Nursing Elites

1. You’re patient, post-op drainage of a pelvic abscess secondary to diverticulitis, begins to cough violently after drinking water. His wound has ruptured and a small segment of the bowel is protruding. What’s your priority?

• A. Ask the patient what happened, call the doctor, and cover the area with a water-soaked bedsheet.
• B. Obtain vital signs, call the doctor, and obtain emergency orders.
• C. Have a CAN hold the wound together while you obtain vital signs, call the doctor and flex the patient’s knees.
• D. Have the doctor called while you remain with the patient, flex the patient’s knees, and cover the wound with sterile towels soaked in sterile saline solution.

Correct answer: D

Rationale: For a patient with a ruptured wound and protruding bowel, call the doctor while remaining with the patient, flex the patient’s knees, and cover the wound with sterile towels soaked in sterile saline solution.

2. The nurse is preparing a discharge teaching plan for the client who had an umbilical hernia repair. Which of the following would the nurse include in the plan?

• A. Restricting pain medication
• B. Maintaining bedrest
• C. Avoiding coughing
• D. Irrigating the drain

Correct answer: C

Rationale: Bedrest is not required following this surgical procedure. The client should take analgesics as needed and as prescribed to control pain. A drain is not used in this surgical procedure, although the client may be instructed in simple dressing changes. Coughing is avoided to prevent disruption of the tissue integrity, which can occur because of the location of this surgical procedure.

3. A client is suspected of having hepatitis. Which diagnostic test results will assist in confirming this diagnosis?

• A. Decreased erythrocyte sedimentation rate
• B. Elevated serum bilirubin
• C. Elevated hemoglobin
• D. Elevated blood urea nitrogen

Correct answer: B

Rationale: Laboratory indicators of hepatitis include elevated liver enzyme levels, elevated serum bilirubin levels, elevated erythrocyte sedimentation rates, and leucopenia. An elevated blood urea nitrogen may indicate renal dysfunction. A hemoglobin level is unrelated to this diagnosis.

4. Which of the following tests should be administered to a client suspected of having diverticulosis?

• A. Abdominal ultrasound
• B. Barium enema
• C. Barium swallow
• D. Gastroscopy

Correct answer: B

Rationale: A barium enema is a diagnostic test used to visualize the colon and can help diagnose diverticulosis.

5. Which of the following tests is most commonly used to diagnose cholecystitis?

• A. Abdominal CT scan
• B. Abdominal ultrasound
• C. Barium swallow
• D. Endoscopy

Correct answer: B

Rationale: An abdominal ultrasound is the most commonly used test to diagnose cholecystitis.

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