Nursing Elites

1. The following are appropriate nursing interventions during colostomy irrigation, EXCEPT:

• A. Increase the irrigating solution flow rate when abdominal cramps is felt
• B. Insert 2-4 inches of an adequately lubricated catheter to the stoma
• C. Position client in semi-Fowler
• D. Hang the solution 18 inches above the stoma

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.

2. When performing endotracheal suctioning, the nurse applies suctioning while withdrawing and gently rotating the catheter 360 degrees for which of the following time periods?

• A. 10-15 seconds
• B. 30-35 seconds
• C. 20-25 seconds
• D. 0-5 seconds

Correct answer: D

Rationale: During endotracheal suctioning, the nurse should apply suctioning while withdrawing and gently rotating the catheter 360 degrees for a short period of 0-5 seconds. This brief duration helps minimize the risk of hypoxia and trauma to the airway. Choices A, B, and C suggest longer time periods for suctioning, which can increase the risk of complications such as hypoxia, mucosal damage, and the removal of excess amounts of airway secretions.

3. The use of the Standards of Nursing Practice is important in the hospital. Which of the following statements best describes what it is?

• A. These are statements that describe the maximum or highest level of acceptable performance in nursing practice
• B. It refers to the scope of nursing practice as defined in Republic Act 9173
• C. It is a license issued by the Professional Regulation Commission to protect the public from substandard nursing
• D. The Standards of Care includes the various steps of the nursing process and the standards of professional

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

4. What is the most appropriate nutritional advice for a patient with hypertension?

• A. Increase salt intake
• B. Reduce fiber intake
• C. Increase potassium intake
• D. Increase sugar intake

Correct answer: C

Rationale: Increasing potassium intake can help manage blood pressure levels in patients with hypertension.

5. Which of the following should a patient with a history of chronic pancreatitis avoid?

• A. Low-fat dairy
• B. Lean meats
• C. High-fiber vegetables
• D. Alcohol

Correct answer: D

Rationale: The correct answer is D: Alcohol. Alcohol consumption can exacerbate chronic pancreatitis due to its detrimental effects on the pancreas. Conversely, options A, B, and C: Low-fat dairy, Lean meats, and High-fiber vegetables, are generally recommended for patients with chronic pancreatitis. These dietary options are easier on the pancreas and less likely to provoke symptoms. Therefore, they are incorrect choices in this context.

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