Nursing Elites

1. Your patient has a retractable gastric peptic ulcer and has had a gastric vagotomy. Which factor increases as a result of vagotomy?

• A. Peristalsis.
• B. Gastric acidity.
• C. Gastric motility.
• D. Gastric pH.

Correct answer: D

Rationale: After a gastric vagotomy, the gastric pH increases as a result of reduced acid secretion.

2. A client being treated for chronic cholecystitis should be given which of the following instructions?

• A. Increase rest
• B. Avoid antacids
• C. Increase protein in diet
• D. Use anticholinergics as prescribed

Correct answer: D

Rationale: Using anticholinergics as prescribed can help manage the symptoms of chronic cholecystitis.

3. The nurse is assessing for stoma prolapse in a client with a colostomy. The nurse would observe which of the following if stoma prolapse occurred?

• A. Sunken and hidden stoma
• B. Dark- and bluish-colored stoma
• C. Narrowed and flattened stoma
• D. Protruding stoma

Correct answer: D

Rationale: A protruding stoma is indicative of stoma prolapse, which occurs when the bowel protrudes excessively through the stoma.

4. The nurse is caring for a client on the first postoperative day following a surgical repair of an abdominal aortic aneurysm. Which nursing diagnosis is the most important for this client?

• A. Risk for infection
• B. Deficient knowledge
• C. Ineffective peripheral tissue perfusion
• D. Activity intolerance

Correct answer: C

Rationale: Peripheral tissue perfusion is a major concern in the postoperative period following an abdominal aneurysm repair. Peripheral pulses should be checked frequently during the first 24 hours. A weak or absent pulse may be a sign of embolization or graft closure, especially if accompanied by a pale, cold, mottled extremity; the nurse should immediately report this to the surgeon. Risk for infection, deficient knowledge, and activity intolerance are all important nursing diagnoses in the postoperative period, but peripheral tissue perfusion is the most immediate concern.

5. 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.

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