Nursing Elites

1. 24 hours after the creation of a colostomy, what should Nurse Violy identify as the normal appearance of the stoma?

• A. Pink, moist, and slightly protruding from the abdomen
• B. Gray, moist, and slightly protruding from the abdomen
• C. Pink, dry, and slightly protruding from the abdomen
• D. Red, moist, and slightly protruding from the abdomen

Correct answer: A

Rationale: Following colostomy surgery, a healthy stoma should appear pink, moist, and slightly protruding from the abdomen, which is why option 'A' is the correct answer. A gray stoma (choice 'B') could indicate poor blood supply or necrosis, which is a serious complication. A dry stoma (choice 'C') is also not normal as it should be moist; a dry stoma may suggest dehydration or other complications. While a stoma can appear red (choice 'D'), this is not typically the normal color; it should usually be pink. Therefore, it's important for healthcare professionals to correctly identify the normal and abnormal appearances of a stoma to ensure proper patient care.

2. Wernicke-Korsakoff syndrome is associated with which vitamin deficiency?

• A. Thiamine (B1)
• B. Riboflavin (B2)
• C. Niacin (B3)
• D. Pyridoxine (B6)

Correct answer: A

Rationale: Wernicke-Korsakoff syndrome is indeed associated with thiamine (vitamin B1) deficiency. This syndrome is commonly seen in individuals with chronic alcoholism due to poor diet and impaired thiamine absorption. Thiamine is essential for normal brain function and energy metabolism. Riboflavin (B2) deficiency can lead to symptoms like sore throat and swollen mucous membranes, not Wernicke-Korsakoff syndrome. Niacin (B3) deficiency causes pellagra, characterized by dermatitis, diarrhea, dementia, and death, but not Wernicke-Korsakoff syndrome. Pyridoxine (B6) deficiency can result in dermatitis, glossitis, and peripheral neuropathy, but it is not associated with Wernicke-Korsakoff syndrome.

3. A client who has dumping syndrome following a hemi-colectomy should avoid which of the following foods when receiving nutritional teaching from a nurse?

• A. Rice
• B. Poached eggs
• C. Fresh apples
• D. White bread

Correct answer: C

Rationale: Fresh apples should be avoided by a client with dumping syndrome following a hemi-colectomy because they are high in fiber and can exacerbate gastrointestinal symptoms such as diarrhea and bloating. Rice and poached eggs are good options as they are easily digestible and less likely to trigger dumping syndrome symptoms. White bread is also preferable over whole grain bread due to its lower fiber content, making it a better choice for individuals with dumping syndrome.

4. Stimulates secretion of bicarbonate ions and digestive enzymes from the pancreas to the small intestine:

• A. pepsin
• B. salivary amylase
• C. CCK
• D. secretin

Correct answer: D

Rationale: Secretin stimulates the pancreas to release bicarbonate ions to neutralize stomach acid and digestive enzymes into the small intestine.

5. A client is being taught about following a low-cholesterol diet after coronary artery bypass grafting. Which of the following food choices reflects the client's understanding of these dietary instructions?

• A. Liver
• B. Milk
• C. BEANS
• D. Eggs

Correct answer: C

Rationale: Choosing beans as a food option indicates that the client understands the low-cholesterol diet instructions. Beans are a good source of fiber and plant-based protein, which can help lower cholesterol levels. On the other hand, liver and eggs are high in cholesterol and should be limited in a low-cholesterol diet. Milk, especially whole milk, can also be high in saturated fats and cholesterol, so it is not the best choice for a low-cholesterol diet.

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