Nursing Elites

1. The client with ascites is scheduled for a paracentesis. The nurse is assisting the physician in performing the procedure. Which of the following positions will the nurse assist the client to assume for this procedure?

• A. Supine
• B. Left side-lying
• C. Right side-lying
• D. Upright position.

Correct answer: D

Rationale: An upright position allows the intestine to float posteriorly and helps prevent intestinal laceration during catheter insertion.

2. The client being seen in a physician’s office has just been scheduled for a barium swallow the next day. The nurse writes down which of the following instructions for the client to follow before the test?

• A. Fast for 8 hours before the test.
• B. Eat a regular supper and breakfast.
• C. Continue to take all oral medications as scheduled.
• D. Monitor own bowel movement pattern for constipation

Correct answer: A

Rationale: A barium swallow is an x-ray study that uses a substance called barium for contrast to highlight abnormalities in the gastrointestinal tract. The client should fast for 8 to 12 hours before the test, depending on physician instructions. Most oral medications also are withheld before the test. After the procedure the nurse must monitor for constipation, which can occur as a result of the presence of barium in the gastrointestinal tract.

3. Jason, a 22 y.o. accident victim, requires an NG tube for feeding. What should you immediately do after inserting an NG tube for liquid enteral feedings?

• A. Aspirate for gastric secretions with a syringe.
• B. Begin feeding slowly to prevent cramping.
• C. Get an X-ray of the tip of the tube within 24 hours.
• D. Clamp off the tube until the feedings begin.

Correct answer: A

Rationale: Immediately after inserting an NG tube for enteral feedings, aspirate for gastric secretions to confirm proper placement.

4. Gail is scheduled for a cholecystectomy. After completion of preoperative teaching, Gail states,”If I lie still and avoid turning after the operation, I’ll avoid pain. Do you think this is a good idea?” What is the best response?

• A. You’ll need to turn from side to side every 2 hours.
• B. It’s always a good idea to rest quietly after surgery.
• C. The doctor will probably order you to lie flat for 24 hours.
• D. Why don’t you decide about activity after you return from the recovery room?

Correct answer: A

Rationale: The best response to Gail is to inform her that she will need to turn from side to side every 2 hours to prevent complications.

5. Which of the following complications of gastric resection should the nurse teach the client to watch for?

• A. Constipation
• B. Dumping syndrome
• C. Gastric spasm
• D. Intestinal spasms

Correct answer: B

Rationale: Clients should be taught to watch for symptoms of dumping syndrome, a common complication after gastric resection.

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