Common board questions

Pain in the left lower quadrant

A 56-year-old patient with diverticulitis has been admitted to the medical unit. The nurse will most likely document which assessment in the charting?

encourage a diet high in fiber content.

A 63-year-old patient is admitted with acute diverticulitis. The most appropriate nursing intervention to lessen this patient's signs and symptoms of increased flatus and chronic constipation alternating with diarrhea, anorexia, and nausea would be to

Administration of an analgesic

A client arrives at the emergency department and complains of severe abdominal pain. The initial diagnosis is acute abdomen, and an x-ray and an abdominal ultrasonogram are prescribed to be obtained immediately. The nurse prepares the client for these diagnostic tests and reviews the health care provider's prescriptions. Which of the following prescriptions would the nurse question if written on the health care provider's prescription form?

"Remove jewelry before the test."

A client being seen in a health care provider's office has just been scheduled for a barium swallow the next day. The nurse writes down which of the following instructions for the client to follow before the test?

History of alcohol use, smoking, and weight loss

A client complains of stomach pain 30 minutes to 1 hour after eating. The pain is not relieved by further intake of food, although it is relieved by vomiting, and a gastric ulcer is suspected. The nurse should gather which of the following additional supportive data for this diagnosis from the client?

History of alcohol use, smoking, and weight loss

A client complains of stomach pain 30 minutes to 1 hour after eating. The pain is not relieved by further intake of food, although it is relieved by vomiting. A gastric ulcer is suspected. Which of the following data would further support this diagnosis?

Hemigastrectomy

A client diagnosed with pernicious anemia asks the nurse what caused the deficiency. The nurse replies that it is likely a result of which of the following conditions that is part of the client's health history?

Vitamin B12 injections

A client has been diagnosed with chronic gastritis and has been told that there is too little intrinsic factor being produced. The nurse tells the client that which of the following will be prescribed to treat the problem?

"That is because the empty stomach sends signals to the brain to stimulate hunger."

A client has had extensive surgery on the gastrointestinal tract and has been started on parenteral nutrition (PN). The client tells the nurse, "I think I'm going crazy...I feel like I'm starving and yet that bag is supposed to be feeding me." The best response of the nurse would be:

A laxative

A client has just returned from the radiology` department following an upper gastrointestinal (GI) series. The nurse reviews the health care provider's prescriptions, expecting to note which of the following needed for routine post- procedure care?

Monitoring for the gag reflex

A client has just undergone a gastroscopy.Which action should be taken by the nurse as the essential post-procedure nursing intervention?

Checking for return of a gag reflex

A client has undergone esophagogastroduodenoscopy (EGD). The nurse places highest priority on which of the following items as part of the client's care plan?

Smaller, more frequent meals should be eaten.

A client has undergone subtotal gastrectomy and the nurse is preparing the client for discharge. Which item should be included when teaching the client about ongoing self- management?

"What is your understanding of celiac disease?"

A client is admitted to an acute care facility with complications of celiac disease. Which question would be helpful initially in obtaining information for the nursing care plan?

Remain with the client and be silent.

A client is admitted to the hospital with a bowel obstruction secondary to a recurrent malignancy, and the health care provider plans to insert a Miller-Abbott tube. When the nurse tries to explain the procedure, the client interrupts the nurse and states, "I don't want to hear about that. Just let the doctor do it." Based on the client's statement, the nurse determines that the best action is to:

Fatigue

A client is admitted to the hospital with acute viral hepatitis. Which signs or symptoms would the nurse expect to note, based upon this diagnosis?

Increase intake of fluids.

A client is admitted to the hospital with viral hepatitis and is complaining of a loss of appetite. In order to provide adequate nutrition, the nurse encourages the client to:

After the procedure, keep client nothing by mouth (NPO) until the gag reflex returns.

A client is scheduled for an endoscopic retrograde cholangiopancreatography (ERCP). The nurse includes which intervention in the plan of care for the client?

Fat-free

A client is scheduled for an oral cholecystography. The nurse would plan to obtain what type of diet for the evening meal before the test?

Takes the client's vital signs

A client presents to the urgent care center with complaints of abdominal pain. Suddenly the client vomits bright red blood. The nurse takes which immediate action?

Clamp the tubing for 30 seconds and restart the flow at a slower rate.

A client receiving a high cleansing enema complains of pain and cramping. The nurse would take which corrective action?

