Nursing Elites

1. A client is scheduled for oral cholecystography. Which one of the following actions would the nurse plan to implement before the test?

• A. Have the client drink 1000 mL of water.
• B. Ask the client about possible allergies to iodine or shellfish.
• C. Administer an intravenous contrast agent the evening before the test.
• D. Administer tap-water enemas until clear.

Correct answer: B

Rationale: Iodine compounds used as radiographic contrast agents, such as iopanoic acid (Telepaque), should not be administered to the client with iodine and seafood allergies because anaphylaxis may occur.

2. When teaching a community group about measures to prevent colon cancer, which instruction should the nurse include?

• A. Limit fat intake to 20% to 25% of your total daily calories.
• B. Include 15 to 20 grams of fiber into your daily diet.
• C. Get an annual rectal examination after age 35.
• D. Undergo sigmoidoscopy annually after age 50.

Correct answer: A

Rationale: Limiting fat intake is a recommended measure to reduce the risk of colon cancer. Including fiber, undergoing annual rectal examinations, and sigmoidoscopy are also important, but limiting fat intake is directly related to reducing cancer risk.

3. The nurse is assessing a 71-year-old female client with ulcerative colitis. Which assessment finding related to the family will have the greatest impact on the client's rehabilitation after discharge?

• A. The family's ability to take care of the client's special diet needs
• B. The family's expectation that the client will resume responsibilities and role-related activities
• C. Emotional support from the family
• D. The family's ability to understand the ups and downs of the illness

Correct answer: C

Rationale: Emotional support from the family is the main need. A special diet doesn't focus on emotional needs. Role expectations don't address the main issue, but emotional support while the client is fulfilling these roles is important. The family's ability to understand the ups and downs of the illness will help them but not the client.

4. A client with liver dysfunction has low serum levels of thrombin. The nurse provides care, anticipating that this client is most at risk of

• A. Dehydration
• B. Malnutrition
• C. Bleeding
• D. Infection

Correct answer: C

Rationale: Thrombin is produced by the liver and is necessary for normal clotting. When a client with liver dysfunction has low serum levels of thrombin, they are at risk of bleeding due to impaired clotting mechanisms. Dehydration (choice A) is not directly related to low thrombin levels. Malnutrition (choice B) may impact overall health but is not the most immediate concern associated with low thrombin levels. Infection (choice D) is not directly related to the clotting function affected by low thrombin levels.

5. 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.

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