Nursing Elites

1. Type A chronic gastritis can be distinguished from type B by its ability to:

• A. Cause atrophy of the parietal cells.
• B. Affect only the antrum of the stomach.
• C. Thin the lining of the stomach walls.
• D. Decrease gastric secretions.

Correct answer: A

Rationale: Type A chronic gastritis can cause atrophy of the parietal cells, which is a distinguishing feature from type B.

2. The nurse provides medication instructions to a client with peptic ulcer disease. Which statement, if made by the client, indicates the best understanding of the medication therapy?

• A. The cimetidine (Tagamet) will cause me to produce less stomach acid.
• B. Sucralfate (Carafate) will change the fluid in my stomach.
• C. Antacids will coat my stomach.
• D. Omeprazole (Prilosec) will coat the ulcer and help it heal.

Correct answer: A

Rationale: Cimetidine (Tagamet) works by reducing stomach acid production, which helps to manage peptic ulcer disease.

3. Hepatic encephalopathy develops when the blood level of which substance increases?

• A. Ammonia
• B. Amylase
• C. Calcium
• D. Potassium

Correct answer: A

Rationale: Hepatic encephalopathy develops when the blood level of ammonia increases.

4. An intubated patient is receiving continuous enteral feedings through a Salem sump tube at a rate of 60ml/hr. Gastric residuals have been 30-40ml when monitored Q4H. You check the gastric residual and aspirate 220ml. What is your first response to this finding?

• A. Notify the doctor immediately.
• B. Stop the feeding, and clamp the NG tube.
• C. Discard the 220ml, and clamp the NG tube.
• D. Give a prescribed GI stimulant such as metoclopramide (Reglan).

Correct answer: B

Rationale: If gastric residuals are high during continuous enteral feedings, the first response is to stop the feeding and clamp the NG tube.

5. A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching for this client, the nurse should stress:

• A. increasing fluid intake to prevent dehydration.
• B. wearing an appliance pouch at all times.
• C. consuming a low-protein, high-fiber diet.
• D. avoiding enteric-coated medications.

Correct answer: A

Rationale: The correct answer is A: increasing fluid intake to prevent dehydration. An ileostomy typically drains liquid waste, so the client is at risk of fluid loss. By increasing fluid intake, the client can prevent dehydration. It's essential for the client to wear a collection appliance at all times because ileostomy drainage is incontinent. Consuming a low-protein, high-fiber diet is not recommended as high-fiber foods can cause intestinal irritation. Enteric-coated medications should be avoided because they may not be absorbed properly after an ileostomy.

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