Nursing Elites

1. Your patient Maria takes NSAIDS for her degenerative joint disease, has developed peptic ulcer disease. Which drug is useful in preventing NSAID-induced peptic ulcer disease?

• A. Calcium carbonate (Tums)
• B. Famotidine (Pepcid)
• C. Misoprostol (Cytotec)
• D. Sucralfate (Carafate)

Correct answer: C

Rationale: Misoprostol (Cytotec) is useful in preventing NSAID-induced peptic ulcer disease.

2. The client with a new colostomy is concerned about the odor from stool from the ostomy drainage bag. The nurse teaches the client to include which of the following foods in the diet to reduce odor?

• A. Yogurt
• B. Broccoli
• C. Cucumbers
• D. Eggs

Correct answer: A

Rationale: The client should be taught to include deodorizing foods in the diet, such as beet greens, parsley, buttermilk, and yogurt. Spinach also reduces odor but is a gas-forming food as well. Broccoli, cucumber, and eggs are gas-forming foods.

3. A 40-year-old male client has been hospitalized with peptic ulcer disease. He is being treated with a histamine receptor antagonist (cimetidine), antacids, and diet. The nurse doing discharge planning will teach him that the action of cimetidine is to:

• A. Reduce gastric acid output
• B. Protect the ulcer surface
• C. Inhibit the production of hydrochloric acid (HCl)
• D. Inhibit vagus nerve stimulation

Correct answer: C

Rationale: Cimetidine inhibits the production of hydrochloric acid (HCl), which helps to treat peptic ulcer disease.

4. The nurse is teaching the client how to perform a colostomy irrigation. To enhance the effectiveness of the irrigation and fecal returns, what measure should the nurse instruct the client to do?

• A. Increase fluid intake
• B. Reduce the amount of irrigation solution
• C. Perform the irrigation in the evening
• D. Place heat on the abdomen

Correct answer: A

Rationale: Increasing fluid intake helps to enhance the effectiveness of colostomy irrigation by softening the stool and promoting better fecal return.

5. The nurse is caring for a client following a Billroth II procedure. On review of the postoperative orders, which of the following if prescribed, should the nurse question and verify?

• A. Irrigating the nasogastric tube
• B. Coughing and deep breathing exercises
• C. Leg exercises
• D. Early ambulation

Correct answer: A

Rationale: In a Billroth II procedure the proximal remnant of the stomach is anastomosed to the proximal jejunum. Patency of the nasogastric tube is critical for preventing the retention of gastric secretions. The nurse should never irrigate or reposition the gastric tube after gastric surgery, unless specifically ordered by the physician. In this situation the nurse should clarify the order. Coughing and deep breathing exercises, leg exercises, and early ambulation are appropriate postoperative interventions.

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