Nursing Elites

1. The client was recently diagnosed with chronic gastritis. What health practice should the nurse address when teaching the client to limit exacerbations of the disease?

• A. Perform 15 minutes of physical activity at least three times per week.
• B. Avoid taking aspirin to treat pain or fever.
• C. Take multivitamins as prescribed and eat organic foods whenever possible.
• D. Maintain a healthy body weight.

Correct answer: B

Rationale: The correct answer is B. Avoiding aspirin is crucial in managing chronic gastritis as it can further irritate the stomach lining, leading to exacerbations of the condition. Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that can increase stomach acid production, potentially worsening gastritis symptoms. Therefore, the nurse should educate the client on using alternative pain or fever relief methods that are less likely to aggravate gastritis, such as acetaminophen.

2. A 40-year-old woman presents with a history of chronic constipation, bloating, and abdominal pain. She notes that the pain is relieved with defecation. She denies any weight loss, blood in her stools, or nocturnal symptoms. Physical examination and routine blood tests are normal. What is the most likely diagnosis?

• A. Inflammatory bowel disease
• B. Irritable bowel syndrome
• C. Celiac disease
• D. Lactose intolerance

Correct answer: B

Rationale: The patient's symptoms of chronic constipation, bloating, abdominal pain relieved with defecation, absence of weight loss, blood in stools, or nocturnal symptoms, along with normal physical examination and routine blood tests, are indicative of irritable bowel syndrome (IBS). IBS is a functional gastrointestinal disorder characterized by abdominal pain or discomfort and altered bowel habits in the absence of any organic cause. It is a diagnosis of exclusion made based on symptom criteria, and the provided clinical scenario aligns with the typical presentation of IBS.

3. A client with heart failure is prescribed furosemide (Lasix). Which instruction should the nurse include in the client's teaching plan?

• A. Take the medication before bedtime.
• B. Report any weight gain of more than 2 pounds in a day.
• C. Increase your intake of high-sodium foods.
• D. Limit your fluid intake to less than 1 liter per day.

Correct answer: B

Rationale: In heart failure, fluid retention is a concern. Furosemide helps manage this by promoting diuresis. Instructing the client to report weight gain exceeding 2 pounds in a day is crucial as it can indicate fluid accumulation, prompting timely intervention to prevent worsening heart failure symptoms and complications.

4. A client with osteoporosis is being discharged home. Which instruction should the nurse include in the discharge teaching?

• A. Avoid weight-bearing exercises.
• B. Take calcium supplements with meals.
• C. Limit vitamin D intake.
• D. Increase intake of caffeine-containing beverages.

Correct answer: B

Rationale: Taking calcium supplements with meals is a crucial instruction for a client with osteoporosis. Calcium absorption is enhanced when taken with food, and proper calcium intake is essential for managing osteoporosis effectively by promoting bone health and density. Avoiding weight-bearing exercises (Choice A) is incorrect because these exercises help improve bone strength. Limiting vitamin D intake (Choice C) is also incorrect as vitamin D is necessary for calcium absorption. Increasing caffeine intake (Choice D) is not recommended as caffeine can interfere with calcium absorption.

5. An outcome for treatment of peripheral vascular disease is, 'The client will have decreased venous congestion.' What client behavior would indicate to the nurse that this outcome has been met?

• A. Avoids prolonged sitting or standing.
• B. Avoids trauma and irritation to skin.
• C. Wears protective shoes.
• D. Quits smoking.

Correct answer: A

Rationale: The correct answer is A: 'Avoids prolonged sitting or standing.' In clients with peripheral vascular disease, decreased venous congestion is a desired outcome. Avoiding prolonged sitting or standing helps improve venous return and reduces congestion in the lower extremities, contributing to the achievement of this treatment goal.

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