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. Before bowel surgery, Lee is to administer enemas until clear. During administration, he complains of intestinal cramps. What do you do next?

• A. Discontinue the procedure.
• B. Lower the height of the enema container.
• C. Complete the procedure as quickly as possible.
• D. Continue administration of the enema as ordered without making any adjustments.

Correct answer: B

Rationale: If a patient complains of intestinal cramps during an enema, lowering the height of the enema container can help reduce discomfort.

3. The client is admitted to the hospital for treatment of acute hepatitis B. Which activity order would the nurse expect to be prescribed?

• A. Bedrest
• B. Encourage ambulation
• C. Out of bed in a chair
• D. No activity restrictions

Correct answer: A

Rationale: Fatigue is a normal response to hepatic cellular damage. During the acute stage, rest is an essential intervention to reduce the metabolic demands on the liver and its blood supply.

4. You’re preparing a teaching plan for a 27 y.o. named Jeff who underwent surgery to close a temporary ileostomy. Which nutritional guideline do you include in this plan?

• A. There is no need to change eating habits.
• B. Eat six small meals a day.
• C. Eat the largest meal in the evening.
• D. Restrict fluid intake.

Correct answer: B

Rationale: After ileostomy closure surgery, it is recommended to eat six small meals a day to aid digestion and absorption.

5. A client with gastric cancer can expect to have surgery for resection. Which of the following should be the nursing management priority for the preoperative client with gastric cancer?

• A. Discharge planning
• B. Correction of nutritional deficits
• C. Prevention of DVT
• D. Instruction regarding radiation treatment

Correct answer: B

Rationale: The priority for preoperative management of a client with gastric cancer is the correction of nutritional deficits.

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