Nursing Elites

1. A client with suspected gastric cancer undergoes an endoscopy of the stomach. Which of the following assessments made after the procedure would indicate the development of a potential complication?

• A. The client complains of a sore throat
• B. The client displays signs of sedation
• C. The client experiences a sudden increase in temperature
• D. The client demonstrates a lack of appetite

Correct answer: C

Rationale: A sudden increase in temperature after an endoscopy can indicate a potential complication, such as perforation.

2. Your patient has a retractable gastric peptic ulcer and has had a gastric vagotomy. Which factor increases as a result of vagotomy?

• A. Peristalsis.
• B. Gastric acidity.
• C. Gastric motility.
• D. Gastric pH.

Correct answer: D

Rationale: After a gastric vagotomy, the gastric pH increases as a result of reduced acid secretion.

3. Five days after undergoing surgery, a client develops a small-bowel obstruction. A Miller-Abbott tube is inserted for bowel decompression. Which nursing diagnosis takes priority?

• A. Imbalanced nutrition: Less than body requirements
• B. Acute pain
• C. Deficient fluid volume
• D. Excess fluid volume

Correct answer: C

Rationale: For a client with a small-bowel obstruction and a Miller-Abbott tube, deficient fluid volume is the priority nursing diagnosis.

4. Which of the following types of diets is implicated in the development of diverticulosis?

• A. Low-fiber diet
• B. High-fiber diet
• C. High-protein diet
• D. Low-carbohydrate diet

Correct answer: A

Rationale: A low-fiber diet is implicated in the development of diverticulosis because it leads to harder stools and increased pressure in the colon. The lack of fiber results in decreased bulk and slower transit time, predisposing individuals to constipation and the formation of diverticula. High-fiber diets, on the other hand, promote regular bowel movements and help prevent diverticular disease. High-protein and low-carbohydrate diets do not have a direct association with diverticulosis.

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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