Nursing Elites

1. The nurse is planning to teach the client with gastroesophageal reflux disease about substances that will increase the lower esophageal sphincter pressure. Which of the following items would the nurse include on this list?

• A. Fatty foods
• B. Nonfat milk
• C. Chocolate
• D. Coffee

Correct answer: B

Rationale: Foods that increase the lower esophageal sphincter (LES) pressure will decrease reflux, and lessen the symptoms of gastroesophageal reflux disease (GERD). The food substance that will increase the LES pressure is nonfat milk. The other substances listed decrease the LES pressure, thus increasing reflux symptoms. Aggravating substances include chocolate, coffee, fatty foods and alcohol.

2. Which of the following factors is believed to cause ulcerative colitis?

• A. Acidic diet
• B. Altered immunity
• C. Chronic constipation
• D. Emotional stress

Correct answer: B

Rationale: Ulcerative colitis is believed to be caused by an altered immune response in the gastrointestinal tract.

3. The client with a duodenal ulcer may exhibit which of the following findings on assessment?

• A. Hematemesis
• B. Malnourishment
• C. Melena
• D. Pain with eating

Correct answer: C

Rationale: Melena (black, tarry stools) can be an indication of a duodenal ulcer.

4. The nurse is caring for a client with a diagnosis of cirrhosis and is monitoring the client for signs of portal hypertension. Which initial sign, if noted in the client, indicates the presence of portal hypertension?

• A. Flat neck veins
• B. Hypotension
• C. Weak pulse
• D. Crackles on auscultation of the lungs

Correct answer: D

Rationale: Clinical signs and symptoms or portal hypertension are identical to those of heart failure and include jugular vein distention, lung crackles, and decreased perfusion to all organs. Initially, the client may have hypertension, flushed skin, and a bounding pulse.

5. Sharon has cirrhosis of the liver and develops ascites. What intervention is necessary to decrease the excessive accumulation of serous fluid in her peritoneal cavity?

• A. Restrict fluids
• B. Encourage ambulation
• C. Increase sodium in the diet
• D. Give antacids as prescribed

Correct answer: A

Rationale: Restricting fluids is necessary to decrease the excessive accumulation of serous fluid in the peritoneal cavity for a patient with ascites due to cirrhosis.

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