Nursing Elites

1. A client is to take one daily dose of ranitidine (Zantac) at home to treat her peptic ulcer. The nurse knows that the client understands proper drug administration of ranitidine when she says that she will take the drug at which of the following times?

• A. Before meals
• B. With meals
• C. At bedtime
• D. When pain occurs

Correct answer: C

Rationale: Ranitidine (Zantac) is best taken at bedtime to reduce stomach acid production overnight.

2. A client returns from surgery with a sigmoid colostomy. An ostomy appliance is attached. The priority nursing diagnosis for daily observation and care is:

• A. Diarrhea related to alteration in bowel elimination.
• B. Impaired skin integrity related to seepage.
• C. Impaired nutrition: More than body requirements related to high-fat diet.
• D. Impaired physical mobility related to surgical procedure.

Correct answer: B

Rationale: Impaired skin integrity would be the priority nursing diagnosis for daily care of the colostomy because the effluent from the colostomy can be irritating to the skin. Diarrhea isn't a concern at this point. The client will be allowed nothing by mouth until peristalsis returns. The client should get out of bed on the first postoperative day, so mobility shouldn't be a problem.

3. Which stoma would you expect a malodorous, enzyme-rich, caustic liquid output that is yellow, green, or brown?

• A. Ileostomy.
• B. Ascending colostomy.
• C. Transverse colostomy.
• D. Descending colostomy.

Correct answer: A

Rationale: An ileostomy would have a malodorous, enzyme-rich, caustic liquid output that is yellow, green, or brown.

4. A nurse is caring for a client who has a new diagnosis of Crohn's disease. Which of the following findings should the nurse expect?

• A. Bloody diarrhea
• B. Fatty stools
• C. Weight gain
• D. High fever

Correct answer: B

Rationale: Clients with Crohn's disease often experience fatty stools (steatorrhea) due to malabsorption of fats. This occurs because the inflammation caused by Crohn's disease can affect the small intestine, impairing the body's ability to absorb nutrients. Bloody diarrhea is more commonly associated with ulcerative colitis. Weight gain is not a typical symptom of Crohn's disease; instead, weight loss is more common due to malabsorption and decreased appetite. High fever can occur during acute flare-ups but is not a primary finding of Crohn's disease.

5. The nurse is reviewing the record of a client with Crohn’s disease. Which of the following stool characteristics would the nurse expect to note documented on the client’s record?

• A. Chronic constipation
• B. Diarrhea
• C. Constipation alternating with diarrhea
• D. Stool constantly oozing from the rectum

Correct answer: B

Rationale: Diarrhea is a common stool characteristic in clients with Crohn’s disease due to inflammation of the gastrointestinal tract.

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