Nokea
A client has been diagnosed with adenocarcinoma of the stomach and is scheduled to undergo a subtotal gastrectomy (Billroth II procedure). During pre-operative teaching, the nurse is reinforcing information about the procedure. Which of the following explanations is most accurate?
- A. The procedure will result in enlargement of the pyloric sphincter
- B. The procedure will result in anastomosis of the gastric stump to the jejunum
- C. The procedure will result in removal of the duodenum
- D. The procedure will result in repositioning of the vagus nerve
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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A client is providing instructions to a client who is scheduled for an oral cholecystogram. The nurse tells the client to
- A. Eat a fat-free meal on the evening before the procedure.
- B. Maintain strict NPO status on the day of the procedure.
- C. Avoid oral intake except for water on the day of the procedure.
- D. Eat a high-fat meal for breakfast on the day of the procedure.
Correct Answer: C
Rationale: For an oral cholecystogram, the client should eat a fat-free meal the evening before the procedure and avoid oral intake except for water on the day of the procedure. During the test, the client may be given a high-fat meal or drink to stimulate gallbladder emptying. Choice A is incorrect because the client should have a fat-free meal, not a high-fat meal. Choice B is incorrect as strict NPO status is not required. Choice D is incorrect as a high-fat meal is not recommended for breakfast on the day of the procedure.
The nurse develops a plan of care for a client with a T tube. Which one of the following nursing interventions should be included?
- A. Inspect skin around the T tube daily for irritation.
- B. Irrigate the T tube every 4 hours to maintain patency.
- C. Maintain the client in a supine position while the T tube is in place.
- D. Keep the T tube clamped except during mealtimes.
Correct Answer: A
Rationale: The correct nursing intervention to include in the plan of care for a client with a T tube is to inspect the skin around the T tube daily for irritation. Bile is erosive and can cause skin irritation, so it is crucial to keep the skin clean and dry. T tubes are not routinely irrigated; irrigation is done only with a physician's order. It is unnecessary to maintain the client in a supine position; instead, assist the client into a position of comfort. T tubes are not typically clamped unless ordered by a physician, and if clamped, it is usually done 1 to 2 hours before and after meals.
The nurse is reviewing the medication record of a client with acute gastritis. Which medication, if noted on the client's record, would the nurse question?
- A. Digoxin (Lanoxin)
- B. Indomethacin (Indocin)
- C. Furosemide (Lasix)
- D. Propranolol hydrochloride (Inderal)
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
When a client has peptic ulcer disease, the nurse would expect a priority intervention to be:
- A. Assisting in inserting a Miller-Abbott tube
- B. Assisting in inserting an arterial pressure line
- C. Inserting a nasogastric tube
- D. Inserting an I.V.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse is reviewing the record of a client with Crohn's disease. Which of the following stool characteristics would the nurse expect to note documented in the client's record?
- A. Chronic constipation
- B. Diarrhea
- C. Constipation alternating with diarrhea
- D. Stool constantly oozing from the rectum
Correct Answer: B
Rationale: Crohn's disease is characterized by nonbloody diarrhea of usually not more than four to five stools daily. Over time, the diarrhea episodes increase in frequency, duration, and severity. Chronic constipation (Choice A), constipation alternating with diarrhea (Choice C), and stool constantly oozing from the rectum (Choice D) are not characteristics typically associated with Crohn's disease.