Nursing Elites

1. The LPN is assisting the client with an NG tube with activities of daily living. Which of these statements would indicate a need for teaching reinforcement?

• A. "Since I'm not eating or drinking by mouth, I do not need to brush my teeth as often."?
• B. "I should remain sitting up at a 45-degree angle or higher for 30 minutes after a feeding."?
• C. "I can clean around the tube with water and mild soap."?
• D. "I should avoid using Vaseline around the nostril and tube."?

Correct answer: A

Rationale: The correct answer is, "Since I'm not eating or drinking by mouth, I do not need to brush my teeth as often."? This statement indicates a need for teaching reinforcement because even when an NG tube is in place, the client should still brush their teeth twice daily. Good oral hygiene is essential to reduce the risk of introducing bacteria that may cause an infection. Choice B is incorrect because remaining sitting up at a 45-degree angle or higher for 30 minutes after a feeding is a correct statement regarding NG tube care, promoting proper digestion and reducing the risk of aspiration. Choice C is also incorrect because cleaning around the tube with water and mild soap is an appropriate practice to maintain cleanliness and prevent infection. Choice D is incorrect because advising to avoid using Vaseline around the nostril and tube is a proper instruction to prevent skin breakdown, occlusion of the tube, and potential aspiration of Vaseline into the lungs.

2. After securing the client's safety from a faulty electric bed, what should the nurse do next?

• A. Discuss the matter with the client's significant others.
• B. Document the incident in the client's record in detail.
• C. Notify the physician.
• D. Prepare an incident report.

Correct answer: D

Rationale: After ensuring the client's safety from the faulty electric bed, the nurse should prioritize preparing an incident report. This report documents the details of what happened and is crucial for quality improvement and risk management. Choice A, discussing the matter with the client's significant others, may be important in some cases but is not the immediate priority after a safety incident. Choice B, documenting the incident in the client's record, is necessary but should be preceded by preparing an incident report. Choice C, notifying the physician, is important but not as urgent as preparing the incident report to ensure timely reporting and investigation of the safety issue.

3. Which of the following medications might cause upper-gastrointestinal (UGI) bleeding?

• A. Cardizem (diltiazem)
• B. Naprosyn (naproxen)
• C. Elavil (amitriptyline)
• D. Corgard (nadolol)

Correct answer: C

Rationale: Naprosyn (naproxen) is known to cause upper-gastrointestinal (UGI) bleeding due to its effects on the stomach lining. Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that can irritate the stomach and increase the risk of UGI bleeding. On the other hand, Cardizem (diltiazem), Elavil (amitriptyline), and Corgard (nadolol) are not typically associated with UGI bleeding. Cardizem is a calcium channel blocker used for hypertension and angina, Elavil is a tricyclic antidepressant, and Corgard is a beta-blocker used for hypertension.

4. The healthcare provider is using Cognitive-Behavioral methods of pain control and knows that these methods can be expected to do all the following except:

• A. completely relieve all pain.
• B. provide benefit by restoring the client's sense of self-control.
• C. help the client to control symptoms.
• D. help the client actively participate in his or her care.

Correct answer: A

Rationale: Cognitive-Behavioral methods of pain control aim to provide benefit by restoring the client's sense of self-control, helping the client to control symptoms, and encouraging the client to actively participate in their care. However, these methods are not intended to completely relieve all pain. These interventions focus on perception and thought, aiming to influence how one interprets events and bodily sensations. Therefore, the correct answer is that they cannot completely relieve all pain, as pain relief is often a multifaceted approach that may require additional interventions beyond Cognitive-Behavioral methods. Choices B, C, and D are correct as Cognitive-Behavioral methods are designed to empower the individual in managing their pain and improving their overall well-being.

5. While undergoing fetal heart monitoring, a pregnant Native-American woman requests that a medicine woman be present in the examination room. Which of the following is an appropriate response by the nurse?

• A. "I will assist you in arranging to have a medicine woman present."?
• B. "We do not allow medicine women in exam rooms."?
• C. "That does not make any difference in the outcome."?
• D. "It is old-fashioned to believe in that."?

Correct answer: A

Rationale: The correct response is to show cultural awareness and acceptance by offering to assist in arranging for the medicine woman to be present. This demonstrates respect for the client's beliefs and preferences. Choice B is inappropriate as it dismisses the client's request without considering its cultural significance. Choice C is dismissive and does not acknowledge the client's values. Choice D is disrespectful and judgmental, undermining the client's beliefs. Therefore, the only appropriate and professional response is to support the client's request and offer assistance in accommodating it.

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