Nursing Elites

1. What are the key considerations when administering medication via a nasogastric (NG) tube?

• A. Checking tube placement before administration
• B. Administering medication in liquid form whenever possible
• C. Crushing tablets and mixing them with water if needed
• D. Flushing the NG tube with water before and after medication

Correct answer: A

Rationale: The correct answer is A: Checking tube placement before administration. This is a crucial step to ensure that the medication reaches the stomach safely and does not end up in the lungs, which can lead to serious complications. Choice B is incorrect as not all medications can be administered in liquid form. Choice C is incorrect because crushing tablets can alter their effectiveness or cause harm. Choice D is incorrect as flushing the NG tube with water is not a standard practice before administering medication, unless specified by healthcare provider instructions.

2. A nurse notices that a colleague has an odor of alcohol while on duty. What is the most appropriate action?

• A. Speak to the colleague in private.
• B. Report the behavior to the nurse manager immediately.
• C. Confront the colleague directly on the floor.
• D. Do nothing and document the situation.

Correct answer: B

Rationale: Reporting the behavior to the nurse manager immediately is the most appropriate action when a nurse suspects a colleague of being impaired while on duty. This is crucial to ensure patient safety and maintain a professional and safe work environment. Speaking to the colleague in private may not address the issue effectively and could potentially put patients at risk if the colleague is indeed impaired. Confronting the colleague directly on the floor may lead to a confrontation and is not the most professional way to handle the situation. Doing nothing and documenting the situation without taking immediate action can jeopardize patient safety and is not an appropriate response when substance use is suspected.

3. The nurse has received a report from the emergency department that a patient with tuberculosis will be coming to the unit. Which items will the nurse need to care for this patient?

• A. N95 respirator, gown, gloves, eyewear
• B. Communication signs for droplet precautions
• C. Negative-pressure airflow in room
• D. Communication signs for airborne precautions

Correct answer: A

Rationale: The correct answer is A. Caring for a patient with tuberculosis requires the nurse to use an N95 respirator, gown, gloves, and eyewear to protect against airborne transmission of the disease. Choice B and D are incorrect because while communication signs for precautions are important, the essential items needed for caring for a patient with tuberculosis are personal protective equipment to prevent transmission. Choice C is also incorrect as negative-pressure airflow in the room is a facility-related requirement and not an item carried by the nurse.

4. When assessing a client with terminal cancer receiving a continuous intravenous infusion of morphine sulfate, what should the nurse check first?

• A. Check for respiratory depression.
• B. Assess pain control.
• C. Check the infusion site for complications.
• D. Monitor the client's blood pressure.

Correct answer: A

Rationale: The correct answer is to check for respiratory depression first when assessing a client receiving a continuous intravenous infusion of morphine sulfate. Respiratory depression is the most common life-threatening side effect associated with morphine administration. Monitoring respiratory status is crucial as it can quickly deteriorate, leading to serious complications or even respiratory arrest. Assessing pain control (choice B) is important but ensuring adequate ventilation takes precedence. Checking the infusion site for complications (choice C) and monitoring blood pressure (choice D) are also essential aspects of care but are secondary to evaluating respiratory status when administering morphine.

5. What is the most important nursing action when caring for a patient with a central venous catheter (CVC)?

• A. Monitor the patient's blood pressure regularly.
• B. Change the CVC dressing every 72 hours.
• C. Flush the CVC with normal saline every shift.
• D. Avoid using the CVC for blood draws.

Correct answer: B

Rationale: The most important nursing action when caring for a patient with a central venous catheter (CVC) is to change the CVC dressing every 72 hours. This practice reduces the risk of infection and ensures the catheter remains secure. Monitoring the patient's blood pressure regularly is important but not the most crucial action when managing a CVC. Flushing the CVC with normal saline is essential but not the most important action. Avoiding using the CVC for blood draws is a good practice, but it is not the most critical nursing action in this scenario.

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