Nursing Elites

1. Which of the following tests can be performed to diagnose a hiatal hernia?

• A. Colonoscopy
• B. Lower GI series
• C. Barium swallow
• D. Abdominal x-rays

Correct answer: C

Rationale: A barium swallow is a diagnostic test that can visualize the esophagus, stomach, and small intestine to diagnose a hiatal hernia.

2. The nurse is irrigating a client's colostomy when she complains of abdominal cramping after receiving about 100 mL of the irrigating solution. What should the nurse's first response be in this situation?

• A. Stop the flow of solution temporarily.
• B. Reposition the client on to her right side.
• C. Remove the irrigation tube.
• D. Massage the abdomen gently.

Correct answer: A

Rationale: The abdominal cramping that can occur during colostomy irrigation results from stimulation of the colon by the irrigating solution. The nurse's first response should be to temporarily stop the flow of solution to allow the cramping to subside. Repositioning the client to the right side will not alleviate the cramping. Removing the tube will not decrease the cramping and will necessitate reinsertion of the tube when the irrigation is resumed. Massaging the abdomen gently may be soothing to some clients, but it is not the nurse's first priority action.

3. Which of the following best describes the method of action of medications, such as ranitidine (Zantac), which are used in the treatment of peptic ulcer disease?

• A. Neutralize acid
• B. Reduce acid secretions
• C. Stimulate gastrin release
• D. Protect the mucosal barrier

Correct answer: B

Rationale: Medications like ranitidine (Zantac) are H2 receptor antagonists that reduce acid secretions in the stomach, helping to treat peptic ulcer disease.

4. The nurse is scheduling diagnostic tests for a client. If all of the following diagnostic tests are ordered, which would be performed last?

• A. Gallbladder series
• B. Barium enema
• C. Barium swallow
• D. Oral cholecystogram

Correct answer: C

Rationale: The correct answer is C, 'Barium swallow.' A barium swallow should be done after a barium enema or gallbladder series to prevent the contrast used in the barium swallow from obstructing the view of other organs. It takes several days for swallowed barium to pass completely out of the gastrointestinal tract. Choices A, B, and D are incorrect because a barium swallow should be the last test performed to ensure clear imaging without interference from residual contrast material.

5. You’re caring for Lewis, a 67 y.o. patient with liver cirrhosis who develops ascites and requires paracentesis. Relief of which symptom indicated that the paracentesis was effective?

• A. Pruritus
• B. Dyspnea
• C. Jaundice
• D. Peripheral Neuropathy

Correct answer: B

Rationale: Dyspnea relief indicates that the paracentesis was effective in reducing ascites.

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