Nursing Elites

1. Janice is waiting for discharge instructions after her herniorrhaphy. Which of the following instructions do you include?

• A. Eat a low-fiber diet.
• B. Resume heavy lifting in 2 weeks.
• C. Lose weight, if obese.
• D. Resume sexual activity once discomfort is gone.

Correct answer: C

Rationale: Advise the patient to lose weight if obese to reduce the risk of complications after herniorrhaphy.

2. The physician orders a Salem sump tube for gastrointestinal intubation. The nurse prepares for the insertion and obtains which of the following items from the supply room?

• A. A tube with a single lumen that connects to suction
• B. A tube with a large lumen and an air vent
• C. A Sengstaken-Blakemore tube
• D. A Dobbhoff weighted tube

Correct answer: B

Rationale: A tube with a large lumen and an air vent is a Salem sump tube. A tube with a single lumen is called a Levin’s tube. A Sengstaken-Blakemore tube is used to control bleeding in the esophagus. A Dobbhoff weighted tube is used for feedings.

3. Nathaniel has severe pruritus due to having hepatitis B. What is the best intervention for his comfort?

• A. Give tepid baths.
• B. Avoid lotions and creams.
• C. Use hot water to increase vasodilation.
• D. Use cold water to decrease the itching.

Correct answer: A

Rationale: Giving tepid baths can help soothe severe pruritus due to hepatitis B.

4. The nurse has given instructions to the client with an ileostomy about foods to eat to thicken the stool. The nurse determines that the client needs further instructions if the client stated to eat which of the following foods to make the stool less watery?

• A. Pasta
• B. Boiled rice
• C. Bran
• D. Low-fat cheese

Correct answer: C

Rationale: Foods that help to thicken the stool of the client with an ileostomy include pasta, boiled rice, and low-fat cheese. Bran is high in dietary fiber and thus will increase the output of watery stool by increasing propulsion through the bowel. Ileostomy output is liquid. Addition or elimination of various foods can help to thicken or loosen this liquid drainage.

5. A client is scheduled for oral cholecystography. Which one of the following actions would the nurse plan to implement before the test?

• A. Have the client drink 1000 mL of water.
• B. Ask the client about possible allergies to iodine or shellfish.
• C. Administer an intravenous contrast agent the evening before the test.
• D. Administer tap-water enemas until clear.

Correct answer: B

Rationale: Iodine compounds used as radiographic contrast agents, such as iopanoic acid (Telepaque), should not be administered to the client with iodine and seafood allergies because anaphylaxis may occur.

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