Nursing Elites

1. What information is correct about stomach cancer?

• A. Stomach pain is often a late symptom.
• B. Surgery is often a successful treatment.
• C. Chemotherapy and radiation are often successful treatments.
• D. The patient can survive for an extended time with TPN.

Correct answer: A

Rationale: Stomach pain is often a late symptom of stomach cancer.

2. You’re preparing a patient with a malignant tumor for colorectal surgery and subsequent colostomy. The patient tells you he’s anxious. What should your initial step be in working with this patient?

• A. Determine what the patient already knows about colostomies.
• B. Show the patient some pictures of colostomies.
• C. Arrange for someone who has a colostomy to visit the patient.
• D. Provide the patient with written material about colostomy care.

Correct answer: A

Rationale: When a patient with a malignant tumor is anxious about colorectal surgery and a colostomy, the initial step is to determine what the patient already knows about colostomies.

3. The nurse is evaluating the plan of care for a client with peptic ulcer disease with a nursing diagnosis of Acute Pain. The nurse would determine that the client has not met the expected outcomes if the client states

• A. That pain is relieved with histamine H2 receptor antagonists.
• B. That irritating foods have been eliminated from the diet.
• C. The client is being awakened at 2 AM with heartburn.
• D. The client has absence of pain before meals.

Correct answer: C

Rationale: Expected outcomes for the client with peptic ulcer disease experiencing pain include elimination of irritating foods from the diet, ability to take prescribed medications that will reduce pain, reporting that the pain is relieved or prevented with medication, and an ability to sleep through the night without pain. The client who continues to be awakened by pain requires further modification of medication therapy, which may include adjustment of timing of histamine H2 receptor antagonist or an additional dose of antacid before the time when pain awakens the client.

4. The nurse is doing pre-op teaching with the client who is about to undergo creation of a Kock pouch. The nurse interprets that the client has the best understanding of the nature of the surgery if the client makes which of the following statements?

• A. I will need to drain the pouch regularly with a catheter.
• B. I will need to wear a drainage bag for the rest of my life.
• C. The drainage from this type of ostomy will be formed.
• D. I will be able to pass stool from my rectum eventually.

Correct answer: A

Rationale: A Kock pouch is a type of continent ileostomy that requires catheterization to empty the internal reservoir. Understanding the need for regular catheterization indicates the client comprehends the procedure.

5. 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.

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