Nursing Elites

1. The nurse is caring for a client following a Billroth II procedure. On review of the post-operative orders, which of the following, if prescribed, would the nurse question and verify?

• A. Irrigating the nasogastric tube
• B. Coughing a deep breathing exercises
• C. Leg exercises
• D. Early ambulation

Correct answer: A

Rationale: Irrigating the nasogastric tube is typically not recommended after a Billroth II procedure unless specifically ordered by a physician due to the risk of disrupting the surgical site.

2. A client is suspected of having hepatitis. Which diagnostic test results will assist in confirming this diagnosis?

• A. Decreased erythrocyte sedimentation rate
• B. Elevated serum bilirubin
• C. Elevated hemoglobin
• D. Elevated blood urea nitrogen

Correct answer: B

Rationale: Laboratory indicators of hepatitis include elevated liver enzyme levels, elevated serum bilirubin levels, elevated erythrocyte sedimentation rates, and leucopenia. An elevated blood urea nitrogen may indicate renal dysfunction. A hemoglobin level is unrelated to this diagnosis.

3. Christina is receiving an enteral feeding that requires a concentration of 80ml of supplement mixed with 20 ml of water. How much water do you mix with an 8 oz (240ml) can of feeding?

• A. 60 ml.
• B. 70 ml.
• C. 80 ml.
• D. 90 ml.

Correct answer: A

Rationale: For an 8 oz (240 ml) can of feeding, mix 60 ml of water to achieve the required concentration.

4. The nurse is caring for a client admitted to the hospital with a suspected diagnosis of acute appendicitis. Which of the following laboratory results would the nurse expect to note if the client indeed has appendicitis?

• A. Leukopenia with a shift to the right
• B. Leukocytosis with a shift to the right
• C. Leukocytosis with a shift to the left
• D. Leukopenia with a shift to the left

Correct answer: C

Rationale: Laboratory findings do not establish the diagnosis of appendicitis, but often moderate elevation of the white blood cell count (leukocytosis) to 10,000 to 18,000 cells/mm3 occurs with a “shift to the left” (an increased number of immature white blood cells.).

5. You’re caring for Lewis, a 67 y.o. patient with liver cirrhosis who develops ascites and requires paracentesis. Relief of which symptom indicated that the paracentesis was effective?

• A. Pruritus
• B. Dyspnea
• C. Jaundice
• D. Peripheral Neuropathy

Correct answer: B

Rationale: Dyspnea relief indicates that the paracentesis was effective in reducing ascites.

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