Nursing Elites

1. A client has been diagnosed with gastroesophageal reflux disease. The nurse interprets that the client has dysfunction of which of the following parts of the digestive system?

• A. Chief cells of the stomach
• B. Parietal cells of the stomach
• C. Lower esophageal sphincter
• D. Upper esophageal sphincter

Correct answer: C

Rationale: The lower esophageal sphincter is a functional sphincter that normally remains closed except when food or fluids are swallowed. If relaxation of this sphincter occurs, the client could experience symptoms of gastroesophageal reflux disease.

2. 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.

3. Findings during an endoscopic exam include a cobblestone appearance of the colon in your patient. The findings are characteristic of which disorder?

• A. Ulcer
• B. Crohn’s disease
• C. Chronic gastritis
• D. Ulcerative colitis

Correct answer: B

Rationale: The cobblestone appearance of the colon is characteristic of Crohn’s disease.

4. The client has orders for a nasogastric (NG) tube insertion. During the procedure, instructions that will assist in the insertion would be:

• A. Instruct the client to tilt his head back for insertion in the nostril, then flex his neck for the final insertion
• B. After insertion into the nostril, instruct the client to extend his neck
• C. Introduce the tube with the client’s head tilted back, then instruct him to keep his head upright for final insertion
• D. Instruct the client to hold his chin down, then back for insertion of the tube

Correct answer: A

Rationale: Instructing the client to tilt his head back for insertion in the nostril, then flex his neck for the final insertion helps facilitate the NG tube insertion.

5. You’re preparing a teaching plan for a 27 y.o. named Jeff who underwent surgery to close a temporary ileostomy. Which nutritional guideline do you include in this plan?

• A. There is no need to change eating habits.
• B. Eat six small meals a day.
• C. Eat the largest meal in the evening.
• D. Restrict fluid intake.

Correct answer: B

Rationale: After ileostomy closure surgery, it is recommended to eat six small meals a day to aid digestion and absorption.

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