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Nurs 321 Exam 1 – Questions With Reviewed Solutions

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Nurs 321 Exam 1 – Questions With Reviewed Solutions

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Nurs 321 Exam 1 – Questions With Reviewed Solutions

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Terms in this set (164)



enteral nutrition giving nutrients into the gastro-intestinal tract through a
feeding tube


parenteral nutrition giving nutrients through a catheter inserted into a vein


check residuals in which tube? g-tube


How much residual is too much? 500 or 250 x2


what to do if residual is too much? put it back, hold the next feeding, tell the provider


when do we flush tube feedings? before AND after feedings and medication administration


how long is everything for enteral tube 24 hours; change if its been longer
feedings good for?


TPN risks infection (bacterial or fungal)
air emboli
wrong spot
electrolyte imbalances
hyper/hypoglycemia


TPN runs out and next bag isnt ready; what hypoglycemia!! start D10!!
do you do?


its been 24 hours and there is still food in change it
TPN; what do you do?


who is at highest risk for re-feeding elderly
syndrome malnourished


Re-feeding syndrome: four things to look fluid overload, hypomagnesium, hypophosphotemia,
out for hypokalemia


how to check if TPN is in the right place x-ray!!!!


pH in metabolic alkalosis greater than 7.45


bicarbonate in metabolic alkalosis above 26, high.

,A patient has been admitted to the hospital c. IV replacement of fluid and electrolytes.
due to experiencing vomiting for several d
days. The cause of the patient's vomiting is
unknown. Which of the following
interventions should be considered the
nurse's priority in providing care for this
patient?
a. Administration of parental antiemetics.
b. Insertion of an NG tube for suction.
c. IV replacement of fluid and electrolytes.
d. Oral administration of broth & tea.


What increases a patient's risk for antibiotics and corticosteroids
candidiasis?


which mouth concern can result from mucositis
chemotherapy, renal disease or liver
disease?


When caring for a patient in the initial b. Maintaining a patent airway.
postoperative period after a partial
glossectomy with a radial neck dissection,
which of the following is the nurse's primary
concern?
Select an answer and submit. For keyboard
navigation, use the up/down arrow keys to
select an answer.
a. Assessing the patient's coping.
b. Maintaining a patent airway.
c. Providing adequate nutrition
d. Relieving the patient's pain.


The nurse provides education to a patient A. Lying flat after meals
who has a hiatal hernia and experiences
GERD after eating. Which activity should the
nurse instruct this patient to avoid?
A. Lying flat after meals
B. Eating small, frequent meals that are not
spicy
C. Sleeping with the HOB elevated 30
degrees
D. Taking ranitidine on an empty stomach


The nurse has requested a dietary consult A. Maintain an ideal body weight.
for a patient with GERD. What statements B. Avoid spicy foods.
provide useful dietary information for this C. Avoid fatty foods.
patient to manage the GERD symptoms?
(Select all that apply.)
A. Maintain an ideal body weight.
B. Avoid spicy foods.
C. Avoid fatty foods.
D. A glass of wine after dinner will help you
relax.
E. A cup of peppermint will help improve
digestion.

, The nurse is caring for a patient who C. Check the provider's order.
encountered a minor esophageal injury after The nurse always checks the physician's order before
accidently swallowing a piece of a chicken administering a medication. After verification of the order, the
bone. The patient will receive medications RN determines that the medication is appropriate to be given
and nutrition for 4 to 6 days by nasogastric though a nasogastric tube. Certain medications have a
tube to control mucosal damage and delayed action or enteric coating. Check the approved drug
promote healing. Which of the following reference or agency pharmacy to verify that these
actions should the nurse plan to take first medications can be given through a nasogastric tube. If a
when administering medications through the medication is not available in an elixir form, the nurse
nasogastric tube? prepares the medication by crushing pills or opening capsules
A. Verify the patient's identification and and mixing each medication in 15 to 30 ml of water.
explain the procedure to the patient. Confirmation of patient identification, tube placement,
B. Flush the nasogastric tube with 30 to 50 residual volume, and presence of bowel sounds are checked.
mL per hospital policy prior to administering Medication is drawn up with the appropriate catheter-tip
the medication. syringe and administered to the patient and then flushed with
C. Check the provider's order. 15 to 30 ml of water. Documentation of medication
D. Prepare the medication for administration. administration and any pertinent information is completed.


A nurse working in an endoscopy clinic is D. The patient who has had untreated GERD for 30 years
screening patients for the risk of developing The patient with untreated GERD is at greatest risk. Barrett's
Barrett's esophagus. The nurse should esophagus is found in the lower one third of the esophagus,
consider which patient at greatest risk? mainly at the gastroesophageal junction (GEJ) and cardiac
A. The patient with a 20-year history of (first part of the stomach) of the stomach. Long-term
alcohol abuse exposure to gastric acid reflux causes metaplastic
B. The patient with a 30-pack-per-year transformation (Barrett's esophagus) that leads to esophageal
smoking history adenocarcinoma. Alcohol abuse,cigarette smoking, and lye
C. The patient who ingested lye as a child ingestion are risk factors of squamous cell carcinoma of the
and is now 47 years old upper portions of the esophagus.
D. The patient who has had untreated GERD
for 30 years


Which clinical manifestations will the nurse A. Pain radiating to the ear
expect to find when taking care of a patient C. Leukoplakia
diagnosed with oral cancer? (Select all that D. Presence of HPV E. Nasal polyposis
apply.)
A. Pain radiating to the ear
B. Otitis media
C. Leukoplakia
D. Presence of HPV E. Nasal polyposis


The nurse completed teaching for the client D. "I'll sit at the table to remove the IV catheter cap to attach
who will be receiving TPN while at home. the IV tubing."
Which client statement indicates that further . The IV infusion tubing is connected to the insertion site cap
teaching is needed? and not removed to administer the TPN solution. Caps are
•A. "My refrigerator is big enough to store changed every 3 to 7 days during dressing changes, with the
several bags of parenteral solution." client in a flat position. An air embolus can occur if the cap is
•B. "I will keep my cellular phone with me at removed while the client is in a sitting position. (Some hospital
all times to use in an emergency." policies say to change caps daily when hanging a new bag of
•C. "I plan to use the main floor bedroom; TPN)
it'll be best with the infusion pump."
•D. "I'll sit at the table to remove the IV
catheter cap to attach the IV tubing."

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