Nokea
The nurse is caring for a client diagnosed with rule-out peptic ulcer disease. Which test confirms this diagnosis?
- A. Esophagogastroduodenoscopy.
- B. Magnetic resonance imaging (MRI).
- C. Occult blood test.
- D. Gastric acid stimulation.
Correct Answer: A
Rationale: Esophagogastroduodenoscopy (EGD) directly visualizes the gastric mucosa to confirm the presence of ulcers, making it the gold standard for diagnosing peptic ulcer disease. MRI is not used, occult blood tests are nonspecific, and gastric acid stimulation assesses acid production, not ulcers.
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Which blood test results would confirm a diagnosis of appendicitis?
- A. WBC of 13,000
- B. RBC of 4.5 million
- C. Platelet count of 300,000
- D. Positive heterophil antibody test
Correct Answer: A
Rationale: An elevated WBC count (e.g., 13,000) indicates inflammation, supporting an appendicitis diagnosis. Normal RBC and platelet counts are not specific, and a heterophil antibody test is for infectious mononucleosis.
Which statement made by the client indicates to the nurse the client may be experiencing GERD?
- A. My chest hurts when I walk up the stairs in my home.
- B. I take antacid tablets with me wherever I go.
- C. My spouse tells me I snore very loudly at night.
- D. I drink six (6) to seven (7) soft drinks every day.
Correct Answer: B
Rationale: Frequent use of antacids suggests ongoing heartburn or reflux symptoms, a hallmark of GERD. Chest pain with exertion is more suggestive of cardiac issues, snoring may indicate sleep apnea, and soft drink consumption is a risk factor but not a direct symptom.
The public health nurse is teaching day-care workers. Which type of hepatitis is transmitted by the fecal-oral route via contaminated food, water, or direct contact with an infected person?
- A. Hepatitis A.
- B. Hepatitis B.
- C. Hepatitis C.
- D. Hepatitis D.
Correct Answer: A
Rationale: Hepatitis A is transmitted via the fecal-oral route through contaminated food, water, or contact, common in settings like daycares. Other types are bloodborne or require co-infection.
The nurse is caring for the client with diverticulitis. The nurse should plan to instruct the client to avoid which food during an episode of diverticulitis?
- A. White bread
- B. Ripe banana
- C. Cooked oatmeal
- D. Iceberg lettuce
Correct Answer: C
Rationale: A. White bread is a recommended food for fiber-restricted diets. It contains less than 1 g fiber per ounce. B. Ripe bananas, canned soft fruits, and most well-cooked vegetables without seeds or skins are recommended for fiber-restricted diets. C. Cooked oatmeal contains 4 g of fiber per serving. Foods high in fiber should be avoided during an episode of diverticulitis, and foods should be restricted to low fiber or clear liquids. Once diverticulitis is resolved, the client should return to a high-fiber diet. D. Iceberg lettuce contains less than 1 g of fiber.
The client with a history of peptic ulcer disease is admitted into the intensive care department with frank gastric bleeding. Which priority intervention should the nurse implement?
- A. Maintain a strict record of intake and output.
- B. Insert a nasogastric (NG) tube and begin saline lavage.
- C. Assist the client with keeping a detailed calorie count.
- D. Provide a quiet environment to promote rest.
Correct Answer: B
Rationale: Inserting an NG tube with saline lavage helps remove blood, assess bleeding severity, and stabilize the client with frank gastric bleeding. Intake/output monitoring, calorie counts, and rest are secondary to controlling active hemorrhage.