Nursing Elites

1. Jerod is experiencing an acute episode of ulcerative colitis. What is the priority for this patient?

• A. Replace lost fluid and sodium.
• B. Monitor for increased serum glucose levels from steroid therapy.
• C. Restrict dietary intake of foods high in potassium.
• D. Note any change in the color and consistency of stools.

Correct answer: A

Rationale: The correct answer is to replace lost fluid and sodium. During an acute episode of ulcerative colitis, the priority is to manage the patient's fluid and electrolyte balance. This is crucial due to the potential for dehydration and electrolyte imbalances resulting from diarrhea and inflammation in the colon. Monitoring serum glucose levels (Choice B) may be important for patients on steroid therapy, but in this scenario, fluid and electrolyte balance take precedence. Restricting dietary intake of foods high in potassium (Choice C) is not a priority in the acute phase of ulcerative colitis. While noting changes in stool color and consistency (Choice D) is important for assessing the patient's gastrointestinal status, it is not the priority when managing acute ulcerative colitis.

2. Ralph has a history of alcohol abuse and has acute pancreatitis. Which lab value is most likely to be elevated?

• A. Calcium
• B. Glucose
• C. Magnesium
• D. Potassium

Correct answer: B

Rationale: In a patient with acute pancreatitis and a history of alcohol abuse, glucose levels are most likely to be elevated.

3. The nurse is reviewing the physician’s orders written for a client admitted with acute pancreatitis. Which physician order would the nurse question if noted on the client’s chart?

• A. NPO status
• B. Insert a nasogastric tube
• C. An anticholinergic medication
• D. Morphine for pain

Correct answer: D

Rationale: Morphine for pain should be questioned as it can cause spasms of the sphincter of Oddi, worsening pancreatitis.

4. A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching for this client, the nurse should stress:

• A. increasing fluid intake to prevent dehydration.
• B. wearing an appliance pouch at all times.
• C. consuming a low-protein, high-fiber diet.
• D. avoiding enteric-coated medications.

Correct answer: A

Rationale: The correct answer is A: increasing fluid intake to prevent dehydration. An ileostomy typically drains liquid waste, so the client is at risk of fluid loss. By increasing fluid intake, the client can prevent dehydration. It's essential for the client to wear a collection appliance at all times because ileostomy drainage is incontinent. Consuming a low-protein, high-fiber diet is not recommended as high-fiber foods can cause intestinal irritation. Enteric-coated medications should be avoided because they may not be absorbed properly after an ileostomy.

5. When counseling a client in ways to prevent cholecystitis, which of the following guidelines is most important?

• A. Eat a low-protein diet
• B. Eat a low-fat, low-cholesterol diet
• C. Limit exercise to 10 minutes/day
• D. Keep weight proportionate to height

Correct answer: B

Rationale: Eating a low-fat, low-cholesterol diet is most important for preventing cholecystitis.

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