Nursing Elites

1. Which nursing measure would be most effective in helping the client cough and deep breathe after a cholecystectomy?

• A. Having the client take rapid, shallow breaths to decrease pain.
• B. Having the client lay on the left side while coughing and deep breathing.
• C. Teaching the client to use a folded blanket or pillow to splint the incision.
• D. Withholding pain medication so the client can be alert enough to follow the nurse's instructions.

Correct answer: C

Rationale: After a cholecystectomy, teaching the client to use a folded blanket or pillow to splint the incision will be most effective in helping the client cough and deep breathe. This technique provides support and reduces pain during coughing and deep breathing, promoting better lung expansion. Having the client take rapid, shallow breaths would not be effective in decreasing pain; instead, deep breathing is encouraged to prevent complications like atelectasis. Lying on the left side would limit lung expansion; therefore, the client should be positioned in semi-Fowler's or Fowler's position to maximize lung expansion. Withholding pain medication can lead to discomfort and reluctance to cough and deep breathe, hindering recovery.

2. Which of the following mechanisms can facilitate the development of diverticulosis into diverticulitis?

• A. Treating constipation with chronic laxative use, leading to dependence on laxatives
• B. Chronic constipation causing an obstruction, reducing forward flow of intestinal contents
• C. Herniation of the intestinal mucosa, rupturing the wall of the intestine
• D. Undigested food blocking the diverticulum, predisposing the area to bacterial invasion

Correct answer: D

Rationale: The correct answer is D. Undigested food blocking the diverticulum can lead to bacterial invasion, causing inflammation and turning diverticulosis into diverticulitis. Choices A, B, and C do not directly facilitate the development of diverticulitis. Choice A involves a different mechanism related to laxative use, choice B describes a complication of chronic constipation but does not necessarily lead to diverticulitis, and choice C refers to a different condition involving herniation of the intestinal mucosa.

3. Which of the following symptoms is a client with colon cancer most likely to exhibit?

• A. A change in appetite
• B. A change in bowel habits
• C. An increase in body weight
• D. An increase in body temperature

Correct answer: B

Rationale: A change in bowel habits is the most common symptom of colon cancer.

4. A client is taking an antacid for treatment of a peptic ulcer. Which of the following statements best indicates that the client understands how to correctly take the antacid?

• A. I should take my antacid before I take my other medications.
• B. I need to decrease my intake of fluids so that I don’t dilute the effects of my antacid.
• C. My antacid will be most effective if I take it whenever I experience stomach pains.
• D. It is best for me to take my antacid 1 to 3 hours after meals.

Correct answer: D

Rationale: It is best for the client to take the antacid 1 to 3 hours after meals to ensure effectiveness.

5. A client presents to the emergency room, reporting that he has been vomiting every 30 to 40 minutes for the past 8 hours. Frequent vomiting puts him at risk for which of the following?

• A. Metabolic acidosis with hyperkalemia
• B. Metabolic acidosis with hypokalemia
• C. Metabolic alkalosis with hyperkalemia
• D. Metabolic alkalosis with hypokalemia

Correct answer: D

Rationale: Frequent vomiting can lead to metabolic alkalosis with hypokalemia due to the loss of stomach acid and electrolytes.

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