Nursing Elites

1. A nurse is giving dietary instructions to a client who has a new colostomy. The nurse encourages the client to eat foods representing which of the following diets for the first 4 to 6 weeks postoperatively?

• A. High-protein
• B. High-carbohydrate
• C. Low-calorie
• D. Low-residue

Correct answer: D

Rationale: For the first 4 to 6 weeks following colostomy formation, the client should take in a low-residue diet. Following this period, the client should eat a high-carbohydrate, high-protein diet. The nurse also instructs the client to add new foods, one at a time, to determine tolerance to that food.

2. Which of the following expected outcomes would be appropriate for the client who has ulcerative colitis?

• A. The client maintains a daily record of intake and output.
• B. The client verbalizes the importance of small, frequent feedings.
• C. The client uses a heating pad to decrease abdominal cramping.
• D. The client accepts that a colostomy is inevitable at some time in his life.

Correct answer: B

Rationale: Small, frequent feedings are better tolerated by clients with ulcerative colitis as they lessen the amount of fecal material present in the gastrointestinal tract and decrease stimulation. The client does not need to maintain a daily record of intake and output unless an exacerbation of the disease occurs. A heating pad should not be applied to the intestine as it is inflamed. It is not inevitable that the client will require surgery to treat ulcerative colitis.

3. Which of the following diagnostic tests should be performed annually over age 50 to screen for colon cancer?

• A. Abdominal CT scan
• B. Abdominal x-ray
• C. Colonoscopy
• D. Fecal occult blood test

Correct answer: D

Rationale: A fecal occult blood test should be performed annually for individuals over age 50 to screen for colon cancer.

4. A nurse orientee is preparing to insert a nasogastric tube, and a nurse educator is observing the procedure. Which of the following supplies if obtained by the nurse orientee would indicate a need for further education regarding this procedure?

• A. Half-inch or one-inch tape
• B. Oil-soluble lubricant
• C. A glass of tap water with a straw
• D. A 50-mL catheter tip syringe

Correct answer: B

Rationale: Water-soluble lubricant is used to lubricate 3 to 4 inches of the tube at the insertion end. An oil lubricant is not used because if the tube accidentally goes into the bronchus, pneumonia can develop. Half-inch tape is used to secure the tube after the correct placement is verified. A 50-mL catheter tip syringe is used to aspirate gastric contents to confirm placement. The client will be asked to take a sip of water through a straw to help with the passage of the tube.

5. You’re caring for a 28 y.o. woman with hepatitis B. She’s concerned about the duration of her recovery. Which response isn’t appropriate?

• A. Encourage her to not worry about the future.
• B. Encourage her to express her feelings about the illness.
• C. Discuss the effects of hepatitis B on future health problems.
• D. Provide avenues for financial counseling if she expresses the need.

Correct answer: A

Rationale: Encouraging the patient to not worry about the future is not appropriate. Instead, address her concerns and provide information.

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