Nursing Elites

1. Sitty, a 66 y.o. patient underwent a colostomy for ruptured diverticulum. She did well during the surgery and returned to your med-surg floor in stable condition. You assess her colostomy 2 days after surgery. Which finding do you report to the doctor?

• A. Blanched stoma
• B. Edematous stoma
• C. Reddish-pink stoma
• D. Brownish-black stoma

Correct answer: A

Rationale: A blanched stoma 2 days after colostomy surgery should be reported to the doctor as it may indicate compromised blood flow.

2. A client with gastric cancer may exhibit which of the following symptoms?

• A. Abdominal cramping
• B. Constant hunger
• C. Feeling of fullness
• D. Weight gain

Correct answer: C

Rationale: Clients with gastric cancer may experience a feeling of fullness due to the presence of the tumor.

3. Kevin has a history of peptic ulcer disease and vomits coffee-ground emesis. What does this indicate?

• A. He has fresh, active upper GI bleeding.
• B. He needs immediate saline gastric lavage.
• C. His gastric bleeding occurred 2 hours earlier.
• D. He needs a transfusion of packed RBCs.

Correct answer: C

Rationale: Coffee-ground emesis is a sign of upper gastrointestinal bleeding that occurred approximately 2 hours earlier. It results from the breakdown of blood in the stomach due to digestive enzymes, giving it a coffee-ground appearance. Choice A is incorrect because coffee-ground emesis indicates older, partially digested blood, not fresh active bleeding. Choice B is incorrect as gastric lavage is not indicated for coffee-ground emesis. Choice D is incorrect because a transfusion of packed RBCs is not the immediate management for this presentation.

4. A 53 y.o. patient has undergone a partial gastrectomy for adenocarcinoma of the stomach. An NG tube is in place and is connected to low continuous suction. During the immediate postoperative period, you expect the gastric secretions to be which color?

• A. Brown.
• B. Clear.
• C. Red.
• D. Yellow.

Correct answer: C

Rationale: During the immediate postoperative period after a partial gastrectomy, gastric secretions are expected to be red.

5. You are developing a careplan on Sally, a 67 y.o. patient with hepatic encephalopathy. Which of the following do you include?

• A. Administering a lactulose enema as ordered.
• B. Encouraging a protein-rich diet.
• C. Administering sedatives, as necessary.
• D. Encouraging ambulation at least four times a day.

Correct answer: A

Rationale: Administering a lactulose enema as ordered helps reduce ammonia levels in patients with hepatic encephalopathy.

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