Nokea
A patient is admitted to the surgical unit with a diagnosis of rule out intestinal obstruction. The nurse is preparing to insert a Salem sump NG tube as ordered. In which of the following positions would it be BEST for the nurse to place this patient during the procedure?
- A. Head of bed elevated 30°-45°.
- B. Head of bed elevated 60°-90°.
- C. Side-lying with head elevated 15°.
- D. Lying flat with head turned to the left side.
Correct Answer: B
Rationale: facilitates swallowing and movement of tube through GI tract
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During the change of shift, the oncoming nurse notes a discrepancy in the number of percocette listed and the number present in the narcotic drawer. The nurse's first action should be to:
- A. Notify the hospital pharmacist
- B. Notify the nursing supervisor
- C. Notify the Board of Nursing
- D. Notify the director of nursing
Correct Answer: B
Rationale: A narcotic discrepancy requires reporting to the supervisor for investigation.
A client with psychotic depression is receiving haloperidol (Haldol). Which of the following adverse effects is associated with haloperidol?
- A. Akathisia
- B. Cataracts
- C. Diaphoresis
- D. Polyuria
Correct Answer: A
Rationale: Akathisia, a movement disorder characterized by restlessness, is a common extrapyramidal side effect of haloperidol.
Based on clinical findings, the physician suspects that a 65-year-old client has kidney disease and has ordered a blood-urea-nitrogen (BUN) test. Which of the following results is within normal limits?
- A. 5 mg/dL
- B. 15 mg/dL
- C. 40 mg/dL
- D. 100 mg/dL
Correct Answer: B
Rationale: Normal BUN is 7-20 mg/dL, so 15 mg/dL (B) is within range. Other values (A, C, D) are too low or high.
Which of the following roommates would be best for the client newly admitted with gastric resection?
- A. A client with Crohn's disease
- B. A client with pneumonia
- C. A client with gastritis
- D. A client with phlebitis
Correct Answer: C
Rationale: Gastritis aligns with gastric resection, posing no infection risk.
The nurse is providing discharge instructions to the parents of a 6-month-old child with surgical repair for cryptorchidism. Which instruction would NOT be stressed?
- A. observe surgical site for bleeding
- B. enforce bed rest for 2-3 days
- C. palpate scrotum to check testicle location
- D. avoid strenuous activity for at least one month
Correct Answer: B
Rationale: Bed rest for 2-3 days is not typically required for cryptorchidism repair in infants, as recovery is quicker. Other instructions are critical for monitoring and safety.