Nursing Elites

1. A patient with chronic alcohol abuse is admitted with liver failure. You closely monitor the patient’s blood pressure because of which change that is associated with the liver failure?

• A. Hypoalbuminemia
• B. Increased capillary permeability
• C. Abnormal peripheral vasodilation
• D. Excess rennin release from the kidneys

Correct answer: C

Rationale: Abnormal peripheral vasodilation is a change associated with liver failure that requires close monitoring of the patient's blood pressure.

2. A client with ulcerative colitis is diagnosed with a mild case of the disease. The nurse doing dietary teaching gives the client examples of foods to eat that represent which of the following therapeutic diets?

• A. High-fat with milk
• B. High-protein without milk
• C. Low-roughage without milk
• D. Low-roughage with milk

Correct answer: C

Rationale: The client with a mild case of ulcerative colitis is often advised to follow a diet low in roughage and avoid milk. This dietary approach helps reduce the frequency of diarrhea in these clients. Therefore, the correct therapeutic diet for the client with ulcerative colitis in this scenario is a low-roughage diet without milk. Choices A, B, and D are incorrect because high-fat, high-protein, and low-roughage with milk diets are not typically recommended for clients with ulcerative colitis, especially those with mild cases.

3. A client has a nasogastric tube inserted at the time of abdominal perineal resection with permanent colostomy. This tube will most likely be removed when the client demonstrates:

• A. Absence of nausea and vomiting.
• B. Passage of mucus from the rectum.
• C. Passage of flatus and feces from the colostomy.
• D. Absence of stomach drainage for 24 hours.

Correct answer: C

Rationale: A sign indicating that a client's colostomy is open and ready to function is passage of feces and flatus. When this occurs, gastric suction is ordinarily discontinued, and the client is allowed to start taking fluids and food orally. Absence of bowel sounds would indicate that the tube should remain in place because peristalsis has not yet returned. Absence of nausea and vomiting is not a criterion for judging whether or not gastric suction should be continued. Passage of mucus from the rectum will not occur in this client because the rectum is removed in this surgery. Absence of stomach drainage is not a criterion for judging whether or not gastric suction should be continued.

4. Which of the following best describes the method of action of medications, such as ranitidine (Zantac), which are used in the treatment of peptic ulcer disease?

• A. Neutralize acid
• B. Reduce acid secretions
• C. Stimulate gastrin release
• D. Protect the mucosal barrier

Correct answer: B

Rationale: Medications like ranitidine (Zantac) are H2 receptor antagonists that reduce acid secretions in the stomach, helping to treat peptic ulcer disease.

5. Which of the following factors is believed to be linked to Crohn’s disease?

• A. Constipation
• B. Diet
• C. Hereditary
• D. Lack of exercise

Correct answer: C

Rationale: Crohn's disease is believed to have a hereditary link, with genetic factors playing a significant role in its development.

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