Nursing Elites

1. Care for the postoperative client after gastric resection should focus on which of the following problems?

• A. Body image
• B. Nutritional needs
• C. Skin care
• D. Spiritual needs

Correct answer: B

Rationale: Postoperative care after gastric resection should focus on the client's nutritional needs to ensure proper healing and recovery.

2. A client with ulcerative colitis has an order to begin salicylate medication to reduce inflammation. The nurse instructs the client to take the medication:

• A. 30 minutes before meals
• B. On an empty stomach
• C. After meals
• D. On arising

Correct answer: C

Rationale: The correct answer is C: After meals. Salicylate medications for ulcerative colitis should be taken after meals to minimize gastrointestinal irritation and enhance absorption. Taking the medication on an empty stomach (Choice B) may increase the risk of gastrointestinal side effects. Taking it 30 minutes before meals (Choice A) may not provide enough protection for the stomach lining. Taking it on arising (Choice D) is not recommended as it may not coincide with the peak absorption times of the medication.

3. The nurse is caring for a client following a Billroth II procedure. On review of the postoperative orders, which of the following if prescribed, should the nurse question and verify?

• A. Irrigating the nasogastric tube
• B. Coughing and deep breathing exercises
• C. Leg exercises
• D. Early ambulation

Correct answer: A

Rationale: In a Billroth II procedure the proximal remnant of the stomach is anastomosed to the proximal jejunum. Patency of the nasogastric tube is critical for preventing the retention of gastric secretions. The nurse should never irrigate or reposition the gastric tube after gastric surgery, unless specifically ordered by the physician. In this situation the nurse should clarify the order. Coughing and deep breathing exercises, leg exercises, and early ambulation are appropriate postoperative interventions.

4. A client is to take one daily dose of ranitidine (Zantac) at home to treat her peptic ulcer. The nurse knows that the client understands proper drug administration of ranitidine when she says that she will take the drug at which of the following times?

• A. Before meals
• B. With meals
• C. At bedtime
• D. When pain occurs

Correct answer: C

Rationale: Ranitidine (Zantac) is best taken at bedtime to reduce stomach acid production overnight.

5. Kevin has a history of peptic ulcer disease and vomits coffee-ground emesis. What does this indicate?

• A. He has fresh, active upper GI bleeding.
• B. He needs immediate saline gastric lavage.
• C. His gastric bleeding occurred 2 hours earlier.
• D. He needs a transfusion of packed RBC’s.

Correct answer: C

Rationale: Coffee-ground emesis indicates that the gastric bleeding occurred 2 hours earlier.

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