Nursing Elites

1. Which of the following tests can be used to diagnose ulcers?

• A. Abdominal x-ray
• B. Barium swallow
• C. Computed tomography (CT) scan
• D. Esophagogastroduodenoscopy (EGD)

Correct answer: D

Rationale: Esophagogastroduodenoscopy (EGD) is a diagnostic test that involves visualizing the esophagus, stomach, and duodenum to diagnose ulcers.

2. When counseling a client in ways to prevent cholecystitis, which of the following guidelines is most important?

• A. Eat a low-protein diet
• B. Eat a low-fat, low-cholesterol diet
• C. Limit exercise to 10 minutes/day
• D. Keep weight proportionate to height

Correct answer: B

Rationale: Eating a low-fat, low-cholesterol diet is most important for preventing cholecystitis.

3. Glenda has cholelithiasis (gallstones). You expect her to complain of:

• A. Pain in the right upper quadrant, radiating to the shoulder.
• B. Pain in the right lower quadrant, with rebound tenderness.
• C. Pain in the left upper quadrant, with shortness of breath.
• D. Pain in the left lower quadrant, with mild cramping.

Correct answer: A

Rationale: Patients with cholelithiasis often complain of pain in the right upper quadrant, radiating to the shoulder.

4. A client returns from surgery with a sigmoid colostomy. An ostomy appliance is attached. The priority nursing diagnosis for daily observation and care is:

• A. Diarrhea related to alteration in bowel elimination.
• B. Impaired skin integrity related to seepage.
• C. Impaired nutrition: More than body requirements related to high-fat diet.
• D. Impaired physical mobility related to surgical procedure.

Correct answer: B

Rationale: Impaired skin integrity would be the priority nursing diagnosis for daily care of the colostomy because the effluent from the colostomy can be irritating to the skin. Diarrhea isn't a concern at this point. The client will be allowed nothing by mouth until peristalsis returns. The client should get out of bed on the first postoperative day, so mobility shouldn't be a problem.

5. The nurse instructs the nursing assistant on how to provide oral hygiene for a client who cannot perform this task for himself. Which of the following techniques should the nurse tell the assistant to incorporate into the client’s daily care?

• A. Assess the oral cavity each time mouth care is given and record observations
• B. Use a soft toothbrush to brush the client’s teeth after each meal
• C. Swab the client’s tongue, gums, and lips with a soft foam applicator every 2 hours.
• D. Rinse the client’s mouth with mouthwash several times a day.

Correct answer: C

Rationale: Swabbing the client’s tongue, gums, and lips with a soft foam applicator every 2 hours helps maintain oral hygiene for a client who cannot perform this task.

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