Nursing Elites

1. The ideal time to begin taking folate to prevent neural tube defects is:

• A. Before conception
• B. Once pregnancy begins
• C. At 6 weeks
• D. Upon completion of the first trimester

Correct answer: A

Rationale: Folate is crucial before conception to prevent neural tube defects. Neural tube development occurs early in pregnancy, often before a woman knows she is pregnant.

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. What are the potential consequences of damage to the stomach?

• A. Reduced digestion of carbohydrates
• B. Inability to produce or secrete bile
• C. Inability to produce or secrete gastric acid
• D. Increased ability to produce or secrete intrinsic factor

Correct answer: C

Rationale: Damage to the stomach can lead to a reduced ability to produce gastric acid (Choice C) and intrinsic factor, the latter of which is crucial for vitamin B12 absorption (Choice D). That's why these two choices are correct. The stomach doesn't play a direct role in the digestion of carbohydrates (Choice A) as this process primarily occurs in the small intestine with the help of pancreatic enzymes. Similarly, bile is produced by the liver and stored in the gallbladder, not the stomach, hence stomach damage wouldn't lead to an inability to produce or secrete bile (Choice B).

4. To prevent baby bottle tooth decay, what should the nurse instruct?

• A. Water
• B. Milk
• C. Iron-fortified formula
• D. Unsweetened fruit juice

Correct answer: A

Rationale: The correct answer is A: Water. Water is the best choice to prevent baby bottle tooth decay as it does not cause tooth decay and is a good option for bedtime bottles. Milk (choice B) and iron-fortified formula (choice C) contain sugars that can contribute to tooth decay. Unsweetened fruit juice (choice D) also contains natural sugars that can be harmful to the baby's teeth.

5. With which of the following should fluoride supplements never be taken?

• A. Water
• B. Juice
• C. Milk
• D. Soda

Correct answer: C

Rationale: Fluoride supplements should never be taken with milk because the fluoride binds with the calcium in the milk, thereby reducing the effectiveness of the fluoride supplement. Other beverages like water, juice, or soda do not share this characteristic as they do not contain the same level of calcium as milk. The rationale behind choosing milk as the correct answer is that it hampers the effectiveness of fluoride supplements, whereas the other choices do not.

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