Nursing Elites

1. The nurse would assess the client experiencing an acute episode of cholecystitis for pain that is located in the right:

• A. Upper quadrant and radiates to the left scapula and shoulder
• B. Upper quadrant and radiates to the right scapula and shoulder
• C. Lower quadrant and radiates to the umbilicus
• D. Lower quadrant and radiates to the back

Correct answer: B

Rationale: Pain from cholecystitis is typically located in the right upper quadrant and may radiate to the right scapula and shoulder.

2. 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.

3. Which of the following interventions should be included in the medical management of Crohn’s disease?

• A. Increasing oral intake of fiber
• B. Administering laxatives
• C. Using long-term steroid therapy
• D. Increasing physical activity

Correct answer: C

Rationale: Long-term steroid therapy is often used in the management of Crohn's disease to reduce inflammation and suppress the immune response.

4. A home care nurse is visiting a client with a diagnosis of pernicious anemia that developed as a result of gastric surgery. The nurse instructs the client that because the stomach lining produces a decreased amount of intrinsic factor in this disorder, the client will need

• A. Vitamin B12 injections.
• B. Vitamin B6 injections.
• C. An antibiotic.
• D. An antacid.

Correct answer: A

Rationale: A lack of the intrinsic factor needed to absorb vitamin B12 occurs in pernicious anemia. Vitamin B12 is needed for the maturation of red blood cells. Vitamin B6 is not necessarily needed for pernicious anemia and can be taken orally. An antibiotic and antacids may be prescribed for certain types of gastric ulcers.

5. Ralph has a history of alcohol abuse and has acute pancreatitis. Which lab value is most likely to be elevated?

• A. Calcium
• B. Glucose
• C. Magnesium
• D. Potassium

Correct answer: B

Rationale: In a patient with acute pancreatitis and a history of alcohol abuse, glucose levels are most likely to be elevated.

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