Nursing Elites

1. Mucosal barrier fortifiers are used in peptic ulcer disease management for which of the following indications?

• A. To inhibit mucus production
• B. To neutralize acid production
• C. To stimulate mucus production
• D. To stimulate hydrogen ion diffusion back into the mucosa

Correct answer: C

Rationale: Mucosal barrier fortifiers stimulate mucus production, which helps protect the lining of the stomach and manage peptic ulcer disease.

2. 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.

3. The nurse is preparing to discontinue a client’s nasogastric tube. The client is positioned properly, and the tube has been flushed with 15 mL of air to clear secretions. Before removing the tube, the nurse makes which statement to the client?

• A. Take a deep breath when I tell you and breathe normally while I remove the tube.
• B. Take a deep breath when I tell you and bear down while I remove the tube.
• C. Take a deep breath when I tell you and slowly exhale while I remove the tube.
• D. Take a deep breath when I tell you and hold it while I remove the tube.

Correct answer: C

Rationale: The client should take a deep breath because the client’s airway will be obstructed temporarily during tube removal. The nurse then tells the client to exhale slowly and withdraws the tube during exhalation. Bearing down could inhibit the removal of the tube. Breathing normally could result in aspiration of gastric secretions during inhalation. Holding the breath does not facilitate tube removal.

4. The client with a colostomy has an order for irrigation of the colostomy. The nurse uses which solution for the irrigation?

• A. Distilled water
• B. Tap water
• C. Sterile water
• D. Lactated Ringer’s

Correct answer: B

Rationale: The correct solution to use for the irrigation of a colostomy is warm tap water or saline solution. If tap water is not suitable for drinking, bottled water can be used. Distilled water, sterile water, and Lactated Ringer’s are not appropriate solutions for colostomy irrigation. Distilled water lacks essential minerals, sterile water may not provide adequate cleaning, and Lactated Ringer’s is not indicated for this procedure.

5. Which of the following aspects is the priority focus of nursing management for a client with peritonitis?

• A. Fluid and electrolyte balance
• B. Gastric irrigation
• C. Pain management
• D. Psychosocial issues

Correct answer: A

Rationale: The priority focus of nursing management for a client with peritonitis is fluid and electrolyte balance to prevent shock.

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