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. To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instructions?

• A. Lie down after meals to promote digestion.
• B. Avoid coffee and alcoholic beverages.
• C. Take antacids before meals.
• D. Limit fluids with meals.

Correct answer: B

Rationale: To prevent reflux of stomach acid into the esophagus, the nurse should advise the client to avoid foods and beverages that tend to increase stomach acid, such as coffee and alcohol. The nurse also should teach the client to avoid lying down after meals, which can aggravate reflux, and to take antacids after eating. The client doesn't need to limit fluids with meals as long as the fluids aren't gastric irritants.

3. The student nurse is teaching the family of a patient with liver failure. You instruct them to limit which foods in the patient’s diet?

• A. Meats and beans.
• B. Butter and gravies.
• C. Potatoes and pastas.
• D. Cakes and pastries.

Correct answer: A

Rationale: For a patient with liver failure, it is important to limit the intake of meats and beans to reduce the risk of hepatic encephalopathy.

4. A nurse is developing a teaching plan for the client with viral hepatitis. The nurse plans to tell the client which of the following in the teaching session?

• A. Activity should be limited to prevent fatigue
• B. The diet should be low in calories
• C. Meals should be large to conserve energy
• D. Alcohol intake should be limited to 2 oz. per day.

Correct answer: A

Rationale: The client with viral hepatitis should limit activity to avoid fatigue during the recuperation period. The diet should be optimal in calories, proteins, and carbohydrates. The client should take in several small meals per day. Alcohol is strictly forbidden.

5. Claire, a 33 y.o. is on your floor with a possible bowel obstruction. Which intervention is priority for her?

• A. Obtain daily weights.
• B. Measure abdominal girth.
• C. Keep strict intake and output.
• D. Encourage her to increase fluids.

Correct answer: B

Rationale: For a patient with a possible bowel obstruction, measuring abdominal girth is a priority to monitor for signs of worsening obstruction or distention.

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