Nursing Elites

1. Which of the following definitions best describes diverticulosis?

• A. An inflamed outpouching of the intestine
• B. A noninflamed outpouching of the intestine
• C. The partial impairment of the forward flow of intestinal contents
• D. An abnormal protrusion of an organ through the structure that usually holds it

Correct answer: B

Rationale: The correct answer is B: 'A noninflamed outpouching of the intestine.' Diverticulosis refers to the presence of small, bulging pouches (diverticula) that can form in the lining of the digestive system, especially the colon. These pouches are typically noninflamed. Choice A is incorrect because it describes diverticulitis, which is the inflammation of these pouches. Choice C is incorrect as it defines bowel obstruction, not diverticulosis. Choice D is incorrect as it refers to a hernia, not diverticulosis.

2. A nurse is preparing to remove a nasogastric tube from a client. The nurse would instruct the client to do which of the following just before the nurse removes the tube?

• A. To perform Valsalva’s maneuver
• B. To take hold and hold a deep breath
• C. To exhale
• D. To inhale and exhale quickly

Correct answer: B

Rationale: When the nurse removes a nasogastric tube, the client is instructed to take and hold a deep breath. This will be obstructed temporarily during the tube removal. This allows for easy withdrawal through the esophagus into the nose. The nurse removes the tube with one smooth, continuous pull.

3. Your patient Maria takes NSAIDS for her degenerative joint disease, has developed peptic ulcer disease. Which drug is useful in preventing NSAID-induced peptic ulcer disease?

• A. Calcium carbonate (Tums)
• B. Famotidine (Pepcid)
• C. Misoprostol (Cytotec)
• D. Sucralfate (Carafate)

Correct answer: C

Rationale: Misoprostol (Cytotec) is useful in preventing NSAID-induced peptic ulcer disease.

4. Which of the following diagnostic tests may be performed to determine if a client has gastric cancer?

• A. Barium enema
• B. Colonoscopy
• C. Gastroscopy
• D. Serum chemistry levels

Correct answer: C

Rationale: A gastroscopy is performed to visualize the stomach lining and obtain biopsies to diagnose gastric cancer.

5. The nurse assesses the client's understanding of the relationship between body position and gastroesophageal reflux. Which response would indicate that the client understands measures to avoid problems with reflux while sleeping?

• A. I can elevate the foot of the bed 4 to 6 inches.
• B. I can sleep on my stomach with my head turned to the left.
• C. I can sleep on my back without a pillow under my head.
• D. I can elevate the head of the bed 4 to 6 inches.

Correct answer: D

Rationale: Sleeping with the head of the bed elevated encourages movement of food through the esophagus by gravity. By fostering esophageal acid clearance, gravity helps keep the acidic pepsin and alkaline biliary secretions from contacting the esophagus. Elevating the foot of the bed does not affect clearance of esophageal acid. Sleeping on the stomach with the head turned to the left will not decrease reflux incidence. Sleeping flat without a pillow under the head does not enhance clearance.

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