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. While caring for a client with peptic ulcer disease, the client reports that he has been nauseated most of the day and is now feeling lightheaded and dizzy. Based upon these findings, which nursing actions would be most appropriate for the nurse to take?

• A. Administering an antacid hourly until nausea subsides.
• B. Monitoring the client's vital signs
• C. Notifying the family and friends of the client's symptoms
• D. Initiating oxygen therapy

Correct answer: B

Rationale: Monitoring the client's vital signs and notifying the physician of the client's symptoms are crucial actions based on the reported symptoms.

3. The most important pathophysiologic factor contributing to the formation of esophageal varices is:

• A. Decreased prothrombin formation
• B. Decreased albumin formation by the liver
• C. Portal hypertension
• D. Increased central venous pressure

Correct answer: C

Rationale: Portal hypertension is the most important pathophysiologic factor contributing to the formation of esophageal varices.

4. Arthur has a family history of colon cancer and is scheduled to have a sigmoidoscopy. He is crying as he tells you, “I know that I have colon cancer, too.” Which response is most therapeutic?

• A. I know just how you feel.
• B. You seem upset.
• C. Oh, don’t worry about it, everything will be just fine.
• D. Why do you think you have cancer?

Correct answer: B

Rationale: Acknowledging the patient's emotions with 'You seem upset' is the most therapeutic response.

5. A client with a peptic ulcer is scheduled for a vagotomy. The client asks the nurse about the purpose of this procedure. The nurse tells the client that the procedure:

• A. Decreases food absorption in the stomach
• B. Heals the gastric mucosa
• C. Halts stress reactions
• D. Reduces the stimulus to acid secretions

Correct answer: D

Rationale: A vagotomy reduces the stimulus to acid secretions by cutting the vagus nerve, which innervates the stomach.

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