Nursing Elites

1. Which of the following expected outcomes would be most appropriate for a client with peptic ulcer disease? The client will:

• A. verbalize absence of epigastric pain.
• B. accept the need to inject himself with vitamin B12 for the rest of his life.
• C. understand the need to increase his exercise activity.
• D. eliminate stress from his life.

Correct answer: A

Rationale: A realistic goal for this client would be to gain relief from epigastric pain. There is no need for vitamin B12 injections because this client has not had any gastric surgery that would lead to vitamin B12 deficiency. Exercise should be modified, not increased, because it can stimulate further production of gastric acid. It is not possible to eliminate stress from a client's life. Instead, the client should be assisted to develop effective coping and problem-solving strategies as necessary.

2. Which of the following tasks should be included in the immediate postoperative management of a client who has undergone gastric resection?

• A. Monitoring gastric pH to detect complications
• B. Assessing for bowel sounds
• C. Providing nutritional support
• D. Monitoring for symptoms of hemorrhage

Correct answer: D

Rationale: Monitoring for symptoms of hemorrhage is a crucial part of the immediate postoperative management of a client who has undergone gastric resection.

3. The client being seen in a physician’s office has just been scheduled for a barium swallow the next day. The nurse writes down which of the following instructions for the client to follow before the test?

• A. Fast for 8 hours before the test
• B. Eat a regular supper and breakfast
• C. Continue to take all oral medications as scheduled.
• D. Monitor own bowel movement pattern for constipation

Correct answer: A

Rationale: Fasting for 8 hours ensures that the stomach is empty, which is necessary for an accurate barium swallow test.

4. A client with suspected gastric cancer undergoes an endoscopy of the stomach. Which of the following assessments made after the procedure would indicate the development of a potential complication?

• A. The client complains of a sore throat
• B. The client displays signs of sedation
• C. The client experiences a sudden increase in temperature
• D. The client demonstrates a lack of appetite

Correct answer: C

Rationale: A sudden increase in temperature after an endoscopy can indicate a potential complication, such as perforation.

5. A client had an abdominal perineal resection with a colostomy 4 days ago and is ready for discharge. Which of the following would be an appropriate expected outcome at this point?

• A. The client maintains a high-fiber diet.
• B. The client discusses concerns about his sexual functioning.
• C. The client maintains bedrest.
• D. The client limits fluid intake to 1000 ml/day.

Correct answer: B

Rationale: Clients often have concerns about their sexuality after a fecal diversion. The nurse should encourage the client to discuss any questions about sexual functioning. The client will not need to maintain a high-fiber diet but will be encouraged to avoid any foods that cause odor and flatulence. The client should be able to ambulate and sit out of bed for several hours at a time at this point. Fluid intake will be encouraged, not restricted.

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