Nursing Elites

1. Donald is a 61 y.o. man with diverticulitis. Diverticulitis is characterized by:

• A. Periodic rectal hemorrhage.
• B. Hypertension and tachycardia.
• C. Vomiting and elevated temperature.
• D. Crampy and lower left quadrant pain and low-grade fever.

Correct answer: D

Rationale: Diverticulitis is characterized by crampy lower left quadrant pain and a low-grade fever.

2. Which of the following would be an expected nutritional outcome for a client who has undergone a subtotal gastrectomy for cancer?

• A. Regain weight loss within 1 month after surgery
• B. Resume normal dietary intake of three meals per day
• C. Control nausea and vomiting through regular use of antiemetics
• D. Achieve optimal nutritional status through oral or parenteral feedings

Correct answer: D

Rationale: Achieving optimal nutritional status through oral or parenteral feedings is an expected nutritional outcome for a client who has undergone a subtotal gastrectomy for cancer.

3. Crohn’s disease can be described as a chronic relapsing disease. Which of the following areas in the GI system may be involved with this disease?

• A. The entire length of the large colon
• B. Only the sigmoid area
• C. The entire large colon through the layers of mucosa and submucosa
• D. The small intestine and colon; affecting the entire thickness of the bowel

Correct answer: D

Rationale: Crohn's disease can affect any part of the gastrointestinal tract from the mouth to the anus, but it commonly affects the small intestine and colon, involving the entire thickness of the bowel wall.

4. Your patient has a retractable gastric peptic ulcer and has had a gastric vagotomy. Which factor increases as a result of vagotomy?

• A. Peristalsis.
• B. Gastric acidity.
• C. Gastric motility.
• D. Gastric pH.

Correct answer: D

Rationale: After a gastric vagotomy, the gastric pH increases as a result of reduced acid secretion.

5. After gastric resection surgery, which of the following signs and symptoms would alert the nurse to the development of a leaking anastomosis?

• A. Pain, fever, and abdominal rigidity.
• B. Diarrhea with fat in the stool.
• C. Palpitations, pallor, and diaphoresis after eating.
• D. Feelings of fullness and nausea after eating.

Correct answer: A

Rationale: Pain, fever, and abdominal rigidity are signs and symptoms of inflammation or peritonitis caused by the leaking anastomosis. Diarrhea with fat in the stool is steatorrhea and is not present in peritonitis. Palpitations, pallor, and diaphoresis after eating are vasomotor symptoms of gastric retention. Feelings of fullness and nausea after eating are not present in peritonitis.

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