Nursing Elites

1. The nurse provides medication instructions to a client with peptic ulcer disease. Which statement, if made by the client, indicates 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) a Histamine H2 receptor antagonist, will decrease the secretion of gastric acid. Sucralfate (Carafate) promotes healing by coating the ulcer. Antacids neutralize acid in the stomach. Omeprazole (Prilosec) inhibits gastric acid secretion.

2. Which of the following expected outcomes would be most appropriate for a client with peptic ulcer disease? The client will:

• A. verbalize absence of epigastric pain.
• B. accept the need to inject himself with vitamin B12 for the rest of his life.
• C. understand the need to increase his exercise activity.
• D. eliminate stress from his life.

Correct answer: A

Rationale: A realistic goal for this client would be to gain relief from epigastric pain. There is no need for vitamin B12 injections because this client has not had any gastric surgery that would lead to vitamin B12 deficiency. Exercise should be modified, not increased, because it can stimulate further production of gastric acid. It is not possible to eliminate stress from a client's life. Instead, the client should be assisted to develop effective coping and problem-solving strategies as necessary.

3. Which of the following tests is most commonly used to diagnose cholecystitis?

• A. Abdominal CT scan
• B. Abdominal ultrasound
• C. Barium swallow
• D. Endoscopy

Correct answer: B

Rationale: An abdominal ultrasound is the most commonly used test to diagnose cholecystitis.

4. A nurse is caring for a client with cirrhosis of the liver. To minimize the effects of the disorder, the nurse teaches the client about foods that are high in thiamine. The nurse determines that the client has best understanding of the dietary measures to follow of the client states an intention to increase intake of:

• A. Pork
• B. Milk
• C. Chicken
• D. Broccoli

Correct answer: A

Rationale: The client with cirrhosis needs to consume foods high in thiamine. Thiamine is present in a variety of foods of plant and animal origin. Pork products are especially rich in this vitamin. Other good food sources include nuts, whole grain cereals, and legumes. Milk contains vitamins A, D, and B2. Broccoli contains vitamins C, E, and K and folic acid.

5. A 30-year old client experiences weight loss, abdominal distention, crampy abdominal pain, and intermittent diarrhea after the birth of her 2nd child. Diagnostic tests reveal gluten-induced enteropathy. Which foods must she eliminate from her diet permanently?

• A. Milk and dairy products
• B. Protein-containing foods
• C. Cereal grains (except rice and corn)
• D. Carbohydrates

Correct answer: C

Rationale: Gluten-induced enteropathy, or celiac disease, requires the elimination of gluten-containing grains like wheat, barley, and rye. Dairy, proteins, and carbohydrates are not excluded unless the client has specific intolerances.

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