Nursing Elites

1. The client with a new colostomy is concerned about the odor from the stool in 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: Yogurt helps reduce odor in the stool by promoting healthy bacteria in the digestive tract.

2. A client is admitted to the hospital after vomiting bright red blood and is diagnosed with a bleeding duodenal ulcer. The client develops a sudden, sharp pain in the midepigastric area along with a rigid, boardlike abdomen. These clinical manifestations most likely indicate which of the following?

• A. An intestinal obstruction has developed
• B. Additional ulcers have developed
• C. The esophagus has become inflamed
• D. The ulcer has perforated

Correct answer: D

Rationale: A sudden, sharp pain in the midepigastric area along with a rigid, boardlike abdomen indicates that the ulcer has perforated.

3. Which of the following diagnostic tests may be performed to determine if a client has gastric cancer?

• A. Barium enema
• B. Colonoscopy
• C. Gastroscopy
• D. Serum chemistry levels

Correct answer: C

Rationale: A gastroscopy is performed to visualize the stomach lining and obtain biopsies to diagnose gastric cancer.

4. Which of the following dietary measures would be useful in preventing esophageal reflux?

• A. Eating small, frequent meals
• B. Increasing fluid intake
• C. Avoiding air swallowing with meals
• D. Adding a bedtime snack to the dietary plan

Correct answer: A

Rationale: Eating small, frequent meals helps prevent esophageal reflux.

5. Which of the following techniques would the nurse use first to determine if a nasogastric tube is positioned in the stomach?

• A. Aspirating with a syringe and observing for the return of gastric contents.
• B. Irrigating with normal saline and observing for the return of solution.
• C. Placing the tube's free end in water and observing for air bubbles.
• D. Instilling air and auscultating over the epigastric area for the presence of the tube.

Correct answer: A

Rationale: The initial way to determine if a nasogastric tube is in the stomach is to apply suction to the tube with a syringe and observe for the return of stomach contents. Then the pH of the aspirate can be measured. This is the method of choice. One would not irrigate until tube placement is confirmed. Observing for air bubbles when the free end of the tube is placed under water is an unacceptable, unsafe method of determining tube placement. Another method is to instill air into the tube with a syringe while auscultating over the epigastric area. Hearing the air enter the stomach helps ensure proper placement, but the method is not foolproof and is no longer considered an effective or preferred way to determine placement.

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