Nursing Elites

1. The nurse is caring for a client who has had a gastroscopy. Which of the following symptoms may indicate that the client is developing a complication related to the procedure? Select all that apply.

• A. The client complains of a sore throat
• B. The client has a temperature of 100*F
• C. The client appears drowsy following the procedure
• D. The client complains of epigastric pain

Correct answer: B

Rationale: A temperature of 100°F, epigastric pain, and hematemesis are signs that may indicate a complication related to the gastroscopy procedure.

2. 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.

3. Which of the following aspects is the priority focus of nursing management for a client with peritonitis?

• A. Fluid and electrolyte balance
• B. Gastric irrigation
• C. Pain management
• D. Psychosocial issues

Correct answer: A

Rationale: The priority focus of nursing management for a client with peritonitis is fluid and electrolyte balance to prevent shock.

4. Which of the following techniques would the nurse use first to determine if a nasogastric tube is positioned in the stomach?

• A. Aspirating with a syringe and observing for the return of gastric contents.
• B. Irrigating with normal saline and observing for the return of solution.
• C. Placing the tube's free end in water and observing for air bubbles.
• D. Instilling air and auscultating over the epigastric area for the presence of the tube.

Correct answer: A

Rationale: The initial way to determine if a nasogastric tube is in the stomach is to apply suction to the tube with a syringe and observe for the return of stomach contents. Then the pH of the aspirate can be measured. This is the method of choice. One would not irrigate until tube placement is confirmed. Observing for air bubbles when the free end of the tube is placed under water is an unacceptable, unsafe method of determining tube placement. Another method is to instill air into the tube with a syringe while auscultating over the epigastric area. Hearing the air enter the stomach helps ensure proper placement, but the method is not foolproof and is no longer considered an effective or preferred way to determine placement.

5. When counseling a client in ways to prevent cholecystitis, which of the following guidelines is most important?

• A. Eat a low-protein diet
• B. Eat a low-fat, low-cholesterol diet
• C. Limit exercise to 10 minutes/day
• D. Keep weight proportionate to height

Correct answer: B

Rationale: Eating a low-fat, low-cholesterol diet is most important for preventing cholecystitis.

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