Nursing Elites

1. When obtaining a nursing history on a client with a suspected gastric ulcer, which signs and symptoms would the nurse expect to see? Select ONE that does not apply.

• A. Epigastric pain at night
• B. Relief of epigastric pain after eating
• C. Vomiting
• D. Weight loss

Correct answer: B

Rationale: Signs and symptoms of a gastric ulcer include epigastric pain at night, vomiting, and weight loss. Relief of epigastric pain after eating is not typically associated with gastric ulcers.

2. Regina is a 46 y.o. woman with ulcerative colitis. You expect her stools to look like:

• A. Watery and frothy.
• B. Bloody and mucoid.
• C. Firm and well-formed.
• D. Alternating constipation and diarrhea.

Correct answer: B

Rationale: Stools in ulcerative colitis are typically bloody and mucoid.

3. To accurately assess for jaundice in a patient with dark skin pigmentation, the nurse should examine which body areas?

• A. Nail beds
• B. Skin on the back of the hand
• C. Hard palate of the mouth
• D. Soles of the feet

Correct answer: C

Rationale: To accurately assess for jaundice in a patient with dark skin pigmentation, the nurse should examine the hard palate of the mouth. Jaundice is best assessed in the sclera; however, in dark-skinned patients, normal yellow pigmentation may be present in the sclera, making it difficult to detect jaundice. Inspection of the hard palate for a yellow color can confirm the presence of jaundice. Cyanosis is best observed in the nail beds, not indicative of jaundice. While skin on the palm of the hand can indicate jaundice, the back of the hand is not a typical area for assessment. Jaundice can be assessed on the soles of the feet in dark-skinned patients, but it is better visualized in the hard palate for accurate evaluation.

4. 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.

5. The nurse is doing an admission assessment on a client with a history of duodenal ulcer. To determine whether the problem is currently active, the nurse would assess the client for which of the following most frequent symptom(s) of duodenal ulcer?

• A. Pain that is relieved by food intake
• B. Pain that radiated down the right arm
• C. N/V
• D. Weight loss

Correct answer: A

Rationale: Pain that is relieved by food intake is the most frequent symptom of duodenal ulcers because the food neutralizes the stomach acid.

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