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. The nurse is caring for a hospitalized client with a diagnosis of ulcerative colitis. Which finding, if noted on assessment of the client, would the nurse report to the physician?

• A. Bloody diarrhea
• B. Hypotension
• C. A hemoglobin of 12 mg/dL
• D. Rebound tenderness

Correct answer: D

Rationale: Rebound tenderness is a sign of peritonitis, a serious complication that needs to be reported to the physician immediately.

3. The nurse is reviewing the medication record of a client with acute gastritis. Which medication, if noted on the client’s record, would the nurse question?

• A. Digoxin (Lanoxin)
• B. Indomethacin (Indocin)
• C. Furosemide (Lasix)
• D. Propranolol hydrochloride (Inderal)

Correct answer: B

Rationale: Indomethacin (Indocin) is an NSAID that can aggravate acute gastritis and should be questioned.

4. Which area of the alimentary canal is the most common location for Crohn’s disease?

• A. Ascending colon
• B. Descending colon
• C. Sigmoid colon
• D. Terminal ileum

Correct answer: D

Rationale: The terminal ileum is the most common location for Crohn's disease.

5. Which of the following terms best describes the pain associated with appendicitis?

• A. Aching
• B. Fleeting
• C. Intermittent
• D. Steady

Correct answer: D

Rationale: The correct answer is D: Steady. The pain associated with appendicitis is typically constant and steady, especially in the lower right quadrant of the abdomen. It is not described as aching (choice A) because it is more persistent and severe than a dull ache. It is not fleeting (choice B) as appendicitis pain tends to worsen over time. It is also not intermittent (choice C) as the pain is continuous and does not come and go.

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