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. Which of the following expected outcomes would be most appropriate for a client with peptic ulcer disease? The client will:

• A. verbalize absence of epigastric pain.
• B. accept the need to inject himself with vitamin B12 for the rest of his life.
• C. understand the need to increase his exercise activity.
• D. eliminate stress from his life.

Correct answer: A

Rationale: A realistic goal for this client would be to gain relief from epigastric pain. There is no need for vitamin B12 injections because this client has not had any gastric surgery that would lead to vitamin B12 deficiency. Exercise should be modified, not increased, because it can stimulate further production of gastric acid. It is not possible to eliminate stress from a client's life. Instead, the client should be assisted to develop effective coping and problem-solving strategies as necessary.

3. A client being treated for chronic cholecystitis should be given which of the following instructions?

• A. Increase rest
• B. Avoid antacids
• C. Increase protein in diet
• D. Use anticholinergics as prescribed

Correct answer: D

Rationale: Using anticholinergics as prescribed can help manage the symptoms of chronic cholecystitis.

4. You’re caring for a 28 y.o. woman with hepatitis B. She’s concerned about the duration of her recovery. Which response isn’t appropriate?

• A. Encourage her to not worry about the future.
• B. Encourage her to express her feelings about the illness.
• C. Discuss the effects of hepatitis B on future health problems.
• D. Provide avenues for financial counseling if she expresses the need.

Correct answer: A

Rationale: Encouraging the patient to not worry about the future is not appropriate. Instead, address her concerns and provide information.

5. Which of the following associated disorders may a client with ulcerative colitis exhibit?

• A. Gallstones
• B. Hydronephrosis
• C. Nephrolithiasis
• D. Toxic megacolon

Correct answer: D

Rationale: Toxic megacolon is a severe complication that may be exhibited by a client with ulcerative colitis.

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