Nursing Elites

1. 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.

2. The student nurse is participating in colorectal cancer-screening program. Which patient has the fewest risk factors for colon cancer?

• A. Janice, a 45 y.o. with a 25-year history of ulcerative colitis
• B. George, a 50 y.o. whose father died of colon cancer
• C. Herman, a 60 y.o. who follows a low-fat, high-fiber diet
• D. Sissy, a 72 y.o. with a history of breast cancer

Correct answer: C

Rationale: Herman, a 60 y.o. who follows a low-fat, high-fiber diet, has the fewest risk factors for colon cancer.

3. The nurse provides medication instructions to a client with peptic ulcer disease. Which statement, if made by the client, indicates best understanding of the medication therapy?

• A. The cimetidine (Tagamet) will cause me to produce less stomach acid.
• B. Sucralfate (Carafate) will change the fluid in my stomach.
• C. Antacids will coat my stomach.
• D. Omeprazole (Prilosec) will coat the ulcer and help it heal.

Correct answer: A

Rationale: Cimetidine (Tagamet) a Histamine H2 receptor antagonist, will decrease the secretion of gastric acid. Sucralfate (Carafate) promotes healing by coating the ulcer. Antacids neutralize acid in the stomach. Omeprazole (Prilosec) inhibits gastric acid secretion.

4. A patient who underwent abdominal surgery now has a gaping incision due to delayed wound healing. Which method is correct when you irrigate a gaping abdominal incision with sterile normal saline solution, using a piston syringe?

• A. Rapidly instill a stream of irrigating solution into the wound.
• B. Apply a wet-to-dry dressing to the wound after the irrigation.
• C. Moisten the area around the wound with normal saline solution after the irrigation.
• D. Irrigate continuously until the solution becomes clear or all of the solution is used.

Correct answer: D

Rationale: Irrigating continuously until the solution becomes clear or all of the solution is used is the correct method when irrigating a gaping abdominal incision.

5. Which stoma would you expect a malodorous, enzyme-rich, caustic liquid output that is yellow, green, or brown?

• A. Ileostomy.
• B. Ascending colostomy.
• C. Transverse colostomy.
• D. Descending colostomy.

Correct answer: A

Rationale: An ileostomy would have a malodorous, enzyme-rich, caustic liquid output that is yellow, green, or brown.

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