulsants are used to manage seizures, not typically indicated after a heart attack. Antibiotics are prescribed to treat bacterial infections, not routinely given after a myocardial infarction.

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