Nokea
A client with a gastric ulcer compared to a friend's duodenal ulcer.
The nurse's response should be based on which of the following statements?
- A. Gastric ulcers have an increased association with clients who experience increased psychological pressures.'
- B. The pain of a duodenal ulcer usually occurs two to four hours after meals.'
- C. Clients with gastric ulcers often gain weight, as food alleviates the pain.'
- D. Antacids such as Maalox are seldom prescribed for clients with duodenal ulcers.'
Correct Answer: B
Rationale: Strategy: Think about each answer choice. (1) refers to duodenal ulcers (2) correct-clients with duodenal ulcers experience pain after meals, e.g., midmorning and midafternoon (3) gastric ulcer clients may be malnourished because food may cause nausea or vomiting (4) antacids are given to duodenal ulcer clients
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The hospital is planning to downsize and eliminate a number of staff positions as a cost-saving measure. To assist staff in this change process, the nurse manager is preparing for the 'unfreezing' phase of change. With this approach the nurse manager should:
- A. Discuss with the staff how to deal with any defensive behavior
- B. Explain to the unit staff why change is necessary
- C. Assist the staff during the acceptance of the new changes
- D. Clarify what the changes mean to the community and hospital
Correct Answer: B
Rationale: Explain to the unit staff why change is necessary. The first phase of change, unfreezing, begins with awareness of the need for change. This can be facilitated by the manager who clearly understands the need and stands behind it.
Assessment findings the nurse could expect to find in the infant with biliary atresia are:
- A. Excessive drooling that requires frequent suctioning
- B. Pale, frothy stools, and poor weight gain
- C. Poor tissue turgor and weight loss
- D. Clay-colored stools and abdominal distention
Correct Answer: D
Rationale: Biliary atresia causes bile duct obstruction, leading to clay-colored stools and abdominal distention from liver enlargement, so D is correct. Answers A, B, and C are not specific to biliary atresia.
The nurse is caring for a client with a history of cirrhosis who is receiving lactulose (Chronulac) 30 mL PO tid. Which of the following findings should the nurse report immediately?
- A. Ammonia level of 40 mcg/dL.
- B. Potassium 3.5 mEq/L.
- C. Diarrhea with 4 stools per day.
- D. Sodium 140 mEq/L.
Correct Answer: C
Rationale: Diarrhea with 4 stools per day suggests lactulose overdose, risking dehydration. Options A, B, and D are normal.
The nurse should visit which of the following clients first?
- A. The client with diabetes with a blood glucose of $95 \mathrm{mg} / \mathrm{dL}$
- B. The client with hypertension being maintained on Lisinopril
- C. The client with chest pain and a history of angina
- D. The client with Raynaud's disease
Correct Answer: C
Rationale: Chest pain in a client with a history of angina suggests possible acute coronary syndrome, requiring immediate assessment to rule out myocardial infarction.
The physician's orders include warm compresses to the left leg three times a day for treatment of an open wound. Which action is appropriate when carrying out these orders?
- A. Use medical aseptic technique.
- B. Leave the wet compress open to the air.
- C. Place both a dry covering and waterproof material over the compress.
- D. Remove the compress after five minutes.
Correct Answer: C
Rationale: A dry covering and waterproof material over the compress maintain warmth and prevent contamination while keeping the surrounding area dry. Aseptic technique is needed for open wounds, open-air compresses lose heat, and five minutes is too short.