Nursing Elites

1. The nurse is caring for a hospitalized client with a diagnosis of ulcerative colitis. Which finding, if noted on assessment of the client, would the nurse report to the physician?

• A. Bloody diarrhea
• B. Hypotension
• C. A hemoglobin of 12 mg/dL
• D. Rebound tenderness

Correct answer: D

Rationale: Rebound tenderness is a sign of peritonitis, a serious complication that needs to be reported to the physician immediately.

2. The nurse is reviewing the record of a client with Crohn’s disease. Which of the following stool characteristics would the nurse expect to note documented in the client’s record?

• A. Chronic constipation
• B. Diarrhea
• C. Constipation alternating with diarrhea
• D. Stool constantly oozing from the rectum

Correct answer: B

Rationale: Crohn’s disease is characterized by nonbloody diarrhea of usually not more than four to five stools daily. Over time, the diarrhea episodes increase in frequency, duration, and severity. Chronic constipation (Choice A), constipation alternating with diarrhea (Choice C), and stool constantly oozing from the rectum (Choice D) are not characteristics typically associated with Crohn’s disease.

3. A female client complains of gnawing epigastric pain for a few hours after meals. At times, when the pain is severe, vomiting occurs. Specific tests are indicated to rule out:

• A. Cancer of the stomach
• B. Peptic ulcer disease
• C. Chronic gastritis
• D. Pylorospasm

Correct answer: A

Rationale: Specific tests are indicated to rule out cancer of the stomach when a client complains of gnawing epigastric pain and vomiting after meals.

4. A client has been taking aluminum hydroxide 30 mL six times per day at home to treat his peptic ulcer. He tells the nurse that he has been unable to have a bowel movement for 3 days. Based on this information, the nurse would determine that which of the following is the most likely cause of the client’s constipation?

• A. The client has not been including enough fiber in his diet
• B. The client needs to increase his daily exercise
• C. The client is experiencing a side effect of the aluminum hydroxide.
• D. The client has developed a gastrointestinal obstruction.

Correct answer: C

Rationale: The client is experiencing a common side effect of aluminum hydroxide, which is constipation.

5. Type A chronic gastritis can be distinguished from type B by its ability to:

• A. Cause atrophy of the parietal cells.
• B. Affect only the antrum of the stomach.
• C. Thin the lining of the stomach walls.
• D. Decrease gastric secretions.

Correct answer: A

Rationale: Type A chronic gastritis can cause atrophy of the parietal cells, which is a distinguishing feature from type B.

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