Nursing Elites

1. Which medication should a patient with a history of peptic ulcer disease avoid?

• A. Acetaminophen
• B. Antacids
• C. Nonsteroidal anti-inflammatory drugs
• D. Antihistamines

Correct answer: C

Rationale: Patients with a history of peptic ulcer disease should avoid Nonsteroidal anti-inflammatory drugs (NSAIDs) because they can worsen peptic ulcers due to their effects on the stomach lining. Acetaminophen (Choice A) is a safer alternative for pain relief in such patients as it does not have the same ulcerogenic effects. Antacids (Choice B) can actually help alleviate symptoms by neutralizing stomach acid and are generally safe to use. Antihistamines (Choice D) are not known to exacerbate peptic ulcers and can be used safely for conditions like allergies.

2. After attempting suicide by taking 200 acetaminophen (Tylenol) tablets, a client is transferred from the emergency department to the locked psychiatric unit. The client is now awake and alert but refuses to speak with the nurse. In this situation, what is the nurse’s first priority?

• A. Establish a rapport to foster trust
• B. Place the client in full restraints
• C. Try to communicate with the client in writing
• D. Ensure safety by initiating suicide precautions

Correct answer: D

Rationale: The nurse's first priority in this situation is to ensure the client's safety by initiating suicide precautions. This involves removing any potential means of self-harm and closely monitoring the client to prevent further attempts. While establishing rapport and communication are important, safety is paramount at this critical juncture. Placing the client in full restraints should be avoided unless absolutely necessary for immediate safety concerns.

3. The client has failed to conceive after many attempts over a three-year time period and asks the nurse, “I have tried everything. What should I do now?” Which statement is the nurse’s best response?

• A. Assess the intravenous fluids for rate and volume
• B. Change the surgical dressing every day at the same time
• C. Monitor the client’s medication levels daily
• D. Monitor the percentage of each meal eaten

Correct answer: A

Rationale: The correct response is to assess the intravenous fluids for rate and volume. In this situation, the client is seeking guidance on fertility issues, not related to intravenous fluids, surgical dressing changes, medication levels, or meal monitoring. The nurse should provide supportive and empathetic guidance, suggesting further options like consulting fertility specialists or exploring additional treatments.

4. The nurse has given post-procedure instructions to a client who underwent a colonoscopy. Evaluation of learning would be evident if the client makes which statement(s)?

• A. All of the above
• B. “My abdominal muscles may be tender because of the procedure.”
• C. “My diet should be light at first, and then I can progress to a regular diet.”
• D. “It is normal to feel gassy or bloated for a short while after the procedure.”

Correct answer: A

Rationale: The correct answer is A: "All of the above." Evaluation of learning after a colonoscopy would be evident if the client mentions all the statements provided. Mild tenderness in the abdominal muscles, starting with a light diet and progressing to a regular diet, and experiencing gas or bloating temporarily are all expected after a colonoscopy. Therefore, all the statements are correct in demonstrating the client's understanding of the post-procedure instructions. Choices B, C, and D provide accurate information about the expected outcomes following a colonoscopy, making them incorrect answers individually but correct when combined as option A.

5. Which of the following nursing interventions is important for a client scheduled to have a Guaiac Test?

• A. Avoid turnips, radish, and horseradish 3 days before
• B. Continue iron preparation to prevent further loss
• C. Do not consume meat 12 hours before the procedure
• D. Encourage consumption of caffeine and dark-colored foods

Correct answer: A

Rationale: The correct answer is A. Turnips, radish, and horseradish are known to cause false-positive results in a Guaiac Test, which is used to detect blood in the stool. Avoiding these foods is crucial to ensure accurate test results. Choice B is incorrect as iron preparation is not directly related to the Guaiac Test. Choice C is incorrect because avoiding meat is not specifically necessary before a Guaiac Test. Choice D is incorrect as caffeine and dark-colored foods can potentially interfere with test results, so they should not be encouraged.

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