Nursing Elites

1. You’re caring for Carin who has just had ileostomy surgery. During the first 24 hours post-op, how much drainage can you expect from the ileostomy?

• A. 100 ml
• B. 500 ml
• C. 1500 ml
• D. 5000 ml

Correct answer: C

Rationale: During the first 24 hours post-op, you can expect about 1500 ml of drainage from the ileostomy.

2. Britney, a 20 y.o. student is admitted with acute pancreatitis. Which laboratory findings do you expect to be abnormal for this patient?

• A. Serum creatinine and BUN
• B. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST)
• C. Serum amylase and lipase
• D. Cardiac enzymes

Correct answer: C

Rationale: Serum amylase and lipase levels are typically elevated in patients with acute pancreatitis.

3. 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.

4. The nurse has provided home care instructions to a client who had a subtotal gastrectomy. The nurse instructs the client regarding the signs and symptoms associated with dumping syndrome. Which of the following signs and symptoms, if identified by the client, indicates an understanding of this potential complication following gastrointestinal surgery?

• A. Hiccups and diarrhea
• B. Fatigue and abdominal pain
• C. Constipation and fever
• D. Diaphoresis and diarrhea

Correct answer: D

Rationale: The correct answer is D: Diaphoresis and diarrhea. Dumping syndrome occurs after gastric surgery when food moves quickly from the stomach to the intestine, causing fluid shifts and leading to symptoms like weakness, dizziness, diaphoresis, flushing, hypotension, abdominal pain, distension, hyperactive bowel sounds, and diarrhea. Choices A, B, and C do not reflect the typical signs and symptoms of dumping syndrome.

5. You’re developing the plan of care for a patient experiencing dumping syndrome after a Billroth II procedure. Which dietary instructions do you include?

• A. Omit fluids with meals.
• B. Increase carbohydrate intake.
• C. Decrease protein intake.
• D. Decrease fat intake.

Correct answer: A

Rationale: To manage dumping syndrome, it is important to omit fluids with meals to slow gastric emptying.

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