Nursing Elites

1. The client being seen in a physician’s office has just been scheduled for a barium swallow the next day. The nurse writes down which of the following instructions for the client to follow before the test?

• A. Fast for 8 hours before the test.
• B. Eat a regular supper and breakfast.
• C. Continue to take all oral medications as scheduled.
• D. Monitor own bowel movement pattern for constipation

Correct answer: A

Rationale: A barium swallow is an x-ray study that uses a substance called barium for contrast to highlight abnormalities in the gastrointestinal tract. The client should fast for 8 to 12 hours before the test, depending on physician instructions. Most oral medications also are withheld before the test. After the procedure the nurse must monitor for constipation, which can occur as a result of the presence of barium in the gastrointestinal tract.

2. You’re caring for a 28 y.o. woman with hepatitis B. She’s concerned about the duration of her recovery. Which response isn’t appropriate?

• A. Encourage her to not worry about the future.
• B. Encourage her to express her feelings about the illness.
• C. Discuss the effects of hepatitis B on future health problems.
• D. Provide avenues for financial counseling if she expresses the need.

Correct answer: A

Rationale: Encouraging the patient to not worry about the future is not appropriate. Instead, address her concerns and provide information.

3. The client with a new colostomy is concerned about the odor from stool from the ostomy drainage bag. The nurse teaches the client to include which of the following foods in the diet to reduce odor?

• A. Yogurt
• B. Broccoli
• C. Cucumbers
• D. Eggs

Correct answer: A

Rationale: The client should be taught to include deodorizing foods in the diet, such as beet greens, parsley, buttermilk, and yogurt. Spinach also reduces odor but is a gas-forming food as well. Broccoli, cucumber, and eggs are gas-forming foods.

4. The nurse would assess the client experiencing an acute episode of cholecystitis for pain that is located in the right:

• A. Upper quadrant and radiates to the left scapula and shoulder
• B. Upper quadrant and radiates to the right scapula and shoulder
• C. Lower quadrant and radiates to the umbilicus
• D. Lower quadrant and radiates to the back

Correct answer: B

Rationale: Pain from cholecystitis is typically located in the right upper quadrant and may radiate to the right scapula and shoulder.

5. Your patient has a retractable gastric peptic ulcer and has had a gastric vagotomy. Which factor increases as a result of vagotomy?

• A. Peristalsis.
• B. Gastric acidity.
• C. Gastric motility.
• D. Gastric pH.

Correct answer: D

Rationale: After a gastric vagotomy, the gastric pH increases as a result of reduced acid secretion.

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