A nurse is teaching a class about providing care within the legal stope of practice to a group of nurses. The nurse should include that which of the following procedures is outside the legal scope of practice for an RN?

Changing the inner cannula on a tracheostomy

Administering a platelet transfusion

Irrigation of an external ear canal

Inserting a tunneled central venous catheter

Answer and Explanation

The Correct Answer is D

A. Changing the inner cannula on a tracheostomy: This procedure falls within the RN's scope of practice, as it involves basic tracheostomy care and maintenance, which nurses commonly perform.
B. Administering a platelet transfusion: Administering blood and blood products, including platelet transfusions, is within the RN's scope of practice, provided the nurse has appropriate training and competency.
C. Irrigation of an external ear canal: Irrigation of an external ear canal is a routine nursing procedure that falls within the RN's scope of practice, as long as it does not involve invasive procedures beyond irrigation.
D. Inserting a tunneled central venous catheter: Inserting tunneled central venous catheters is typically performed by advanced practice nurses or physicians with specific training and certification, such as nurse practitioners or interventional radiologists. This procedure is beyond the scope of practice for RNs and requires specialized skills and knowledge.

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Correct Answer is C

Explanation

A. "Eat a high-fat snack at bedtime": Consuming high-fat foods, especially close to bedtime, can exacerbate heartburn symptoms. Fatty foods delay gastric emptying and can contribute to increased acid production, leading to heartburn. Therefore, advising the client to avoid high-fat snacks before bedtime is essential for managing heartburn.
B. "Sip carbonated beverages throughout the day": Carbonated beverages, including soda and sparkling water, can exacerbate heartburn symptoms due to their acidic nature and carbonation. Therefore, advising the client to avoid or limit carbonated beverages is essential for managing heartburn.
C. "Drink hot herbal tea to relieve symptoms": Herbal teas such as chamomile or ginger tea can help alleviate heartburn symptoms by promoting digestion and soothing the gastrointestinal tract. Warm beverages can have a soothing effect on the esophagus and stomach, potentially providing relief from heartburn discomfort. Therefore, advising the client to drink hot herbal tea to relieve symptoms is an appropriate recommendation.
D. "Lie down for 30 min after meals": Remaining upright for at least 30 minutes after meals can help prevent acid reflux and reduce the risk of heartburn. However, lying down immediately after eating can worsen heartburn symptoms by allowing stomach acid to flow back into the esophagus. Therefore, advising the client to lie down for 30 minutes after meals is not an appropriate instruction for managing heartburn.

A. Add water to the formula. B. Reposition the NG tube. C. Increase the rate of formula delivery. D. Switch to a lactose-free formula.

Correct Answer is A

Explanation

A. Adding water to the formula will decrease its osmolarity, reducing the risk of hyperosmolar dehydration. This action helps to dilute the formula and make it more isotonic, which is better tolerated by the client's gastrointestinal tract.
B. Repositioning the NG tube may be necessary if there are issues with tube placement or if the tube has migrated. However, it is not directly related to addressing hyperosmolar dehydration.
C. Increasing the rate of formula delivery may exacerbate hyperosmolar dehydration by introducing more concentrated formula into the gastrointestinal tract, leading to further dehydration.
D. Switching to a lactose-free formula may be appropriate if the client has lactose intolerance, but it does not address the issue of hyperosmolar dehydration. Adding water to the formula is the more appropriate intervention in this scenario to decrease osmolarity and prevent dehydration.

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A nurse is teaching a class about providing care within the legal stope of practice to a group of nurses. The nurse should include that which of the following procedures is outside the legal scope of practice for an RN?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who is at 20 weeks of gestation about how to manage heartburn. Which of the following instructions should the nurse include?

Correct Answer is C

Explanation

A nurse is assessing a client who is receiving enteral feedings via ah NG tube. The client has developed hyperosmolar dehydration. Which of the following actions should the nurse take when administering the client's feedings?

Correct Answer is A

Explanation

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