Nursing Elites

1. A client presents to the emergency room, reporting that he has been vomiting every 30 to 40 minutes for the past 8 hours. Frequent vomiting puts him at risk for which of the following?

• A. Metabolic acidosis with hyperkalemia
• B. Metabolic acidosis with hypokalemia
• C. Metabolic alkalosis with hyperkalemia
• D. Metabolic alkalosis with hypokalemia

Correct answer: D

Rationale: Frequent vomiting can lead to metabolic alkalosis with hypokalemia due to the loss of stomach acid and electrolytes.

2. The nurse is preparing to discontinue a client’s nasogastric tube. The client is positioned properly, and the tube has been flushed with 15 mL of air to clear secretions. Before removing the tube, the nurse makes which statement to the client?

• A. Take a deep breath when I tell you and breathe normally while I remove the tube.
• B. Take a deep breath when I tell you and bear down while I remove the tube.
• C. Take a deep breath when I tell you and slowly exhale while I remove the tube.
• D. Take a deep breath when I tell you and hold it while I remove the tube.

Correct answer: C

Rationale: The client should take a deep breath because the client’s airway will be obstructed temporarily during tube removal. The nurse then tells the client to exhale slowly and withdraws the tube during exhalation. Bearing down could inhibit the removal of the tube. Breathing normally could result in aspiration of gastric secretions during inhalation. Holding the breath does not facilitate tube removal.

3. The nurse has given instructions to the client with an ileostomy about foods to eat to thicken the stool. The nurse determines that the client needs further instructions if the client stated to eat which of the following foods to make the stool less watery?

• A. Pasta
• B. Boiled rice
• C. Bran
• D. Low-fat cheese

Correct answer: C

Rationale: Foods that help to thicken the stool of the client with an ileostomy include pasta, boiled rice, and low-fat cheese. Bran is high in dietary fiber and thus will increase the output of watery stool by increasing propulsion through the bowel. Ileostomy output is liquid. Addition or elimination of various foods can help to thicken or loosen this liquid drainage.

4. The nurse is reviewing the medication record of a client with acute gastritis. Which medication if noted on the client’s record, would the nurse question?

• A. Digoxin (Lanoxin)
• B. Indomethacin (Indocin)
• C. Furosemide (Lasix)
• D. Propranolol hydrochloride (Inderal)

Correct answer: B

Rationale: Indomethacin (Indocin) is a Nonsteroidal anti-inflammatory drug and can cause ulceration of the esophagus, stomach, duodenum, or small intestine. Indomethacin is contraindicated in a client with gastrointestinal disorders. Furosemide (Lasix) is a loop diuretic. Digoxin is an antidysrhythmic. Propranolol (Inderal) is a B- adrenergic blocker. Furosemide, digoxin, and propranolol are not contraindicated in clients with gastric disorders.

5. A client is to take one daily dose of ranitidine (Zantac) at home to treat her peptic ulcer. The nurse knows that the client understands proper drug administration of ranitidine when she says that she will take the drug at which of the following times?

• A. Before meals
• B. With meals
• C. At bedtime
• D. When pain occurs

Correct answer: C

Rationale: Ranitidine (Zantac) is best taken at bedtime to reduce stomach acid production overnight.

Similar Questions