Nursing Elites

1. A nurse is giving dietary instructions to a client who has a new colostomy. The nurse encourages the client to eat foods representing which of the following diets for the first 4 to 6 weeks postoperatively?

• A. High-protein
• B. High-carbohydrate
• C. Low-calorie
• D. Low-residue

Correct answer: D

Rationale: For the first 4 to 6 weeks following colostomy formation, the client should take in a low-residue diet. Following this period, the client should eat a high-carbohydrate, high-protein diet. The nurse also instructs the client to add new foods, one at a time, to determine tolerance to that food.

2. The nurse is planning to teach the client with gastroesophageal reflux disease about substances that will increase the lower esophageal sphincter pressure. Which of the following items would the nurse include on this list?

• A. Fatty foods
• B. Nonfat milk
• C. Chocolate
• D. Coffee

Correct answer: B

Rationale: Foods that increase the lower esophageal sphincter (LES) pressure will decrease reflux, and lessen the symptoms of gastroesophageal reflux disease (GERD). The food substance that will increase the LES pressure is nonfat milk. The other substances listed decrease the LES pressure, thus increasing reflux symptoms. Aggravating substances include chocolate, coffee, fatty foods and alcohol.

3. Which of the following interventions should be included in the medical management of Crohn’s disease?

• A. Increasing oral intake of fiber
• B. Administering laxatives
• C. Using long-term steroid therapy
• D. Increasing physical activity

Correct answer: C

Rationale: Long-term steroid therapy is often used in the management of Crohn's disease to reduce inflammation and suppress the immune response.

4. Which of the following substances is most likely to cause gastritis?

• A. Milk
• B. Bicarbonate of soda or baking soda
• C. Enteric-coated aspirin
• D. Nonsteroidal anti-inflammatory drugs (NSAIDs)

Correct answer: D

Rationale: The correct answer is D, Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs are known to cause gastritis by irritating the stomach lining. Choice A, Milk, is unlikely to cause gastritis and is actually a common remedy for mild gastritis symptoms. Choice B, Bicarbonate of soda or baking soda, is often used to relieve heartburn and indigestion, not cause gastritis. Choice C, Enteric-coated aspirin, is less likely to cause gastritis compared to NSAIDs because the enteric coating helps protect the stomach lining from irritation.

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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