Nursing Elites

1. A patient has a severe exacerbation of ulcerative colitis. Long-term medications will probably include:

• A. Antacids.
• B. Antibiotics.
• C. Corticosteroids.
• D. Histamine2-receptor blockers.

Correct answer: C

Rationale: Long-term medications for a severe exacerbation of ulcerative colitis probably include corticosteroids.

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. A client with peptic ulcer is scheduled for a Vagotomy. The client asks the nurse about the purpose of this procedure. The nurse tells the client that the procedure

• A. Decreases food absorption in the stomach.
• B. Heals the gastric mucosa.
• C. Halts stress reactions.
• D. Reduces the stimulus to acid secretions.

Correct answer: D

Rationale: A vagotomy, or cutting of the vagus nerve, is done to eliminate parasympathetic stimulation of gastric secretion, thereby reducing the stimulus to acid secretions. Options A, B, and C are incorrect as a vagotomy does not affect food absorption, heal the gastric mucosa, or halt stress reactions.

4. Which of the following associated disorders may the client with Crohn’s disease exhibit?

• A. Ankylosing spondylitis
• B. Colon cancer
• C. Malabsorption
• D. Lactase deficiency

Correct answer: A

Rationale: Clients with Crohn's disease may exhibit associated disorders such as ankylosing spondylitis, which is an inflammatory condition affecting the spine.

5. The nurse assesses the client's understanding of the relationship between body position and gastroesophageal reflux. Which response would indicate that the client understands measures to avoid problems with reflux while sleeping?

• A. I can elevate the foot of the bed 4 to 6 inches.
• B. I can sleep on my stomach with my head turned to the left.
• C. I can sleep on my back without a pillow under my head.
• D. I can elevate the head of the bed 4 to 6 inches.

Correct answer: D

Rationale: Sleeping with the head of the bed elevated encourages movement of food through the esophagus by gravity. By fostering esophageal acid clearance, gravity helps keep the acidic pepsin and alkaline biliary secretions from contacting the esophagus. Elevating the foot of the bed does not affect clearance of esophageal acid. Sleeping on the stomach with the head turned to the left will not decrease reflux incidence. Sleeping flat without a pillow under the head does not enhance clearance.

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