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. 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. The nurse is irrigating a client's colostomy when she complains of abdominal cramping after receiving about 100 mL of the irrigating solution. What should the nurse's first response be in this situation?

• A. Stop the flow of solution temporarily.
• B. Reposition the client on to her right side.
• C. Remove the irrigation tube.
• D. Massage the abdomen gently.

Correct answer: A

Rationale: The abdominal cramping that can occur during colostomy irrigation results from stimulation of the colon by the irrigating solution. The nurse's first response should be to temporarily stop the flow of solution to allow the cramping to subside. Repositioning the client to the right side will not alleviate the cramping. Removing the tube will not decrease the cramping and will necessitate reinsertion of the tube when the irrigation is resumed. Massaging the abdomen gently may be soothing to some clients, but it is not the nurse's first priority action.

4. Which stoma would you expect a malodorous, enzyme-rich, caustic liquid output that is yellow, green, or brown?

• A. Ileostomy.
• B. Ascending colostomy.
• C. Transverse colostomy.
• D. Descending colostomy.

Correct answer: A

Rationale: An ileostomy would have a malodorous, enzyme-rich, caustic liquid output that is yellow, green, or brown.

5. A nurse is providing instructions to a client who will collect a stool specimen for occult blood. The nurse instructs the client to avoid which of the following for 3 days before the collection of the stool specimen?

• A. Milk products
• B. Hard cheese
• C. Turnips
• D. Cottage cheese

Correct answer: C

Rationale: The correct answer is C: Turnips. The nurse would instruct the client to avoid red meat, poultry, fish, turnips, horseradish, and foods such as fruits and vegetables for 3 days before and during testing. These products may alter test results. Choices A, B, and D are incorrect because they are not specifically mentioned as items to avoid before collecting a stool specimen for occult blood.

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