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. Medical management of the client with diverticulitis should include which of the following treatments?

• A. Reduced fluid intake
• B. Increased fiber in diet
• C. Administration of antibiotics
• D. Exercises to increase intra-abdominal pressure

Correct answer: C

Rationale: Medical management of diverticulitis typically includes the administration of antibiotics to treat infection and inflammation.

3. You’re patient, post-op drainage of a pelvic abscess secondary to diverticulitis, begins to cough violently after drinking water. His wound has ruptured and a small segment of the bowel is protruding. What’s your priority?

• A. Ask the patient what happened, call the doctor, and cover the area with a water-soaked bedsheet.
• B. Obtain vital signs, call the doctor, and obtain emergency orders.
• C. Have a CAN hold the wound together while you obtain vital signs, call the doctor and flex the patient’s knees.
• D. Have the doctor called while you remain with the patient, flex the patient’s knees, and cover the wound with sterile towels soaked in sterile saline solution.

Correct answer: D

Rationale: For a patient with a ruptured wound and protruding bowel, call the doctor while remaining with the patient, flex the patient’s knees, and cover the wound with sterile towels soaked in sterile saline solution.

4. A client’s ulcerative colitis symptoms have been present for longer than 1 week. The nurse recognizes that the client should be assessed carefully for signs of which of the following complications?

• A. Heart failure
• B. DVT
• C. Hypokalemia
• D. Hypocalcemia

Correct answer: C

Rationale: The client should be assessed carefully for signs of hypokalemia, a common complication of prolonged ulcerative colitis symptoms.

5. Which of the following tests should be administered to a client suspected of having diverticulosis?

• A. Abdominal ultrasound
• B. Barium enema
• C. Barium swallow
• D. Gastroscopy

Correct answer: B

Rationale: A barium enema is a diagnostic test used to visualize the colon and can help diagnose diverticulosis.

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