Nursing Elites

1. The student nurse is participating in colorectal cancer-screening program. Which patient has the fewest risk factors for colon cancer?

• A. Janice, a 45 y.o. with a 25-year history of ulcerative colitis
• B. George, a 50 y.o. whose father died of colon cancer
• C. Herman, a 60 y.o. who follows a low-fat, high-fiber diet
• D. Sissy, a 72 y.o. with a history of breast cancer

Correct answer: C

Rationale: Herman, a 60 y.o. who follows a low-fat, high-fiber diet, has the fewest risk factors for colon cancer.

2. Type A chronic gastritis can be distinguished from type B by its ability to:

• A. Cause atrophy of the parietal cells.
• B. Affect only the antrum of the stomach.
• C. Thin the lining of the stomach walls.
• D. Decrease gastric secretions.

Correct answer: A

Rationale: Type A chronic gastritis can cause atrophy of the parietal cells, which is a distinguishing feature from type B.

3. The client with Crohn’s disease has a nursing diagnosis of Acute Pain. The nurse would teach the client to avoid which of the following in managing this problem?

• A. Lying supine with the legs straight
• B. Massaging the abdomen
• C. Using antispasmodic medication
• D. Using relaxation techniques

Correct answer: A

Rationale: In managing acute pain associated with Crohn’s disease, the client should avoid lying supine with the legs straight. This position increases muscle tension in the abdomen, potentially aggravating inflamed intestinal tissues as the abdominal muscles are stretched. Massaging the abdomen, using antispasmodic medication, and employing relaxation techniques are beneficial in alleviating pain. Massaging can help relax abdominal muscles, antispasmodic medication can reduce spasms contributing to pain, and relaxation techniques aid in overall pain management. Therefore, choices B, C, and D are appropriate interventions for managing pain in clients with CroCrohn’s disease.

4. After an abdominal resection for colon cancer, Madeline returns to her room with a Jackson-Pratt drain in place. The purpose of the drain is to:

• A. Irrigate the incision with a saline solution.
• B. Prevent bacterial infection of the incision.
• C. Measure the amount of fluid lost after surgery.
• D. Prevent accumulation of drainage in the wound.

Correct answer: D

Rationale: The purpose of the Jackson-Pratt drain is to prevent the accumulation of drainage in the wound after an abdominal resection.

5. 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.

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