Nursing Elites

1. The nurse provides discharge instructions to a patient with hepatitis B. Which of the following statements, if made by the patient, would indicate the need for further instruction?

• A. I can never donate blood.
• B. I can never have unprotected sex.
• C. I cannot share needles.
• D. I should avoid drugs and alcohol.

Correct answer: D

Rationale: The correct answer is D. This patient statement indicates a need for further teaching. The patient should be instructed that, in order to avoid complications, alcohol should be avoided for six months to one year. Illicit drugs and toxic chemicals should also be avoided. Acetaminophen may be taken only when necessary and not beyond the recommended dosage. Choices A, B, and C are correct statements regarding precautions to prevent the spread of hepatitis B and do not indicate a need for further instruction.

2. Regina is a 46 y.o. woman with ulcerative colitis. You expect her stools to look like:

• A. Watery and frothy.
• B. Bloody and mucoid.
• C. Firm and well-formed.
• D. Alternating constipation and diarrhea.

Correct answer: B

Rationale: Stools in ulcerative colitis are typically bloody and mucoid.

3. Which of the following complications of gastric resection should the nurse teach the client to watch for?

• A. Constipation
• B. Dumping syndrome
• C. Gastric spasm
• D. Intestinal spasms

Correct answer: B

Rationale: Clients should be taught to watch for symptoms of dumping syndrome, a common complication after gastric resection.

4. Before administering an intermittent tube feeding through a nasogastric tube, the nurse assesses for gastric residual. The nurse understands that this procedure is important to

• A. Confirm proper nasogastric tube placement.
• B. Observe gastric contents.
• C. Assess fluid and electrolyte status.
• D. Evaluate absorption of the last feeding.

Correct answer: D

Rationale: Evaluating the absorption of the last feeding is important because administration of a tube feeding to a full stomach could result in overdistention, thus predisposing the client to regurgitation and possible aspiration.

5. The nurse has given instructions to the client with an ileostomy about foods to eat to thicken the stool. The nurse determines that the client needs further instructions if the client stated to eat which of the following foods to make the stool less watery?

• A. Pasta
• B. Boiled rice
• C. Bran
• D. Low-fat cheese

Correct answer: C

Rationale: Foods that help to thicken the stool of the client with an ileostomy include pasta, boiled rice, and low-fat cheese. Bran is high in dietary fiber and thus will increase the output of watery stool by increasing propulsion through the bowel. Ileostomy output is liquid. Addition or elimination of various foods can help to thicken or loosen this liquid drainage.

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