Nursing Elites

1. A 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 the 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.

2. 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. administration of pain medication every 4 hours
• C. Evaluating the client's response to antidiarrheal medications
• D. Maintaining intake and output records

Correct answer: D

Rationale: Delegating tasks such as providing skin care, maintaining intake and output records, and obtaining the client's weight are within the scope of practice for an unlicensed assistant. Assessing bowel sounds and evaluating the response to medications require nursing judgment and should not be delegated.

3. Which of the following tasks should be included in the immediate postoperative management of a client who has undergone gastric resection?

• A. Monitoring gastric pH to detect complications
• B. Assessing for bowel sounds
• C. Providing nutritional support
• D. Monitoring for symptoms of hemorrhage

Correct answer: D

Rationale: Monitoring for symptoms of hemorrhage is a crucial part of the immediate postoperative management of a client who has undergone gastric resection.

4. Type A chronic gastritis can be distinguished from type B by its ability to:

• A. Cause atrophy of the parietal cells.
• B. Affect only the antrum of the stomach.
• C. Thin the lining of the stomach walls.
• D. Decrease gastric secretions.

Correct answer: A

Rationale: Type A chronic gastritis can cause atrophy of the parietal cells, which is a distinguishing feature from type B.

5. 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.

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