Nursing Elites

1. What is the most appropriate next step when a client with an NG tube attached to low suctioning becomes nauseated, and the nurse observes a decrease in the flow of gastric secretions?

• A. Increase the suction pressure
• B. Irrigate the NG tube with sterile water
• C. Turn the client on their side
• D. Replace the NG tube with a new one

Correct answer: B

Rationale: The correct answer is to irrigate the NG tube with sterile water. When a client with an NG tube attached to low suctioning becomes nauseated and there is a decrease in the flow of gastric secretions, it indicates a possible blockage in the tube. Irrigating the tube with sterile water can help clear the blockage, allowing for proper suctioning and relieving the client's nausea. Increasing the suction pressure (Choice A) can further worsen the issue by potentially causing harm to the client. Turning the client on their side (Choice C) may not address the underlying problem of tube blockage. Replacing the NG tube with a new one (Choice D) should only be considered if other interventions, like irrigation, fail to clear the blockage.

2. What is the best dietary recommendation for a patient with chronic kidney disease?

• A. Low-protein diet
• B. High-protein diet
• C. Low-sodium diet
• D. High-sodium diet

Correct answer: A

Rationale: The correct answer is a low-protein diet for a patient with chronic kidney disease. In chronic kidney disease, the kidneys may have difficulty filtering waste products from protein metabolism, leading to a buildup of toxins in the body. Therefore, reducing protein intake can help lessen the workload on the kidneys. Choices B, C, and D are incorrect. A high-protein diet would increase the workload on the kidneys, while a low-sodium diet is beneficial for conditions like hypertension or heart failure but not specifically targeted for chronic kidney disease. A high-sodium diet can worsen fluid retention and hypertension in patients with kidney disease.

3. A client receiving chemotherapy for cancer has developed stomatitis. Which of the following interventions should the nurse implement?

• A. Provide lemon-glycerin swabs
• B. Encourage the client to eat soft foods
• C. Avoid using toothpaste
• D. Instruct the client to use a mouthwash containing alcohol

Correct answer: B

Rationale: The correct intervention for a client with stomatitis, a common side effect of chemotherapy, is to encourage the client to eat soft foods. Soft foods help prevent further irritation to the mouth. Providing lemon-glycerin swabs (choice A) can be too harsh and irritating to the mouth. Avoiding toothpaste (choice C) is not necessary unless it contains harsh ingredients that can further irritate the mouth. Instructing the client to use a mouthwash containing alcohol (choice D) is contraindicated as alcohol-containing mouthwashes can be too harsh and drying for clients with stomatitis.

4. What are the risk factors for deep vein thrombosis (DVT) and how can it be prevented?

• A. Immobility and oral contraceptive use
• B. Pregnancy and smoking
• C. Obesity and varicose veins
• D. Hypertension and high cholesterol

Correct answer: A

Rationale: The correct answer is A: Immobility and oral contraceptive use. Immobility and oral contraceptive use are significant risk factors for deep vein thrombosis (DVT). Immobility leads to blood stasis, increasing the risk of clot formation, while oral contraceptive use can promote hypercoagulability. Prevention strategies for DVT include promoting mobility to enhance blood circulation and using anticoagulants to prevent clot formation. Choices B, C, and D are incorrect. While pregnancy and smoking can increase the risk of DVT, they are not the specific factors mentioned in the question. Similarly, obesity and varicose veins, as well as hypertension and high cholesterol, are not the primary risk factors associated with DVT.

5. A client takes prednisone daily for the treatment of chronic asthma. The nurse should plan to monitor the client for which of the following adverse effects?

• A. Hyperglycemia
• B. Hypertension
• C. Gastric ulcer formation
• D. Diarrhea

Correct answer: C

Rationale: The correct answer is C: Gastric ulcer formation. Prednisone, a corticosteroid, increases the risk of gastric ulcer formation, especially with long-term use. While prednisone can also lead to hyperglycemia (choice A) and hypertension (choice B) as adverse effects, monitoring for gastric ulcer formation is a priority due to its association with corticosteroid therapy. Diarrhea (choice D) is not a common adverse effect of prednisone and is less likely compared to gastric ulcers.

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