Nursing Elites

1. Which of the following statements about Helicobacter pylori (H. pylori) is false?

• A. H. pylori does not invade the gastric or duodenal epithelium
• B. H. pylori stimulates gastric acid secretion
• C. Eradication of H. pylori prevents adenocarcinoma of the stomach
• D. H. pylori produces a urease that splits urea into ammonia and CO2

Correct answer: C

Rationale: H. pylori is known to reside in the mucus layer of the stomach and does not invade the epithelium. It produces urease that splits urea into ammonia and CO2. This action helps in neutralizing the acidic environment and allows H. pylori to survive. Additionally, urease activity can be detected in diagnostic tests for H. pylori. The stimulation of gastric acid secretion and disruption of the protective mucus layer are mechanisms by which H. pylori promotes injury. While eradicating H. pylori infection has been associated with a decreased risk of developing gastric cancer, it does not prevent adenocarcinoma of the stomach entirely.

2. A client with a history of myocardial infarction (MI) is prescribed nitroglycerin (Nitrostat) for chest pain. Which instruction should the nurse provide?

• A. Take the medication with food.
• B. Swallow the tablet whole.
• C. Take the medication at bedtime.
• D. Place the tablet under your tongue.

Correct answer: D

Rationale: The correct instruction for a client prescribed nitroglycerin (Nitrostat) for chest pain is to place the tablet under the tongue. This route allows for rapid absorption of the medication, providing quick relief for chest pain associated with myocardial infarction.

3. A 28-year-old woman presents with abdominal pain, bloating, and diarrhea. She notes that her symptoms improve with fasting. She has a history of iron deficiency anemia. What is the most likely diagnosis?

• A. Irritable bowel syndrome
• B. Celiac disease
• C. Lactose intolerance
• D. Crohn's disease

Correct answer: B

Rationale: The symptoms of abdominal pain, bloating, diarrhea improving with fasting, and a history of iron deficiency anemia are characteristic of celiac disease. Celiac disease is an autoimmune disorder triggered by gluten consumption, leading to damage in the small intestine. The improvement with fasting may be due to the temporary avoidance of gluten-containing foods. Irritable bowel syndrome, lactose intolerance, and Crohn's disease do not typically present with improvement of symptoms with fasting or have a clear association with iron deficiency anemia.

4. A client returns to the unit after a neck dissection. The surgeon placed a Jackson-Pratt drain in the wound. When assessing the wound drainage over the first 24 postoperative hours, what finding would prompt the nurse to notify the health care provider immediately?

• A. Presence of small blood clots in the drainage
• B. 60 mL of milky or cloudy drainage
• C. Spots of drainage on the dressings surrounding the drain
• D. 120 mL of serosanguinous drainage

Correct answer: B

Rationale: Milky or cloudy drainage can indicate infection or lymphatic leakage, which requires immediate attention. This finding may suggest a serious complication post neck dissection, warranting prompt notification of the healthcare provider for further evaluation and intervention.

5. A client with hypertension is receiving dietary education from a nurse. Which recommendation should the nurse include?

• A. Increase your intake of saturated fats.
• B. Limit your sodium intake to less than 2 grams per day.
• C. Avoid foods high in potassium.
• D. Consume at least three alcoholic beverages daily.

Correct answer: B

Rationale: The correct recommendation for a client with hypertension is to limit sodium intake to less than 2 grams per day. High sodium intake can worsen hypertension by increasing blood pressure. Choices A, C, and D are incorrect. Increasing saturated fats (Choice A) can be detrimental to heart health and exacerbate hypertension. Avoiding foods high in potassium (Choice C) is not recommended as potassium-rich foods can actually be beneficial for managing blood pressure. Consuming three alcoholic beverages daily (Choice D) can also have a negative impact on blood pressure and overall health.

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