Nursing Elites

1. A 30-year old client experiences weight loss, abdominal distention, crampy abdominal pain, and intermittent diarrhea after the birth of her 2nd child. Diagnostic tests reveal gluten-induced enteropathy. Which foods must she eliminate from her diet permanently?

• A. Milk and dairy products
• B. Protein-containing foods
• C. Cereal grains (except rice and corn)
• D. Carbohydrates

Correct answer: C

Rationale: Gluten-induced enteropathy, or celiac disease, requires the elimination of gluten-containing grains like wheat, barley, and rye. Dairy, proteins, and carbohydrates are not excluded unless the client has specific intolerances.

2. Which of the following tests should be administered to a client suspected of having diverticulosis?

• A. Abdominal ultrasound
• B. Barium enema
• C. Barium swallow
• D. Gastroscopy

Correct answer: B

Rationale: A barium enema is a diagnostic test used to visualize the colon and can help diagnose diverticulosis.

3. The home care nurse is visiting a client with a diagnosis of pernicious anemia that developed as a result of gastric surgery. The nurse instructs the client that because the stomach lining produces a decreased amount of intrinsic factor in this disorder, the client will need

• A. Vitamin B12 injections
• B. Vitamin B6 injections
• C. An antibiotic
• D. An antacid

Correct answer: A

Rationale: A lack of intrinsic factor needed to absorb vitamin B12 occurs in pernicious anemia. Vitamin B12 is needed for the maturation of red blood cells. Vitamin B6 is not necessarily needed for pernicious anemia and can be taken orally. An antibiotic and antacids may be prescribed for certain types of gastric ulcers.

4. When planning care for a client with ulcerative colitis who is experiencing symptoms, which client care activities can the nurse appropriately delegate to a unlicensed assistant?

• A. Assessing the client's bowel sounds
• B. Providing skin care following bowel movements
• C. Evaluating the client's response to antidiarrheal medications
• D. administration of pain medication every 4 hours

Correct answer: B

Rationale: Providing skin care following bowel movements, maintaining intake and output records, and obtaining the client's weight can be delegated to a unlicensed assistant.

5. Which of the following activities should the nurse encourage the client with a peptic ulcer to avoid?

• A. Chewing gum.
• B. Smoking cigarettes.
• C. Eating chocolate.
• D. Taking acetaminophen (Tylenol).

Correct answer: B

Rationale: Cigarette smoking should be avoided because of its stimulatory effect on gastric secretions. Nicotine also increases the release of epinephrine, which leads to vasoconstriction. The client may chew gum if desired. The client may eat chocolate if desired. A client with a peptic ulcer should check with the physician before taking any over-the-counter drug, but acetaminophen does not typically cause gastric irritation.

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