Nursing Elites

1. Radiation therapy is used to treat colon cancer before surgery for which of the following reasons?

• A. Reducing the size of the tumor
• B. Eliminating the malignant cells
• C. Curing the cancer
• D. Helping the bowel heal after surgery

Correct answer: A

Rationale: Radiation therapy is used before surgery to reduce the size of the tumor, making it easier to remove.

2. The nurse is irrigating a client's colostomy when she complains of abdominal cramping after receiving about 100 mL of the irrigating solution. What should the nurse's first response be in this situation?

• A. Stop the flow of solution temporarily.
• B. Reposition the client on to her right side.
• C. Remove the irrigation tube.
• D. Massage the abdomen gently.

Correct answer: A

Rationale: The abdominal cramping that can occur during colostomy irrigation results from stimulation of the colon by the irrigating solution. The nurse's first response should be to temporarily stop the flow of solution to allow the cramping to subside. Repositioning the client to the right side will not alleviate the cramping. Removing the tube will not decrease the cramping and will necessitate reinsertion of the tube when the irrigation is resumed. Massaging the abdomen gently may be soothing to some clients, but it is not the nurse's first priority action.

3. When teaching an elderly client how to prevent constipation, which of the following instructions should the nurse include?

• A. Drink 6 glasses of fluid each day.
• B. Avoid grain products and nuts.
• C. Add at least 4 grams of brain to your cereal each morning.
• D. Be sure to get regular exercise.

Correct answer: D

Rationale: To prevent constipation, elderly clients should be encouraged to get regular exercise, which promotes bowel motility.

4. A client is admitted with a diagnosis of ulcerative colitis. Which of the following symptoms should the nurse expect the client to report when responding to questions about his bowel elimination pattern?

• A. Constipation.
• B. Bloody, diarrheal stools.
• C. Steatorrhea.
• D. Alternating periods of constipation and diarrhea.

Correct answer: B

Rationale: Diarrhea is the primary symptom of ulcerative colitis. It is profuse and severe; the client may pass as many as 15 to 20 watery stools per day. Stools may contain blood, mucus, and pus. The frequent diarrhea is often accompanied by anorexia and nausea. Constipation is not a sign or symptom of ulcerative colitis. Steatorrhea (fatty stools) is more typical of pancreatitis and cholecystitis. Alternating diarrhea and constipation is associated with irritable bowel syndrome.

5. You have a patient with achalasia (incomplete muscle relaxation of the GI tract, especially sphincter muscles). Which medications do you anticipate to administer?

• A. Isosorbide dinitrate (Isordil)
• B. Digoxin (Lanoxin)
• C. Captopril (Capoten)
• D. Propanolol (Inderal)

Correct answer: A

Rationale: Isosorbide dinitrate (Isordil) is a medication used to relax the muscles of the GI tract in patients with achalasia.

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