Nursing Elites

1. Which of the following complications of gastric resection should the nurse teach the client to watch for?

• A. Constipation
• B. Dumping syndrome
• C. Gastric spasm
• D. Intestinal spasms

Correct answer: B

Rationale: Clients should be taught to watch for symptoms of dumping syndrome, a common complication after gastric resection.

2. In a client with diarrhea, which outcome indicates that fluid resuscitation is successful?

• A. The client passes formed stools at regular intervals
• B. The client reports a decrease in stool frequency and liquidity
• C. The client exhibits firm skin turgor
• D. The client no longer experiences perianal burning

Correct answer: C

Rationale: Firm skin turgor indicates adequate hydration, which is a key goal of fluid resuscitation. Formed stools, decreased stool frequency, and relief from perianal burning are important but do not directly indicate successful fluid resuscitation.

3. The client with a new colostomy is concerned about the odor from stool from the ostomy drainage bag. The nurse teaches the client to include which of the following foods in the diet to reduce odor?

• A. Yogurt
• B. Broccoli
• C. Cucumbers
• D. Eggs

Correct answer: A

Rationale: The client should be taught to include deodorizing foods in the diet, such as beet greens, parsley, buttermilk, and yogurt. Spinach also reduces odor but is a gas-forming food as well. Broccoli, cucumber, and eggs are gas-forming foods.

4. Mucosal barrier fortifiers are used in peptic ulcer disease management for which of the following indications?

• A. To inhibit mucus production
• B. To neutralize acid production
• C. To stimulate mucus production
• D. To stimulate hydrogen ion diffusion back into the mucosa

Correct answer: C

Rationale: Mucosal barrier fortifiers stimulate mucus production, which helps protect the lining of the stomach and manage peptic ulcer disease.

5. The nurse is doing preoperative teaching with the client who is about to undergo creation of a Kock pouch. The nurse interprets that the client has the best understanding of the nature of the surgery if the client makes which of the following statements?

• A. I will need to drain the pouch regularly with a catheter.
• B. I will need to wear a drainage bag for the rest of my life.
• C. The drainage from this type of ostomy will be formed.
• D. I will be able to pass stool from the rectum eventually.

Correct answer: A

Rationale: A Kock pouch is a continent ileostomy. As the ileostomy begins to function, the client drains it every 3 to 4 hours and then decreases the draining about 3 times a day or as needed when full. The client does not need to wear a drainage bag but should wear an absorbent dressing to absorb mucous drainage from the stoma. Ileostomy drainage is liquid. The client would be able to pass stool only from the rectum if an ileal-anal pouch or anastomosis were created. This type of operation is a two-stage procedure.

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