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. Fistulas are most common with which of the following bowel disorders?

• A. Crohn’s disease
• B. Diverticulitis
• C. Diverticulosis
• D. Ulcerative colitis

Correct answer: A

Rationale: Fistulas are most common in Crohn's disease due to the transmural inflammation that characterizes this condition.

3. After a subtotal gastrectomy, care of the client’s nasogastric tube and drainage system should include which of the following nursing interventions?

• A. Irrigate the tube with 30 ml of sterile water every hour, if needed.
• B. Reposition the tube if it is not draining well
• C. Monitor the client for N/V, and abdominal distention
• D. Turn the machine to high suction of the drainage is sluggish on low suction.

Correct answer: C

Rationale: Monitoring the client for nausea, vomiting, and abdominal distention is crucial for ensuring proper functioning of the nasogastric tube and drainage system.

4. Which of the following symptoms indicates diverticulosis?

• A. No symptoms exist
• B. Change in bowel habits
• C. Anorexia with low-grade fever
• D. Episodic, dull, or steady midabdominal pain

Correct answer: A

Rationale: Diverticulosis often has no symptoms and is usually found incidentally during tests for other conditions.

5. The nurse is providing discharge instructions to a client following gastrectomy. Which measure will the nurse instruct the client to follow to assist in preventing dumping syndrome?

• A. Eat high-carbohydrate foods
• B. Limit the fluids taken with meals
• C. Ambulate following a meal
• D. Sit in a high-Fowlers position during meals

Correct answer: B

Rationale: To prevent dumping syndrome after a gastrectomy, it is recommended to limit fluids taken with meals to slow down gastric emptying and reduce the symptoms.

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