Nursing Elites

1. The nurse has given instructions to the client with an ileostomy about foods to eat to thicken the stool. The nurse determines that the client needs further instructions if the client stated to eat which of the following foods to make the stool less watery?

• A. Pasta
• B. Boiled rice
• C. Bran
• D. Low-fat cheese

Correct answer: C

Rationale: Foods that help to thicken the stool of the client with an ileostomy include pasta, boiled rice, and low-fat cheese. Bran is high in dietary fiber and thus will increase the output of watery stool by increasing propulsion through the bowel. Ileostomy output is liquid. Addition or elimination of various foods can help to thicken or loosen this liquid drainage.

2. A nurse is developing a plan of care for a client who will be returning to a nursing unit following a percutaneous transhephatic cholangiogram. The nurse includes which intervention in the postprocedure plan of care?

• A. Place a sandbag over the insertion site.
• B. Allow the client bathroom privileges only.
• C. Encourage fluid intake.
• D. Allow the client to sit in a chair for meals.

Correct answer: A

Rationale: Following this procedure, the nurse monitors the client’s vital signs closely for indications of hemorrhage and observes the needle insertion site for bleeding and bile leakage. A sandbag is placed over the insertion site to prevent bleeding. The client is maintained on bedrest, and oral intake is avoided in the immediate postprocedure period in case surgery is necessary to control hemorrhage of bile extravasation.

3. When teaching a community group about measures to prevent colon cancer, which instruction should the nurse include?

• A. Limit fat intake to 20% to 25% of your total daily calories.
• B. Include 15 to 20 grams of fiber into your daily diet.
• C. Get an annual rectal examination after age 35.
• D. Undergo sigmoidoscopy annually after age 50.

Correct answer: A

Rationale: Limiting fat intake is a recommended measure to reduce the risk of colon cancer. Including fiber, undergoing annual rectal examinations, and sigmoidoscopy are also important, but limiting fat intake is directly related to reducing cancer risk.

4. The nurse provides medication instructions to a client with peptic ulcer disease. Which statement, if made by the client, indicates the best understanding of the medication therapy?

• A. The cimetidine (Tagamet) will cause me to produce less stomach acid.
• B. Sucralfate (Carafate) will change the fluid in my stomach.
• C. Antacids will coat my stomach.
• D. Omeprazole (Prilosec) will coat the ulcer and help it heal.

Correct answer: A

Rationale: Cimetidine (Tagamet) works by reducing stomach acid production, which helps to manage peptic ulcer disease.

5. Which of the following diets is most commonly associated with colon cancer?

• A. Low-fiber, high fat
• B. Low-fat, high-fiber
• C. Low-protein, high-carbohydrate
• D. Low carbohydrate, high protein

Correct answer: A

Rationale: A low-fiber, high-fat diet is most commonly associated with an increased risk of colon cancer.

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