Nursing Elites

1. Which of the following associated disorders may a client with ulcerative colitis exhibit?

• A. Gallstones
• B. Hydronephrosis
• C. Nephrolithiasis
• D. Toxic megacolon

Correct answer: D

Rationale: Toxic megacolon is a severe complication that may be exhibited by a client with ulcerative colitis.

2. A patient with Crohn’s disease is admitted after 4 days of diarrhea. Which of the following urine specific gravity values do you expect to find in this patient?

• A. 1.005
• B. 1.011
• C. 1.02
• D. 1.03

Correct answer: D

Rationale: A urine specific gravity of 1.030 indicates concentrated urine, which is expected in a patient with dehydration due to diarrhea from Crohn’s disease.

3. The nurse is caring for a client following a Billroth II procedure. On review of the postoperative orders, which of the following if prescribed, should the nurse question and verify?

• A. Irrigating the nasogastric tube
• B. Coughing and deep breathing exercises
• C. Leg exercises
• D. Early ambulation

Correct answer: A

Rationale: In a Billroth II procedure the proximal remnant of the stomach is anastomosed to the proximal jejunum. Patency of the nasogastric tube is critical for preventing the retention of gastric secretions. The nurse should never irrigate or reposition the gastric tube after gastric surgery, unless specifically ordered by the physician. In this situation the nurse should clarify the order. Coughing and deep breathing exercises, leg exercises, and early ambulation are appropriate postoperative interventions.

4. When teaching a community group about measures to prevent colon cancer, which instruction should the nurse include?

• A. Limit fat intake to 20% to 25% of your total daily calories.
• B. Include 15 to 20 grams of fiber into your daily diet.
• C. Get an annual rectal examination after age 35.
• D. Undergo sigmoidoscopy annually after age 50.

Correct answer: A

Rationale: Limiting fat intake is a recommended measure to reduce the risk of colon cancer. Including fiber, undergoing annual rectal examinations, and sigmoidoscopy are also important, but limiting fat intake is directly related to reducing cancer risk.

5. Which of the following symptoms indicates diverticulosis?

• A. No symptoms exist
• B. Change in bowel habits
• C. Anorexia with low-grade fever
• D. Episodic, dull, or steady midabdominal pain

Correct answer: A

Rationale: Diverticulosis often has no symptoms and is usually found incidentally during tests for other conditions.

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