Nursing Elites

1. Which of the following conditions can cause a hiatal hernia?

• A. Increased intrathoracic pressure
• B. Weakness of the esophageal muscle
• C. Increased esophageal muscle pressure
• D. Weakness of the diaphragmic muscle

Correct answer: D

Rationale: Weakness of the diaphragmic muscle can lead to a hiatal hernia as it allows part of the stomach to push through the diaphragm into the chest cavity.

2. You are developing a careplan on Sally, a 67 y.o. patient with hepatic encephalopathy. Which of the following do you include?

• A. Administering a lactulose enema as ordered.
• B. Encouraging a protein-rich diet.
• C. Administering sedatives, as necessary.
• D. Encouraging ambulation at least four times a day.

Correct answer: A

Rationale: Administering a lactulose enema as ordered helps reduce ammonia levels in patients with hepatic encephalopathy.

3. Which of the following definitions best describes gastritis?

• A. Erosion of the gastric mucosa
• B. Inflammation of a diverticulum
• C. Inflammation of the gastric mucosa
• D. Reflux of stomach acid into the esophagus

Correct answer: C

Rationale: The correct answer is C: 'Inflammation of the gastric mucosa.' Gastritis is characterized by inflammation of the stomach lining, specifically the gastric mucosa. This inflammation can be caused by various factors such as infections, medications, alcohol, or autoimmune diseases. Choice A, 'Erosion of the gastric mucosa,' is incorrect because erosion refers to the wearing away of tissue rather than inflammation. Choice B, 'Inflammation of a diverticulum,' is incorrect because gastritis specifically involves inflammation of the stomach lining, not a diverticulum. Choice D, 'Reflux of stomach acid into the esophagus,' describes gastroesophageal reflux disease (GERD), which is different from gastritis.

4. You’re advising a 21 y.o. with a colostomy who reports problems with flatus. What food should you recommend?

• A. Peas
• B. Cabbage
• C. Broccoli
• D. Yogurt

Correct answer: D

Rationale: Yogurt can help reduce problems with flatus in patients with a colostomy.

5. The nurse is reviewing the physician’s orders written for a client admitted with acute pancreatitis. Which physician order would the nurse question if noted on the client’s chart?

• A. NPO status
• B. Insert a nasogastric tube
• C. An anticholinergic medication
• D. Morphine for pain

Correct answer: D

Rationale: Morphine for pain should be questioned as it can cause spasms of the sphincter of Oddi, worsening pancreatitis.

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