Nursing Elites

1. Which area of the alimentary canal is the most common location for Crohn’s disease?

• A. Ascending colon
• B. Descending colon
• C. Sigmoid colon
• D. Terminal ileum

Correct answer: D

Rationale: The terminal ileum is the most common location for Crohn's disease.

2. The nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to:

• A. restrict fluid intake to 1 qt (1,000 ml)/day.
• B. drink liquids only with meals.
• C. don't drink liquids 2 hours before meals.
• D. drink liquids only between meals.

Correct answer: D

Rationale: A client who experiences dumping syndrome after a subtotal gastrectomy should be advised to ingest liquids between meals rather than with meals. Taking fluids between meals allows for adequate hydration, reduces the amount of bulk ingested with meals, and aids in preventing rapid gastric emptying. There is no need to restrict the amount of fluids, just the time when the client drinks fluids. Drinking liquids with meals increases the risk of dumping syndrome by increasing the amount of bulk and stimulating rapid gastric emptying. Small amounts of water are allowable before meals.

3. Which of the following areas is the most common site of fistulas in clients with Crohn’s disease?

• A. Anorectal
• B. Ileum
• C. Rectovaginal
• D. Transverse colon

Correct answer: A

Rationale: The anorectal area is the most common site of fistulas in clients with Crohn's disease.

4. You’re caring for Beth who underwent a Billroth II procedure (surgical removal of the pylorus and duodenum) for treatment of a peptic ulcer. Which findings suggest that the patient is developing dumping syndrome, a complication associated with this procedure?

• A. Flushed, dry skin.
• B. Headache and bradycardia.
• C. Dizziness and sweating.
• D. Dyspnea and chest pain.

Correct answer: C

Rationale: Dizziness and sweating are common signs of dumping syndrome, a complication of the Billroth II procedure.

5. 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.

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