Nursing Elites

1. The nurse has provided home care instructions to a client who had a subtotal gastrectomy. The nurse instructs the client regarding the signs and symptoms associated with dumping syndrome. Which of the following signs and symptoms, if identified by the client, indicates an understanding of this potential complication following gastrointestinal surgery?

• A. Hiccups and diarrhea
• B. Fatigue and abdominal pain
• C. Constipation and fever
• D. Diaphoresis and diarrhea

Correct answer: D

Rationale: The correct answer is D: Diaphoresis and diarrhea. Dumping syndrome occurs after gastric surgery when food moves quickly from the stomach to the intestine, causing fluid shifts and leading to symptoms like weakness, dizziness, diaphoresis, flushing, hypotension, abdominal pain, distension, hyperactive bowel sounds, and diarrhea. Choices A, B, and C do not reflect the typical signs and symptoms of dumping syndrome.

2. The nurse is assessing a client 24 hours following a cholecystectomy. The nurse notes that the T-tube has drained 750ml of green-brown drainage. Which nursing intervention is most appropriate?

• A. Notify the physician
• B. Document the findings
• C. Irrigate the T-tube
• D. Clamp the T-tube

Correct answer: B

Rationale: Documenting the findings is the most appropriate action as 750ml of green-brown drainage is expected after a cholecystectomy.

3. Janice is waiting for discharge instructions after her herniorrhaphy. Which of the following instructions do you include?

• A. Eat a low-fiber diet.
• B. Resume heavy lifting in 2 weeks.
• C. Lose weight, if obese.
• D. Resume sexual activity once discomfort is gone.

Correct answer: C

Rationale: Advise the patient to lose weight if obese to reduce the risk of complications after herniorrhaphy.

4. 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.

5. A nurse is caring for a client with cirrhosis of the liver. To minimize the effects of the disorder, the nurse teaches the client about foods that are high in thiamine. The nurse determines that the client has best understanding of the dietary measures to follow of the client states an intention to increase intake of:

• A. Pork
• B. Milk
• C. Chicken
• D. Broccoli

Correct answer: A

Rationale: The client with cirrhosis needs to consume foods high in thiamine. Thiamine is present in a variety of foods of plant and animal origin. Pork products are especially rich in this vitamin. Other good food sources include nuts, whole grain cereals, and legumes. Milk contains vitamins A, D, and B2. Broccoli contains vitamins C, E, and K and folic acid.

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