Blood loss

A client who has a history of chronic ulcerative colitis is anemic. The nurse interprets that which factor is likely responsible for this laboratory finding?

Occult blood

A client who has been prescribed indomethacin (Indocin) for gout is asked to provide a stool sample for guaiac testing. The nurse explains that the purpose of the test is to determine:

"I should take a laxative and my stool should return to normal color."

A client who has undergone a barium enema is being readied for discharge from the ambulatory care unit. The nurse determines that the client has understood the discharge instructions if the client states:

Smaller and more frequent meals should be eaten

A client who has undergone a subtotal gastrectomy is being prepared for discharge. Which item concerning ongoing self- management should the nurse reinforce to the client? .

"I should take a laxative, and my stool will then return to a normal color."

A client who has undergone barium enema is being readied for discharge. The nurse determines that the client has understood discharge instructions when the client states:

Avoid eating or drinking after midnight before the test.

A client will undergo a barium swallow to confirm a diagnosis of a hiatal hernia. In preparation for the test, the nurse instructs the client to:

30 minutes before meals

A client with Crohn's disease has a prescription to begin taking antispasmodic medication. The nurse should time the medication so that each dose is taken:

Cut the tube and pull it out.

A client with a Sengstaken-Blakemore tube in place to treat esophageal varices suddenly becomes restless. The client's heart rate and blood pressure increase and the client has difficulty breathing. The important initial nursing action is to:

A low-fiber diet

A client with a history of gastrointestinal upset has been diagnosed with acute diverticulitis. To aid the client in symptom management, the nurse suggests foods that are on which of the following diets?

Nasogastric (NG) tube

A client with a tentative diagnosis of gastroesophageal reflux is going to undergo ambulatory pH monitoring. The nurse brings which of the following items to the bedside?

Upright

A client with ascites is scheduled for a paracentesis. The nurse is assisting the health care provider in performing the procedure. Which of the following positions will the nurse assist the client to assume for this procedure?

Client previously oriented to person only; can now state name, year, and present location

A client with hepatic encephalopathy is receiving lactulose (Cephulac). The nurse determines that the medication is effective if which of the following is observed?

Protect the gastric mucosa.

A client with peptic ulcer disease has been prescribed to take misoprostol (Cytotec) and sucralfate (Carafate). The nurse teaches the client that these two medications will work primarily to:

A pyloroplasty involves an incision and resuturing of the pylorus to relax the muscle and enlarge the opening from the stomach to the duodenum.

A client with peptic ulcer disease is scheduled for a pyloroplasty and the client asks the nurse about the procedure. The nurse bases the response on which of the following?

Tube with a lumen and an air vent

A health care provider asks a nurse to obtain a Salem Sump tube for gastric intubation. The nurse selects which of the following tubes from the unit storage area?

Upright Position

A health care provider is about to perform a paracentesis on a client with abdominal ascites. The nurse would assist the client to assume which of the following positions?

Document the finding in the client's record

A health care provider places a Miller-Abbott tube in a client who has a bowel obstruction. Six hours later, the nurse measures the length of the tube outside of the nares and notes that the tube has advanced 6 cm since it was first placed. Based on this finding, which action should the nurse take next?

Take and hold a deep breath.

A licensed practical nurse (LPN) is preparing to assist a registered nurse (RN) with removing a nasogastric (NG) tube from the client. The LPN would instruct the client to do which of the following?

Semi-Fowler's

A nurse assigned to care for a client with cirrhosis reviews the medical record and notes that the client has difficulty maintaining an effective breathing pattern due to pressure on the diaphragm. The nurse plans care, knowing that which client position will best assist in facilitating breathing?

Supine with the head raised slightly and the knees slightly flexed

A nurse assistant is helping a registered nurse (RN) conduct an abdominal assessment. The LPN assists the client into which of the following positions?

Consuming low-fat or nonfat foods

A nurse documents that a client with a hiatal hernia is complying with the prescribed treatment if the client reports doing which of the following?

Eating low-fat or nonfat foods

A nurse documents that a client with a hiatal hernia is implementing effective health maintenance measures after the client reports doing which of the following?

Aspiration

A nurse gathers data from a client admitted tothe hospital with gastroesophageal reflux disease (GERD) who is scheduled for a Nissen fundoplication. Based on an understanding of this disease, the nurse determines that the client may be at risk for which complication?

