Nursing Elites

1. Which of the following tests is most commonly used to diagnose cholecystitis?

• A. Abdominal CT scan
• B. Abdominal ultrasound
• C. Barium swallow
• D. Endoscopy

Correct answer: B

Rationale: An abdominal ultrasound is the most commonly used test to diagnose cholecystitis.

2. After gastric resection surgery, which of the following signs and symptoms would alert the nurse to the development of a leaking anastomosis?

• A. Pain, fever, and abdominal rigidity.
• B. Diarrhea with fat in the stool.
• C. Palpitations, pallor, and diaphoresis after eating.
• D. Feelings of fullness and nausea after eating.

Correct answer: A

Rationale: Pain, fever, and abdominal rigidity are signs and symptoms of inflammation or peritonitis caused by the leaking anastomosis. Diarrhea with fat in the stool is steatorrhea and is not present in peritonitis. Palpitations, pallor, and diaphoresis after eating are vasomotor symptoms of gastric retention. Feelings of fullness and nausea after eating are not present in peritonitis.

3. Ralph has a history of alcohol abuse and has acute pancreatitis. Which lab value is most likely to be elevated?

• A. Calcium
• B. Glucose
• C. Magnesium
• D. Potassium

Correct answer: B

Rationale: In a patient with acute pancreatitis and a history of alcohol abuse, glucose levels are most likely to be elevated.

4. The nurse is caring for a client admitted to the hospital with a suspected diagnosis of acute appendicitis. Which of the following laboratory results would the nurse expect to note if the client indeed has appendicitis?

• A. Leukopenia with a shift to the right
• B. Leukocytosis with a shift to the right
• C. Leukocytosis with a shift to the left
• D. Leukopenia with a shift to the left

Correct answer: C

Rationale: Laboratory findings do not establish the diagnosis of appendicitis, but often moderate elevation of the white blood cell count (leukocytosis) to 10,000 to 18,000 cells/mm3 occurs with a “shift to the left” (an increased number of immature white blood cells.).

5. Which of the following expected outcomes would be appropriate for the client who has ulcerative colitis?

• A. The client maintains a daily record of intake and output.
• B. The client verbalizes the importance of small, frequent feedings.
• C. The client uses a heating pad to decrease abdominal cramping.
• D. The client accepts that a colostomy is inevitable at some time in his life.

Correct answer: B

Rationale: Small, frequent feedings are better tolerated by clients with ulcerative colitis as they lessen the amount of fecal material present in the gastrointestinal tract and decrease stimulation. The client does not need to maintain a daily record of intake and output unless an exacerbation of the disease occurs. A heating pad should not be applied to the intestine as it is inflamed. It is not inevitable that the client will require surgery to treat ulcerative colitis.

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