Nursing Elites

1. Rob is a 46 y.o. admitted to the hospital with a suspected diagnosis of Hepatitis B. He’s jaundiced and reports weakness. Which intervention will you include in his care?

• A. Regular exercise.
• B. A low-protein diet.
• C. Allow patient to select his meals.
• D. Rest period after small, frequent meals.

Correct answer: D

Rationale: For a patient with hepatitis B who is jaundiced and reports weakness, providing rest periods after small, frequent meals is important.

2. In a client with diarrhea, which outcome indicates that fluid resuscitation is successful?

• A. The client passes formed stools at regular intervals
• B. The client reports a decrease in stool frequency and liquidity
• C. The client exhibits firm skin turgor
• D. The client no longer experiences perianal burning

Correct answer: C

Rationale: Firm skin turgor indicates adequate hydration, which is a key goal of fluid resuscitation. Formed stools, decreased stool frequency, and relief from perianal burning are important but do not directly indicate successful fluid resuscitation.

3. Michael, a 42 y.o. man is admitted to the med-surg floor with a diagnosis of acute pancreatitis. His BP is 136/76, pulse 96, Resps 22 and temp 101. His past history includes hyperlipidemia and alcohol abuse. The doctor prescribes an NG tube. Before inserting the tube, you explain the purpose to patient. Which of the following is a most accurate explanation?

• A. It empties the stomach of fluids and gas.
• B. It prevents spasms at the sphincter of Oddi.
• C. It prevents air from forming in the small intestine and large intestine.
• D. It removes bile from the gallbladder.

Correct answer: A

Rationale: Explain to the patient that the NG tube is used to empty the stomach of fluids and gas, which helps relieve symptoms of acute pancreatitis.

4. The nurse is caring for a client following a Billroth II procedure. On review of the post-operative orders, which of the following, if prescribed, would the nurse question and verify?

• A. Irrigating the nasogastric tube
• B. Coughing a deep breathing exercises
• C. Leg exercises
• D. Early ambulation

Correct answer: A

Rationale: Irrigating the nasogastric tube is typically not recommended after a Billroth II procedure unless specifically ordered by a physician due to the risk of disrupting the surgical site.

5. Anna is 45 y.o. and has a bleeding ulcer. Despite multiple blood transfusions, her HGB is 7.5g/dl and HCT is 27%. Her doctor determines that surgical intervention is necessary and she undergoes partial gastrectomy. Postoperative nursing care includes:

• A. Giving pain medication Q6H.
• B. Flushing the NG tube with sterile water.
• C. Positioning her in high Fowler’s position.
• D. Keeping her NPO until the return of peristalsis.

Correct answer: D

Rationale: Postoperative care for a patient who underwent partial gastrectomy includes keeping her NPO until the return of peristalsis to prevent complications.

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