Clamp the NG tube for 30 minutes following administration of the medication.

A nurse has a prescription to give 30 mL of an antacid to a client through a nasogastric (NG) tube that is connected to wall suction. The nurse would do which of the following to perform this procedure correctly?

Low and intermittent

A nurse has assisted in the insertion of a Levin tube for gastrointestinal (GI) decompression. The nurse plans to set the suction to which of the following pressures?

Low and intermittent

A nurse has assisted with the insertion of a Levin tube for gastrointestinal (GI) decompression. The nurse expects that the health care provider will prescribe the suction setting at:

A decrease in sour eructation

A nurse has been reinforcing dietary teaching for a client with peptic ulcer disease who has a routine follow-up visit. Which behavior is the best indicator of a successful outcome for this client?

It is all right to drive an hour after the test is finished.

A nurse has given postprocedure instructions to a client who has undergone a colonoscopy. The nurse determines that the client did not fully understand the directions if the client states that:

"I'm glad I don't have to lie still for this procedure."

A nurse has taught a client about an upcoming endoscopic retrograde cholangiopancreatography (ERCP) procedure. The nurse determines that the client needs additional information if the client makes which statement?

Left Sims' position

A nurse is administering a cleansing enema to a client with a fecal impaction. Before administering the enema, the nurse assists the client to which of the following positions?

Esophageal varices

A nurse is assigned to care for a client with a Sengstaken-Blakemore tube. The nurse should suspect that the client has which diagnosis?

Give frequent oral and nasal care.

A nurse is assisting in caring for a client with aSengstaken-Blakemore tube. To prevent ulceration and necrosis of oral and nasal mucosa, the nurse plans to:

From the tip of the client's nose to the earlobe and then down to the xiphoid process

A nurse is assisting in insertion of a nasogastric (NG) tube for an adult client. The LPN helps determine the correct length to insert the tube by measuring:

Irrigating the nasogastric (NG) tube

A nurse is caring for a client after a Billroth II procedure. On review of the postoperative prescriptions, which of the following, if prescribed, would the nurse question and verify?

Provide frequent oral and nasal care on a regular basis.

A nurse is caring for a client with a Sengstaken- Blakemore tube. To prevent ulceration and necrosis of oral and nasal mucosa, the nurse should plan to:

Placement of the NG tube is accurate.

A nurse is caring for a client with a nasogastric (NG) tube and tests the pH of the aspirate to determine correct placement. The nurse notes that the pH is 5 and determines that the:

A pair of scissors

A nurse is caring for a client with esophageal varices who is going to have a Sengstaken- Blakemore tube inserted. The nurse brings which priority item to the bedside so that it is available at all times?

Constipation

A nurse is caring for a client with pneumonia who has a history of bleeding esophageal varices. Based on this information, the nurse plans care, knowing that it is important to prevent:

Drowsiness

A nurse is collecting admission data on the client with hepatitis. Which of the following findings would be a direct result of this client's condition?

The transfer of digested food molecules from the GI tract into the bloodstream

A nurse is collecting data about how well a client with a gastrointestinal (GI) disorder is able to absorb food. While carrying out this function, the nurse recalls that absorption is best defined as:

A mechanical and chemical process involving the breakdown of food

A nurse is collecting data about how well a client with a gastrointestinal (GI) disorder is able to digest food. The nurse recalls that digestion is best defined as:

"My pain comes shortly after I eat, maybe a half hour or so later."

A nurse is collecting data from a client admitted to the hospital with a diagnosis of suspected gastric ulcer and is asking the client questions about pain. Which statement, if made by the client, would support the diagnosis of gastric ulcer?

Pruritus

A nurse is collecting data on a client admitted to the hospital with hepatitis. Which data would indicate that the client may have liver damage?

Turkey and lettuce sandwich

A nurse is evaluating the effect of dietary counseling on the client with cholecystitis. The nurse determines that the client understands the instructions given if the client states that which food item is acceptable to include in the diet?

Avoid coughing.

A nurse is getting a client who underwent umbilical hernia repair ready for discharge. The nurse tells the client that it is important to continue to do which of the following after discharge?

Sweating and pallor

A nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which of the following symptoms indicate this occurrence?

