Nokea
A nurse is caring for a client who has a nasogastric (NG) tube and is receiving intermittent
feedings through an open system. Which of the following actions should the nurse take first?
- A. Make sure the enteral formula is at room temperature.
- B. Wipe the top of the formula can with alcohol.
- C. Rinse the feeding bag with water between feedings.
- D. Tell the client to keep the head of the bed elevated at least 30°
Correct Answer: B
Rationale: The correct answer is B: Wipe the top of the formula can with alcohol. This is the first action the nurse should take because it ensures the cleanliness and sterility of the formula before administering it to the client through the NG tube, reducing the risk of contamination and infection.
A: Making sure the enteral formula is at room temperature is important but not the first action to take.
C: Rinsing the feeding bag with water between feedings is not necessary for every feeding and does not address the immediate need to ensure the cleanliness of the formula.
D: Instructing the client to keep the head of the bed elevated is important for preventing aspiration but is not the first action to take in this scenario.
You may also like to solve these questions
The staff on a medical-surgical unit is in conflict with the occupational therapy department. What type of communication will be used to discuss the problems?
- A. Downward communication
- B. Lateral communication
- C. Distorted communication
- D. Upward communication
Correct Answer: B
Rationale: The correct answer is B: Lateral communication. In this scenario, the conflict between the staff and the occupational therapy department requires communication between individuals at the same hierarchical level. Lateral communication enables direct discussion and collaboration among peers to address issues and find solutions.
A: Downward communication involves communication from higher to lower levels in the hierarchy, which would not be suitable for resolving conflicts between different departments.
C: Distorted communication implies a breakdown in the communication process, leading to misunderstandings and misinterpretations, which would not be effective in addressing the conflict.
D: Upward communication involves communication from lower to higher levels in the hierarchy, which may not be the most appropriate method for resolving conflicts between departments.
Strategies to advance your career and opportunities available in your first job can coexist. Identify factors that will help you prioritize these opportunities to fulfill your goals. (Select all that apply.)
- A. Self-actualization and assessing your values and your lifestyle.
- B. Determine where you can grow and develop professionally.
- C. Your ability to work as a team member.
- D. Reflect on your long-term career aspirations.
Correct Answer: A
Rationale: The correct answer is A because self-actualization and assessing your values and lifestyle are essential for aligning your career goals with personal values, leading to long-term satisfaction and fulfillment. By understanding your core values and lifestyle preferences, you can prioritize job opportunities that align with your aspirations.
Choice B is incorrect because while professional growth is important, it may not necessarily align with your personal values and lifestyle. Choice C is incorrect as teamwork skills are important, but they do not directly relate to prioritizing career opportunities based on personal values. Choice D is incorrect as reflecting on long-term career aspirations alone may not provide a holistic view of how to prioritize opportunities in alignment with personal values and lifestyle.
What is the best description of cultural competence in nursing?
- A. Ignoring cultural differences
- B. Adapting care to cultural needs
- C. Learning about different cultures
- D. Teaching cultural awareness
Correct Answer: B
Rationale: The correct answer is B because cultural competence in nursing involves adapting care to meet the cultural needs and preferences of each individual patient. This includes understanding and respecting their beliefs, values, and practices to provide effective and respectful care. Ignoring cultural differences (A) goes against the core principle of cultural competence. Simply learning about different cultures (C) is not enough; it is essential to apply that knowledge in practice. Teaching cultural awareness (D) is important but does not fully capture the holistic approach of adapting care to meet cultural needs.
Which leadership style is most effective in a crisis situation?
- A. Democratic
- B. Autocratic
- C. Transformational
- D. Laissez-faire
Correct Answer: B
Rationale: The correct answer is B: Autocratic. In a crisis situation, quick and decisive actions are crucial. An autocratic leadership style allows for immediate decision-making and clear direction, which is essential in rapidly changing and high-stress environments. This style ensures swift responses and minimizes confusion or delays.
Incorrect choices:
A: Democratic leadership involves group decision-making, which may be time-consuming and not suitable for urgent crisis situations.
C: Transformational leadership focuses on inspiring and empowering others, which may not be as effective in a crisis when quick and direct actions are needed.
D: Laissez-faire leadership gives employees a high degree of freedom and independence, which can lead to chaos and lack of direction in a crisis scenario.
An RN comes upon a serious motor vehicle accident that has just occurred and no first responders are on the scene. One car has been flipped upside down, and she can see the driver still in the car. The RN decides to stop and help. She knows she is protected from civil liability as long as she does which of the following?
- A. Acts in an ordinary, reasonable, and prudent professional manner
- B. Assures that information obtained is not communicated to anyone else
- C. Does not make any verbal comments that could lead to economic harm
- D. Fails to meet the established standards of practice
Correct Answer: A
Rationale: The correct answer is A: Acts in an ordinary, reasonable, and prudent professional manner. The RN is protected from civil liability under the Good Samaritan laws when they act in a manner that is considered ordinary, reasonable, and prudent for a healthcare professional in an emergency situation. By stopping to help at the accident scene, the RN is fulfilling their duty to provide aid as a healthcare professional. Choices B and C are incorrect because withholding information or refraining from making certain verbal comments would not protect the RN from liability in this emergency scenario. Choice D is incorrect because failing to meet the established standards of practice would expose the RN to potential liability.