Nursing Elites

1. 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.

2. Which of the following factors is believed to be linked to Crohn’s disease?

• A. Constipation
• B. Diet
• C. Hereditary
• D. Lack of exercise

Correct answer: C

Rationale: Crohn's disease is believed to have a hereditary link, with genetic factors playing a significant role in its development.

3. The nurse is planning to teach the client with gastroesophageal reflux disease about substances that will increase the lower esophageal sphincter pressure. Which of the following items would the nurse include on this list?

• A. Fatty foods
• B. Nonfat milk
• C. Chocolate
• D. Coffee

Correct answer: B

Rationale: Foods that increase the lower esophageal sphincter (LES) pressure will decrease reflux, and lessen the symptoms of gastroesophageal reflux disease (GERD). The food substance that will increase the LES pressure is nonfat milk. The other substances listed decrease the LES pressure, thus increasing reflux symptoms. Aggravating substances include chocolate, coffee, fatty foods and alcohol.

4. 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.

5. You’re caring for Beth who underwent a Billroth II procedure (surgical removal of the pylorus and duodenum) for treatment of a peptic ulcer. Which findings suggest that the patient is developing dumping syndrome, a complication associated with this procedure?

• A. Flushed, dry skin.
• B. Headache and bradycardia.
• C. Dizziness and sweating.
• D. Dyspnea and chest pain.

Correct answer: C

Rationale: Dizziness and sweating are common signs of dumping syndrome, a complication of the Billroth II procedure.

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