Nursing Elites

1. Crohn’s disease can be described as a chronic relapsing disease. Which of the following areas in the GI system may be involved with this disease?

• A. The entire length of the large colon
• B. Only the sigmoid area
• C. The entire large colon through the layers of mucosa and submucosa
• D. The small intestine and colon; affecting the entire thickness of the bowel

Correct answer: D

Rationale: Crohn's disease can affect any part of the gastrointestinal tract from the mouth to the anus, but it commonly affects the small intestine and colon, involving the entire thickness of the bowel wall.

2. 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.

3. A client being treated for chronic cholecystitis should be given which of the following instructions?

• A. Increase rest
• B. Avoid antacids
• C. Increase protein in diet
• D. Use anticholinergics as prescribed

Correct answer: D

Rationale: Using anticholinergics as prescribed can help manage the symptoms of chronic cholecystitis.

4. The client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate post-op period for which of the following most frequent complications of this type of surgery?

• A. Intestinal obstruction
• B. Fluid and electrolyte imbalance
• C. Malabsorption of fat
• D. Folate deficiency

Correct answer: B

Rationale: Fluid and electrolyte imbalance is a common complication following ileostomy surgery due to the loss of large volumes of fluid and electrolytes through the stoma. Monitoring and replacing fluids and electrolytes is essential.

5. 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.

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