Nursing Elites

1. In a client with Crohn’s disease, which of the following symptoms should not be a direct result from antibiotic therapy?

• A. Decrease in bleeding
• B. Decrease in temperature
• C. Decrease in body weight
• D. Decrease in the number of stools

Correct answer: C

Rationale: Decrease in body weight is not a direct result of antibiotic therapy but may occur due to the underlying disease process.

2. When teaching an elderly client how to prevent constipation, which of the following instructions should the nurse include?

• A. Drink 6 glasses of fluid each day.
• B. Avoid grain products and nuts.
• C. Add at least 4 grams of brain to your cereal each morning.
• D. Be sure to get regular exercise.

Correct answer: D

Rationale: To prevent constipation, elderly clients should be encouraged to get regular exercise, which promotes bowel motility.

3. 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 RBCs.

Correct answer: C

Rationale: Coffee-ground emesis is a sign of upper gastrointestinal bleeding that occurred approximately 2 hours earlier. It results from the breakdown of blood in the stomach due to digestive enzymes, giving it a coffee-ground appearance. Choice A is incorrect because coffee-ground emesis indicates older, partially digested blood, not fresh active bleeding. Choice B is incorrect as gastric lavage is not indicated for coffee-ground emesis. Choice D is incorrect because a transfusion of packed RBCs is not the immediate management for this presentation.

4. Your goal is to minimize David’s risk of complications after a heriorrhaphy. You instruct the patient to:

• A. Avoid the use of pain medication.
• B. Cough and deep breathe Q2H.
• C. Splint the incision if he can’t avoid sneezing or coughing.
• D. Apply heat to scrotal swelling.

Correct answer: C

Rationale: Instruct the patient to splint the incision if he can't avoid sneezing or coughing to minimize the risk of complications after heriorrhaphy.

5. Your patient has a GI tract that is functioning, but has the inability to swallow foods. Which is the preferred method of feeding for your patient?

• A. TPN
• B. PPN
• C. NG feeding
• D. Oral liquid supplements

Correct answer: C

Rationale: NG feeding is the preferred method for patients with a functioning GI tract but an inability to swallow foods.

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