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NMNC 1135 – Exam 3 Content | Study Guide

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NMNC 1135 Exam 3, covering nursing fundamentals and safe practice. It reviews enteral feeding procedures (tube placement verification, gastric residual volume, flushing, feeding initiation), urinary elimination (stress incontinence management with Kegel exercises, urinary retention interventions, catheterization guidelines), and bowel elimination (enemas, bowel training, incontinence care). Medication administration safety is emphasized, including the six rights, avoiding needlestick injuries, using Z-track technique for IM injections, buccal medication teaching, and the nurse’s accountability in medication errors. Additional topics include aspiration risk prevention, IM and intradermal injection sites and angles, clean-voided urine specimen collection, use of inhalers with spacers, and nutrition guidelines (full liquid diet components).

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A nurse is preparing to administer an enteral feeding. In which order will the nurse
implement the steps, starting with the first one?
1. Elevate head of bed to at least 30 degrees.2. Check for gastric residual volume.3.
Flush tubing with 30 mL of water.4. Verify tube placement.5. Initiate feeding.
-2, 1, 4, 5, 3
-1, 4, 2, 3, 5
-4, 2, 1, 5, 3
-2, 4, 1, 3, 5


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, -1, 4, 2, 3, 5


-The steps for an enteral feeding are as follows: place patient in high-
Fowler's position or elevate head of bed to at least 30 (preferably 45)
degrees, verify tube placement, check for gastric residual volume, flush
tubing with 30 mL of water, and initiate feeding.




A patient asks about treatment for stress urinary incontinence. Which is the nurse’s
best response?
-Perform pelvic floor exercises.
-Wear an adult diaper.
-Avoid voiding frequently.
-Drink cranberry juice.


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-Perform pelvic floor exercises.

-Poor muscle tone leads to an inability to control urine flow. The nurse
should recommend pelvic muscle strengthening exercises such as Kegel
exercises; this solution best addresses the patient's problem. Evidence has
shown that patients with urgency, stress, and mixed urinary incontinence
can eventually achieve continence when treated with pelvic floor muscle
training. Drinking cranberry juice is a preventative measure for urinary tract
infection. The nurse should not encourage the patient to reduce voiding;
residual urine in the bladder increases the risk of infection. Wearing an
adult diaper could be considered if attempts to correct the root of the
problem fail.




A registered nurse interprets that a scribbled medication prescription reads 25 mg.
The nurse administers 25 mg of the medication to a patient and then discovers that
the dose was incorrectly interpreted and should have been 15 mg. Who is ultimately
responsible for the error?
-Hospital

, -Pharmacist
-Nurse
-Health care provider


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-Nurse

-Ultimately, the person administering the medication is responsible for
ensuring that it is correct. The nurse administered the medication, so in this
case it is the nurse. Accept full accountability and responsibility for all
actions surrounding the administration of medications. Do not assume that
a medication that is ordered for a patient is the correct medication or the
correct dose. This is the importance of verifying the six rights of medication
administration. The ultimate responsibility and accountability are with the
nurse, not the health care provider, pharmacist, or hospital.




The nurse has prepared a pain injection for a patient but was called to check on
another patient. When asked to give the medication what action by the new nurse is
best?
-Avoid the issue and pretend to not hear the request.
-Administer the medication just this once.
-Give the medication if the pain score greater than 8.
-Refuse to give the medication.


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