Nursing Elites

1. Cholestyramine resin (Questran Light) is prescribed for the client with an elevated serum cholesterol level. The nurse would instruct the client to take the medication

• A. After meals.
• B. Mixed with fruit juice.
• C. Via rectal suppository.
• D. At least 3 hours before meals.

Correct answer: B

Rationale: Cholestyramine resin binds with bile salts in the intestines to form a compound that is excreted in the feces. The client should be instructed to mix the medication with 3 to 6 oz of water, milk, fruit juice, or soup. The medication should be administered before meals. The medication is not administered via rectal suppository.

2. The client has been admitted with a diagnosis of acute pancreatitis. The nurse would assess this client for pain that is:

• A. Severe and unrelenting, located in the epigastric area and radiating to the back.
• B. Severe and unrelenting, located in the left lower quadrant and radiating to the groin.
• C. Burning and aching, located in the epigastric area and radiating to the umbilicus.
• D. Burning and aching, located in the left lower quadrant and radiating to the hip.

Correct answer: A

Rationale: Acute pancreatitis typically presents with severe, unrelenting pain in the epigastric area that radiates to the back. This pain is due to inflammation and autodigestion of the pancreas.

3. 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.

4. Which of the following complications is thought to be the most common cause of appendicitis?

• A. A fecalith
• B. Bowel kinking
• C. Internal bowel occlusion
• D. Abdominal bowel swelling

Correct answer: A

Rationale: A fecalith is a hardened stool that can block the appendix, leading to inflammation and infection, which is the most common cause of appendicitis.

5. Which of the following would be an expected nutritional outcome for a client who has undergone a subtotal gastrectomy for cancer?

• A. Regain weight loss within 1 month after surgery
• B. Resume normal dietary intake of three meals per day
• C. Control nausea and vomiting through regular use of antiemetics
• D. Achieve optimal nutritional status through oral or parenteral feedings

Correct answer: D

Rationale: Achieving optimal nutritional status through oral or parenteral feedings is an expected nutritional outcome for a client who has undergone a subtotal gastrectomy for cancer.

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