Nursing Elites

1. 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.

2. An intubated patient is receiving continuous enteral feedings through a Salem sump tube at a rate of 60ml/hr. Gastric residuals have been 30-40ml when monitored Q4H. You check the gastric residual and aspirate 220ml. What is your first response to this finding?

• A. Notify the doctor immediately.
• B. Stop the feeding, and clamp the NG tube.
• C. Discard the 220ml, and clamp the NG tube.
• D. Give a prescribed GI stimulant such as metoclopramide (Reglan).

Correct answer: B

Rationale: If gastric residuals are high during continuous enteral feedings, the first response is to stop the feeding and clamp the NG tube.

3. The pain of a duodenal ulcer can be distinguished from that of a gastric ulcer by which of the following characteristics?

• A. Early satiety
• B. Pain on eating
• C. Dull upper epigastric pain
• D. Pain on empty stomach

Correct answer: D

Rationale: Pain on an empty stomach is characteristic of a duodenal ulcer, while pain on eating is characteristic of a gastric ulcer.

4. The client with Crohn’s disease has a nursing diagnosis of acute pain. The nurse would teach the client to avoid which of the following in managing this problem?

• A. Lying supine with the legs straight
• B. Massaging the abdomen
• C. Using antispasmodic medication
• D. Using relaxation techniques

Correct answer: A

Rationale: Lying supine with the legs straight can increase abdominal tension and exacerbate pain. The client should be advised to lie with the legs bent to reduce muscle tension and discomfort.

5. You’re caring for a 28 y.o. woman with hepatitis B. She’s concerned about the duration of her recovery. Which response isn’t appropriate?

• A. Encourage her to not worry about the future.
• B. Encourage her to express her feelings about the illness.
• C. Discuss the effects of hepatitis B on future health problems.
• D. Provide avenues for financial counseling if she expresses the need.

Correct answer: A

Rationale: Encouraging the patient to not worry about the future is not appropriate. Instead, address her concerns and provide information.

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