Nursing Elites

1. A client with a peptic ulcer had a partial gastrectomy and vagotomy (Billroth I). In planning the discharge teaching, the client should be cautioned by the nurse about which of the following?

• A. Sit up for at least 30 minutes after eating
• B. Avoid fluids between meals
• C. Increase the intake of high-carbohydrate foods
• D. Avoid eating large meals that are high in simple sugars and liquids

Correct answer: D

Rationale: The correct answer is D: 'Avoid eating large meals that are high in simple sugars and liquids.' Clients who have undergone partial gastrectomy are at risk of dumping syndrome, which can occur due to the rapid emptying of stomach contents into the small intestine. Consuming large meals high in simple sugars and liquids can exacerbate this syndrome, leading to symptoms like abdominal cramping and diarrhea. Choices A, B, and C are not directly related to preventing dumping syndrome and are not the priority concerns for a client post-partial gastrectomy.

2. How should a healthcare provider assess a patient with potential diabetic ketoacidosis (DKA)?

• A. Monitor blood glucose and check for ketones in urine
• B. Administer insulin and provide fluids
• C. Administer potassium and check for electrolyte imbalance
• D. Administer sodium bicarbonate and monitor urine output

Correct answer: A

Rationale: Correct answer: To assess a patient with potential diabetic ketoacidosis (DKA), healthcare providers should monitor blood glucose and check for ketones in the urine. Elevated blood glucose levels and the presence of ketones in urine are indicative of DKA. Choice B is incorrect because administering insulin and providing fluids are treatments for DKA rather than assessment measures. Choice C is incorrect as administering potassium and checking for electrolyte imbalance are interventions related to managing DKA complications, not initial assessment. Choice D is incorrect because administering sodium bicarbonate and monitoring urine output are not primary assessment actions for DKA.

3. What are the primary differences between Type 1 and Type 2 diabetes in terms of pathophysiology and treatment?

• A. Type 1: No insulin production; Type 2: Insulin resistance
• B. Type 1: Insulin resistance; Type 2: Insulin deficiency
• C. Type 1: Autoimmune; Type 2: Lifestyle-related
• D. Type 1: Insulin therapy; Type 2: Diet modification

Correct answer: A

Rationale: The correct answer is A. Type 1 diabetes is characterized by the absence of insulin production, while Type 2 diabetes involves insulin resistance. Choice B is incorrect because Type 1 diabetes is not related to insulin resistance. Choice C is inaccurate as Type 1 diabetes is autoimmune while Type 2 diabetes is more associated with lifestyle factors. Choice D is not correct since insulin therapy is primarily used in Type 1 diabetes, whereas diet modification is a common approach in managing Type 2 diabetes.

4. A client who decides not to have surgery despite significant blockages in his coronary arteries is an example of what principle?

• A. Fidelity
• B. Autonomy
• C. Justice
• D. Non-maleficence

Correct answer: B

Rationale: The correct answer is B: Autonomy. Autonomy in healthcare refers to respecting a patient's right to make decisions about their own care, even if those decisions may not align with healthcare providers' recommendations. In this scenario, the client's decision not to have surgery despite significant blockages in his coronary arteries demonstrates his autonomy in making choices about his own health. Choice A, Fidelity, refers to the concept of keeping promises and being faithful to commitments, which is not applicable in this situation. Choice C, Justice, involves fairness and equal treatment in healthcare, which is not the primary principle at play when a patient exercises autonomy. Choice D, Non-maleficence, relates to the principle of doing no harm, which is important but not directly relevant to the client's decision to refuse surgery.

5. Which of the following is an early indicator that a client with a tracheostomy may require suctioning?

• A. Decreased respiratory rate
• B. Irritability
• C. Bradycardia
• D. Decreased oxygen saturation

Correct answer: B

Rationale: Irritability is an early indicator that suctioning is necessary for a client with a tracheostomy. Irritability can signal discomfort or difficulty breathing, which may be due to the need for suctioning to clear the airway. Decreased respiratory rate, bradycardia, and decreased oxygen saturation are not typically early indicators that suctioning is needed in a client with a tracheostomy. These symptoms may occur later if the airway is not cleared promptly.

Similar Questions