the nurse supervises care of a client who is receiving enteral feeding via a nasogastric tube the nurse determines that care is appropriate if which o
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Nursing Elites

ATI RN

ATI RN Custom Exams Set 3

1. The nurse supervises care of a client who is receiving enteral feeding via a nasogastric tube. The nurse determines that care is appropriate if which of the following is observed? (Select all that apply)

Correct answer: D

Rationale: Elevating the head of the bed to 30 degrees reduces the risk of aspiration by promoting proper digestion and preventing reflux. Warming the formula to room temperature is essential to prevent discomfort and complications. Aspirating and measuring the gastric aspirate is not a recommended nursing action for monitoring enteral feeding via a nasogastric tube, as it can introduce the risk of introducing contaminants into the feeding tube. Therefore, choices A and B are incorrect, making choice D the correct answer.

2. Which type of anemia is associated with chronic kidney disease?

Correct answer: D

Rationale: The correct answer is D, Erythropoietin deficiency anemia. Chronic kidney disease often leads to anemia due to decreased production of erythropoietin. This hormone, produced by the kidneys, stimulates the bone marrow to produce red blood cells. Choices A, B, and C are incorrect. Iron-deficiency anemia is characterized by low iron levels, vitamin B12 deficiency anemia by inadequate vitamin B12, and aplastic anemia by bone marrow failure.

3. The client has been diagnosed with hemorrhoids. Which statement from the client indicates that further teaching is needed?

Correct answer: C

Rationale: Choice C indicates the need for further teaching because regular use of laxatives can lead to dependence and is not recommended for hemorrhoids. Increased fiber intake and fluid consumption (Choice A) help prevent constipation, warm compresses and sitz baths (Choice B) provide relief, and using analgesic ointments or suppositories (Choice D) can help manage pain associated with hemorrhoids.

4. The nurse is planning to provide education about foods containing thiamine to a group of clients. Which food high in thiamine should the nurse include?

Correct answer: B

Rationale: The correct answer is B: Pork. Pork is high in thiamine, which is important for preventing thiamine deficiency. Thiamine, also known as Vitamin B1, is essential for the body's metabolism and proper functioning of the nervous system. While fish, beef, and eggs are nutritious foods, they do not contain as high levels of thiamine as pork does. Therefore, when educating clients about thiamine-rich foods, pork would be the most appropriate choice.

5. What intervention would be the most important for the nurse to implement for the client with a left nephrectomy?

Correct answer: A

Rationale: The most important intervention for a client with a left nephrectomy is to assess the intravenous fluids for rate and volume. After nephrectomy, monitoring intravenous fluids is crucial to ensure proper hydration and kidney function. Changing the surgical dressing daily, monitoring medication levels, and tracking meal intake are also important aspects of care but not as critical as ensuring adequate intravenous fluid management post-surgery.

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