Nursing Elites

1. 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.

2. Which of the following tests is most commonly used to diagnose cholecystitis?

• A. Abdominal CT scan
• B. Abdominal ultrasound
• C. Barium swallow
• D. Endoscopy

Correct answer: B

Rationale: An abdominal ultrasound is the most commonly used test to diagnose cholecystitis.

3. The nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to:

• A. restrict fluid intake to 1 qt (1,000 ml)/day.
• B. drink liquids only with meals.
• C. don't drink liquids 2 hours before meals.
• D. drink liquids only between meals.

Correct answer: D

Rationale: A client who experiences dumping syndrome after a subtotal gastrectomy should be advised to ingest liquids between meals rather than with meals. Taking fluids between meals allows for adequate hydration, reduces the amount of bulk ingested with meals, and aids in preventing rapid gastric emptying. There is no need to restrict the amount of fluids, just the time when the client drinks fluids. Drinking liquids with meals increases the risk of dumping syndrome by increasing the amount of bulk and stimulating rapid gastric emptying. Small amounts of water are allowable before meals.

4. The client has been admitted with a diagnosis of acute pancreatitis. The nurse would assess this client for pain that is:

• A. Severe and unrelenting, located in the epigastric area and radiating to the back.
• B. Severe and unrelenting, located in the left lower quadrant and radiating to the groin.
• C. Burning and aching, located in the epigastric area and radiating to the umbilicus.
• D. Burning and aching, located in the left lower quadrant and radiating to the hip.

Correct answer: A

Rationale: Acute pancreatitis typically presents with severe, unrelenting pain in the epigastric area that radiates to the back. This pain is due to inflammation and autodigestion of the pancreas.

5. Anna is 45 y.o. and has a bleeding ulcer. Despite multiple blood transfusions, her HGB is 7.5g/dl and HCT is 27%. Her doctor determines that surgical intervention is necessary and she undergoes partial gastrectomy. Postoperative nursing care includes:

• A. Giving pain medication Q6H.
• B. Flushing the NG tube with sterile water.
• C. Positioning her in high Fowler’s position.
• D. Keeping her NPO until the return of peristalsis.

Correct answer: D

Rationale: Postoperative care for a patient who underwent partial gastrectomy includes keeping her NPO until the return of peristalsis to prevent complications.

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