Nursing Elites

1. If a gastric acid perforates, which of the following actions should not be included in the immediate management of the client?

• A. Blood replacement
• B. Antacid administration
• C. Nasogastric tube suction
• D. Fluid and electrolyte replacement

Correct answer: B

Rationale: Antacid administration should not be included in the immediate management of a gastric perforation.

2. What information is correct about stomach cancer?

• A. Stomach pain is often a late symptom.
• B. Surgery is often a successful treatment.
• C. Chemotherapy and radiation are often successful treatments.
• D. The patient can survive for an extended time with TPN.

Correct answer: A

Rationale: Stomach pain is often a late symptom of stomach cancer.

3. 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.

4. The nurse is evaluating the plan of care for a client with peptic ulcer disease with a nursing diagnosis of Acute Pain. The nurse would determine that the client has not met the expected outcomes if the client states

• A. That pain is relieved with histamine H2 receptor antagonists.
• B. That irritating foods have been eliminated from the diet.
• C. The client is being awakened at 2 AM with heartburn.
• D. The client has absence of pain before meals.

Correct answer: C

Rationale: Expected outcomes for the client with peptic ulcer disease experiencing pain include elimination of irritating foods from the diet, ability to take prescribed medications that will reduce pain, reporting that the pain is relieved or prevented with medication, and an ability to sleep through the night without pain. The client who continues to be awakened by pain requires further modification of medication therapy, which may include adjustment of timing of histamine H2 receptor antagonist or an additional dose of antacid before the time when pain awakens the client.

5. After abdominal surgery, your patient has a severe coughing episode that causes wound evisceration. In addition to calling the doctor, which intervention is most appropriate?

• A. Irrigate the wound & organs with Betadine.
• B. Cover the wound with a saline soaked sterile dressing.
• C. Apply a dry sterile dressing & binder.
• D. Push the organs back & cover with moist sterile dressings.

Correct answer: B

Rationale: Covering the wound with a saline soaked sterile dressing is the most appropriate intervention for wound evisceration.

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