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. Which of the following nursing interventions should have the highest priority during the first hour after the admission of a client with cholecystitis who is experiencing pain, nausea, and vomiting?

• A. Administering pain medication.
• B. Completing the admission history.
• C. Maintaining hydration.
• D. Teaching about planned diagnostic tests.

Correct answer: A

Rationale: Administering pain medication would have the highest priority during the first hour after the client's admission. Pain relief is essential to address the client's immediate discomfort and distress. Completing the admission history, maintaining hydration, and teaching about planned diagnostic tests are important aspects of care but can be addressed after addressing the client's pain and stabilizing their condition.

3. The nurse is assessing for stoma prolapse in a client with a colostomy. The nurse would observe which of the following if stoma prolapse occurred?

• A. Sunken and hidden stoma
• B. Dark- and bluish-colored stoma
• C. Narrowed and flattened stoma
• D. Protruding stoma

Correct answer: D

Rationale: A protruding stoma is indicative of stoma prolapse, which occurs when the bowel protrudes excessively through the stoma.

4. The client with chronic pancreatitis needs information on dietary modification to manage the health problem. The nurse teaches the client to limit which of the following items in the diet?

• A. Carbohydrate
• B. Protein
• C. Fat
• D. Water-soluble vitamins

Correct answer: C

Rationale: The client should limit fat in the diet. The client also should take in small meals, which also will reduce the amount of carbohydrates and protein that the client must digest at any one time. The client does not need to limit water-soluble vitamins in the diet.

5. The client is admitted to the hospital with viral hepatitis, complaining of 'no appetite' and 'losing my taste for food.' To provide adequate nutrition, the nurse would instruct the client to

• A. Eat a good supper when anorexia is not as severe.
• B. Eat less often, preferably only three large meals daily.
• C. Increase intake of fluids including juices.
• D. Select foods high in fat.

Correct answer: C

Rationale: Although no special diet is required to treat viral hepatitis, it is generally recommended that clients consume a diet with low-fat content because fat may be tolerated poorly due to decreased bile production. Small, frequent meals are preferable and may prevent nausea. Appetite is often better in the morning, so it is easier to eat a good breakfast. An adequate fluid intake of 2500 to 3000 mL per day that includes nutritional juices is also important.

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