Nursing Elites

1. Which of the following expected outcomes would be appropriate for the client who has ulcerative colitis?

• A. The client maintains a daily record of intake and output.
• B. The client verbalizes the importance of small, frequent feedings.
• C. The client uses a heating pad to decrease abdominal cramping.
• D. The client accepts that a colostomy is inevitable at some time in his life.

Correct answer: B

Rationale: Small, frequent feedings are better tolerated by clients with ulcerative colitis as they lessen the amount of fecal material present in the gastrointestinal tract and decrease stimulation. The client does not need to maintain a daily record of intake and output unless an exacerbation of the disease occurs. A heating pad should not be applied to the intestine as it is inflamed. It is not inevitable that the client will require surgery to treat ulcerative colitis.

2. You promote hemodynamic stability in a patient with upper GI bleeding by:

• A. Encouraging oral fluid intake.
• B. Monitoring central venous pressure.
• C. Monitoring laboratory test results and vital signs.
• D. Giving blood, electrolyte and fluid replacement.

Correct answer: D

Rationale: Promoting hemodynamic stability in a patient with upper GI bleeding involves giving blood, electrolyte, and fluid replacement.

3. A nurse is giving dietary instructions to a client who has a new colostomy. The nurse encourages the client to eat foods representing which of the following diets for the first 4 to 6 weeks postoperatively?

• A. High-protein
• B. High-carbohydrate
• C. Low-calorie
• D. Low-residue

Correct answer: D

Rationale: For the first 4 to 6 weeks following colostomy formation, the client should take in a low-residue diet. Following this period, the client should eat a high-carbohydrate, high-protein diet. The nurse also instructs the client to add new foods, one at a time, to determine tolerance to that food.

4. Nathaniel has severe pruritus due to having hepatitis B. What is the best intervention for his comfort?

• A. Give tepid baths.
• B. Avoid lotions and creams.
• C. Use hot water to increase vasodilation.
• D. Use cold water to decrease the itching.

Correct answer: A

Rationale: Giving tepid baths can help soothe severe pruritus due to hepatitis B.

5. A nurse is caring for a client diagnose with pancreatitis. The nurse anticipates that the client would not experience an elevation of which of the following enzymes?

• A. Lipase
• B. Lactase
• C. Amylase
• D. Trypsin

Correct answer: B

Rationale: Lactase is produced in the small intestine and aids in splitting neutral fats into glycerol and fatty acids. Lipase, amylase, and trypsin are produced in the pancreas and aid in the digestion of fats, starches, and proteins, respectively.

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