Nursing Elites

1. A client with gastric cancer can expect to have surgery for resection. Which of the following should be the nursing management priority for the preoperative client with gastric cancer?

• A. Discharge planning
• B. Correction of nutritional deficits
• C. Prevention of DVT
• D. Instruction regarding radiation treatment

Correct answer: B

Rationale: The priority for preoperative management of a client with gastric cancer is the correction of nutritional deficits.

2. Which of the following dietary measures would be useful in preventing esophageal reflux?

• A. Eating small, frequent meals
• B. Increasing fluid intake
• C. Avoiding air swallowing with meals
• D. Adding a bedtime snack to the dietary plan

Correct answer: A

Rationale: Eating small, frequent meals helps prevent esophageal reflux.

3. After gastric resection surgery, which of the following signs and symptoms would alert the nurse to the development of a leaking anastomosis?

• A. Pain, fever, and abdominal rigidity.
• B. Diarrhea with fat in the stool.
• C. Palpitations, pallor, and diaphoresis after eating.
• D. Feelings of fullness and nausea after eating.

Correct answer: A

Rationale: Pain, fever, and abdominal rigidity are signs and symptoms of inflammation or peritonitis caused by the leaking anastomosis. Diarrhea with fat in the stool is steatorrhea and is not present in peritonitis. Palpitations, pallor, and diaphoresis after eating are vasomotor symptoms of gastric retention. Feelings of fullness and nausea after eating are not present in peritonitis.

4. Matt is a 49 y.o. with a hiatal hernia that you are about to counsel. Health care counseling for Matt should include which of the following instructions?

• A. Restrict intake of high-carbohydrate foods.
• B. Increase fluid intake with meals.
• C. Increase fat intake.
• D. Eat three regular meals a day.

Correct answer: D

Rationale: For a patient with a hiatal hernia, it is important to eat three regular meals a day to prevent symptoms.

5. A client is admitted with a diagnosis of ulcerative colitis. Which of the following symptoms should the nurse expect the client to report when responding to questions about his bowel elimination pattern?

• A. Constipation.
• B. Bloody, diarrheal stools.
• C. Steatorrhea.
• D. Alternating periods of constipation and diarrhea.

Correct answer: B

Rationale: Diarrhea is the primary symptom of ulcerative colitis. It is profuse and severe; the client may pass as many as 15 to 20 watery stools per day. Stools may contain blood, mucus, and pus. The frequent diarrhea is often accompanied by anorexia and nausea. Constipation is not a sign or symptom of ulcerative colitis. Steatorrhea (fatty stools) is more typical of pancreatitis and cholecystitis. Alternating diarrhea and constipation is associated with irritable bowel syndrome.

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