Nursing Elites

1. The nurse assesses the client's understanding of the relationship between body position and gastroesophageal reflux. Which response would indicate that the client understands measures to avoid problems with reflux while sleeping?

• A. I can elevate the foot of the bed 4 to 6 inches.
• B. I can sleep on my stomach with my head turned to the left.
• C. I can sleep on my back without a pillow under my head.
• D. I can elevate the head of the bed 4 to 6 inches.

Correct answer: D

Rationale: Sleeping with the head of the bed elevated encourages movement of food through the esophagus by gravity. By fostering esophageal acid clearance, gravity helps keep the acidic pepsin and alkaline biliary secretions from contacting the esophagus. Elevating the foot of the bed does not affect clearance of esophageal acid. Sleeping on the stomach with the head turned to the left will not decrease reflux incidence. Sleeping flat without a pillow under the head does not enhance clearance.

2. Which of the following associated disorders may the client with Crohn’s disease exhibit?

• A. Ankylosing spondylitis
• B. Colon cancer
• C. Malabsorption
• D. Lactase deficiency

Correct answer: A

Rationale: Clients with Crohn's disease may exhibit associated disorders such as ankylosing spondylitis, which is an inflammatory condition affecting the spine.

3. 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.

4. While caring for a client with peptic ulcer disease, the client reports that he has been nauseated most of the day and is now feeling lightheaded and dizzy. Based upon these findings, which nursing actions would be most appropriate for the nurse to take?

• A. Administering an antacid hourly until nausea subsides.
• B. Monitoring the client's vital signs
• C. Notifying the family and friends of the client's symptoms
• D. Initiating oxygen therapy

Correct answer: B

Rationale: Monitoring the client's vital signs and notifying the physician of the client's symptoms are crucial actions based on the reported symptoms.

5. When a client has peptic ulcer disease, the nurse would expect a priority intervention to be:

• A. Assisting in inserting a Miller-Abbott tube
• B. Assisting in inserting an arterial pressure line
• C. Inserting a nasogastric tube
• D. Inserting an I.V.

Correct answer: C

Rationale: Inserting a nasogastric tube is a priority intervention for a client with peptic ulcer disease to decompress the stomach.

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