Nursing Elites

1. The most important pathophysiologic factor contributing to the formation of esophageal varices is:

• A. Decreased prothrombin formation
• B. Decreased albumin formation by the liver
• C. Portal hypertension
• D. Increased central venous pressure

Correct answer: C

Rationale: Portal hypertension is the most important pathophysiologic factor contributing to the formation of esophageal varices.

2. Which of the following best describes the method of action of medications, such as ranitidine (Zantac), which are used in the treatment of peptic ulcer disease?

• A. Neutralize acid
• B. Reduce acid secretions
• C. Stimulate gastrin release
• D. Protect the mucosal barrier

Correct answer: B

Rationale: Medications like ranitidine (Zantac) are H2 receptor antagonists that reduce acid secretions in the stomach, helping to treat peptic ulcer disease.

3. You’re preparing a patient with a malignant tumor for colorectal surgery and subsequent colostomy. The patient tells you he’s anxious. What should your initial step be in working with this patient?

• A. Determine what the patient already knows about colostomies.
• B. Show the patient some pictures of colostomies.
• C. Arrange for someone who has a colostomy to visit the patient.
• D. Provide the patient with written material about colostomy care.

Correct answer: A

Rationale: When a patient with a malignant tumor is anxious about colorectal surgery and a colostomy, the initial step is to determine what the patient already knows about colostomies.

4. Eleanor, a 62 y.o. woman with diverticulosis is your patient. Which interventions would you expect to include in her care?

• A. Low-fiber diet and fluid restrictions.
• B. Total parenteral nutrition and bed rest.
• C. High-fiber diet and administration of psyllium.
• D. Administration of analgesics and antacids.

Correct answer: C

Rationale: Care for a patient with diverticulosis includes a high-fiber diet and administration of psyllium.

5. The nurse is caring for a client on the first postoperative day following a surgical repair of an abdominal aortic aneurysm. Which nursing diagnosis is the most important for this client?

• A. Risk for infection
• B. Deficient knowledge
• C. Ineffective peripheral tissue perfusion
• D. Activity intolerance

Correct answer: C

Rationale: Peripheral tissue perfusion is a major concern in the postoperative period following an abdominal aneurysm repair. Peripheral pulses should be checked frequently during the first 24 hours. A weak or absent pulse may be a sign of embolization or graft closure, especially if accompanied by a pale, cold, mottled extremity; the nurse should immediately report this to the surgeon. Risk for infection, deficient knowledge, and activity intolerance are all important nursing diagnoses in the postoperative period, but peripheral tissue perfusion is the most immediate concern.

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