Nursing Elites

1. Which of the following aspects is the priority focus of nursing management for a client with peritonitis?

• A. Fluid and electrolyte balance
• B. Gastric irrigation
• C. Pain management
• D. Psychosocial issues

Correct answer: A

Rationale: The priority focus of nursing management for a client with peritonitis is fluid and electrolyte balance to prevent shock.

2. You’re caring for a 28 y.o. woman with hepatitis B. She’s concerned about the duration of her recovery. Which response isn’t appropriate?

• A. Encourage her to not worry about the future.
• B. Encourage her to express her feelings about the illness.
• C. Discuss the effects of hepatitis B on future health problems.
• D. Provide avenues for financial counseling if she expresses the need.

Correct answer: A

Rationale: Encouraging the patient to not worry about the future is not appropriate. Instead, address her concerns and provide information.

3. Which of the following mechanisms can facilitate the development of diverticulosis into diverticulitis?

• A. Treating constipation with chronic laxative use, leading to dependence on laxatives
• B. Chronic constipation causing an obstruction, reducing forward flow of intestinal contents
• C. Herniation of the intestinal mucosa, rupturing the wall of the intestine
• D. Undigested food blocking the diverticulum, predisposing the area to bacterial invasion

Correct answer: D

Rationale: The correct answer is D. Undigested food blocking the diverticulum can lead to bacterial invasion, causing inflammation and turning diverticulosis into diverticulitis. Choices A, B, and C do not directly facilitate the development of diverticulitis. Choice A involves a different mechanism related to laxative use, choice B describes a complication of chronic constipation but does not necessarily lead to diverticulitis, and choice C refers to a different condition involving herniation of the intestinal mucosa.

4. A client with a peptic ulcer is scheduled for a vagotomy. The client asks the nurse about the purpose of this procedure. The nurse tells the client that the procedure:

• A. Decreases food absorption in the stomach
• B. Heals the gastric mucosa
• C. Halts stress reactions
• D. Reduces the stimulus to acid secretions

Correct answer: D

Rationale: A vagotomy reduces the stimulus to acid secretions by cutting the vagus nerve, which innervates the stomach.

5. The nurse is reviewing the medication record of a client with acute gastritis. Which medication, if noted on the client’s record, would the nurse question?

• A. Digoxin (Lanoxin)
• B. Indomethacin (Indocin)
• C. Furosemide (Lasix)
• D. Propranolol hydrochloride (Inderal)

Correct answer: B

Rationale: Indomethacin (Indocin) is an NSAID that can aggravate acute gastritis and should be questioned.

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