Nursing Elites

1. The nurse is providing discharge instructions to a client following gastrectomy. Which measure will the nurse instruct the client to follow to assist in preventing dumping syndrome?

• A. Eat high-carbohydrate foods
• B. Limit the fluids taken with meals
• C. Ambulate following a meal
• D. Sit in a high-Fowlers position during meals

Correct answer: B

Rationale: To prevent dumping syndrome after a gastrectomy, it is recommended to limit fluids taken with meals to slow down gastric emptying and reduce the symptoms.

2. A client has been diagnosed with gastroesophageal reflux disease. The nurse interprets that the client has dysfunction of which of the following parts of the digestive system?

• A. Chief cells of the stomach
• B. Parietal cells of the stomach
• C. Lower esophageal sphincter
• D. Upper esophageal sphincter

Correct answer: C

Rationale: The lower esophageal sphincter is a functional sphincter that normally remains closed except when food or fluids are swallowed. If relaxation of this sphincter occurs, the client could experience symptoms of gastroesophageal reflux disease.

3. A nurse is providing the client with biliary obstruction a simple overview of the anatomy of the liver and gallbladder. The nurse tells the client that normally the liver stores bile in the gallbladder, which is connected to the liver by the?

• A. Liver canaliculi
• B. Common bile duct
• C. Cystic duct
• D. Right hepatic duct.

Correct answer: C

Rationale: The gallbladder receives bile from the liver through the cystic duct. The liver collects bile in the canaliculi. Bile then flows into the common hepatic duct. From the common hepatic duct, the bile can be stored in the gallbladder through the cystic duct. Otherwise, the bile can flow directly into the duodenum by way of the common bile duct.

4. Matt is a 49 y.o. with a hiatal hernia that you are about to counsel. Health care counseling for Matt should include which of the following instructions?

• A. Restrict intake of high-carbohydrate foods.
• B. Increase fluid intake with meals.
• C. Increase fat intake.
• D. Eat three regular meals a day.

Correct answer: D

Rationale: For a patient with a hiatal hernia, it is important to eat three regular meals a day to prevent symptoms.

5. A nurse orientee is preparing to insert a nasogastric tube, and a nurse educator is observing the procedure. Which of the following supplies if obtained by the nurse orientee would indicate a need for further education regarding this procedure?

• A. Half-inch or one-inch tape
• B. Oil-soluble lubricant
• C. A glass of tap water with a straw
• D. A 50-mL catheter tip syringe

Correct answer: B

Rationale: Water-soluble lubricant is used to lubricate 3 to 4 inches of the tube at the insertion end. An oil lubricant is not used because if the tube accidentally goes into the bronchus, pneumonia can develop. Half-inch tape is used to secure the tube after the correct placement is verified. A 50-mL catheter tip syringe is used to aspirate gastric contents to confirm placement. The client will be asked to take a sip of water through a straw to help with the passage of the tube.

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