Nursing Elites

1. The client has orders for a nasogastric (NG) tube insertion. During the procedure, instructions that will assist in the insertion would be:

• A. Instruct the client to tilt his head back for insertion in the nostril, then flex his neck for the final insertion
• B. After insertion into the nostril, instruct the client to extend his neck
• C. Introduce the tube with the client’s head tilted back, then instruct him to keep his head upright for final insertion
• D. Instruct the client to hold his chin down, then back for insertion of the tube

Correct answer: A

Rationale: Instructing the client to tilt his head back for insertion in the nostril, then flex his neck for the final insertion helps facilitate the NG tube insertion.

2. A nurse is providing instructions to a client who will collect a stool specimen for occult blood. The nurse instructs the client to avoid which of the following for 3 days before the collection of the stool specimen?

• A. Milk products
• B. Hard cheese
• C. Turnips
• D. Cottage cheese

Correct answer: C

Rationale: The correct answer is C: Turnips. The nurse would instruct the client to avoid red meat, poultry, fish, turnips, horseradish, and foods such as fruits and vegetables for 3 days before and during testing. These products may alter test results. Choices A, B, and D are incorrect because they are not specifically mentioned as items to avoid before collecting a stool specimen for occult blood.

3. A client has been diagnosed with gastroesophageal reflux disease. The nurse interprets that the client has dysfunction of which of the following parts of the digestive system?

• A. Chief cells of the stomach
• B. Parietal cells of the stomach
• C. Lower esophageal sphincter
• D. Upper esophageal sphincter

Correct answer: C

Rationale: The lower esophageal sphincter is a functional sphincter that normally remains closed except when food or fluids are swallowed. If relaxation of this sphincter occurs, the client could experience symptoms of gastroesophageal reflux disease.

4. The client with GERD complains of a chronic cough. The nurse understands that in a client with GERD this symptom may be indicative of which of the following conditions?

• A. Development of laryngeal cancer
• B. Irritation of the esophagus
• C. Esophageal scar tissue formation
• D. Aspiration of gastric contents

Correct answer: D

Rationale: Aspiration of gastric contents can lead to a chronic cough in clients with GERD.

5. Which of the following symptoms may be exhibited by a client with Crohn’s disease?

• A. Bloody diarrhea
• B. Narrow stools
• C. N/V
• D. Steatorrhea

Correct answer: D

Rationale: Clients with Crohn's disease may exhibit symptoms such as steatorrhea, which is the presence of excess fat in the stool.

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