Personal history of ulcerative colitis or gastrointestinal (GI) polyps

A nurse is participating in a health screening clinic and is preparing teaching materials about colorectal cancer. The nurse would plan to include which risk factor for colorectal cancer in the material?

Pulsation between the umbilicus and pubis

A nurse is performing an abdominal assessment on a client. The nurse interprets that which finding is abnormal and should be reported t the registered nurse (RN) or health care provider?

Stop the irrigation temporarily.

A nurse is performing colostomy irrigation on a client. During the irrigation, the client begins to complain of abdominal cramps. Which of the following is the appropriate nursing action?

Left Sim's

A nurse is preparing to administer a soapsuds enema to a client. Into which position does the nurse place the client to administer the enema?

Fowler's

A nurse is preparing to administer an enteral feeding through a nasogastric tube. The nurse would place the client in which position during and after the feedings?

Vitamin B12 and folic acid studies

A nurse is providing discharge instructions to a client who has had a total gastrectomy. The nurse tells the client about the importance of returning to the health care clinic as scheduled for which priority assessment?

Cimetidine (Tagamet) results in decreased secretion of stomach acid.

A nurse is providing medication instructions to a client with peptic ulcer disease. Which of the following represents correct information given by the nurse?

1 to 2 days

A nurse is providing post-procedure teaching after a client underwent an upper gastrointestinal (GI) series. The nurse reminds the client that the stools will remain white for approximately:

Eat anything as long as it does not aggravate or cause pain.

A nurse is reinforcing dietary instructions to a client with peptic ulcer disease. The nurse encourages the client to:

Position the client supine and flat.

A nurse is reviewing the health care provider's prescriptions written for a client admitted with prescription would the nurse verify if noted on the client's chart?

Administer antacids, as prescribed. Encourage coughing and deep breathing. Administer anticholinergics, as prescribed.

A nurse is reviewing the prescriptions of a client admitted to the hospital with a diagnosis of acute pancreatitis. Choose the interventions that the nurse would expect to be prescribed for the client. Select all that apply.

Diarrhea

A nurse is reviewing the record of a client with Crohn's disease. Which of the following stool characteristics would the nurse expect to see documented in the record?

"Be sure to sleep with your head elevated in bed."

A nurse is teaching a client with a newly diagnosed hiatal hernia about measures to prevent recurrence of symptoms. Which statement would be included in the teaching?

Impaired nutritional status

A nurse is working with a client diagnosed with anorexia nervosa. The nurse plans care, focusing on which of the following as the primary problem?

Ask the client to extend the arms.

A nurse notes that the medical record of a client with cirrhosis states that the client has asterixis. To verify this information, the nurse would do which of the following?

Regular monthly injections of vitamin B12 will prevent this complication.

A nurse reinforces instructions to a client following a gastrectomy about the signs and symptoms of pernicious anemia, knowing that:

Take action to prevent dumping syndrome.

A nurse who is providing instructions to a client following gastric resection would include which of the following suggestions?

Monitor for return of the gag reflex

A nurse will be providing postprocedure care to a client who has undergone esophagogastroduodenoscopy (EGD). The nurse would plan to do which of the following first once the client arrives?

Postprandial blood glucose readings

A post-gastrectomy client is at high risk for hyperglycemia related to uncontrolled gastric emptying of fluid and food into the small intestine (dumping syndrome). Because of this risk, the nurse plans to monitor the:

Reducing stressors in life

A postgastrectomy client who is being discharged from the hospital tells the nurse, "I hope my stomach problems are over. I need to get back to work right away. I've missed a lot of work and I'm really behind. If I don't get my act together, I may lose my job." Based on the client's statement, the nurse determines that at this time, it is appropriate to discuss:

A left side-lying position with a small pillow or folded towel under the puncture site

After a liver biopsy, the nurse places the client in which of the following positions?

Hemorrhage

After the deflation of the balloon of a client's Sengstaken-Blakemore tube, the nurse monitors the client closely for which esophageal complication?

70 mcg/dL

An adult client with hepatic encephalopathy has a serum ammonia level of 120 mcg/dL and receives treatment with lactulose (Chronulac) syrup. The nurse determines that the client has the best and most optimal response if the level changes to which of the following after medication administration?

Requires the client to lie still for short intervals

An ultrasound of the gallbladder is scheduled for the client with a suspected diagnosis of cholecystitis. The nurse explains to the client that this test:

to administer the feeding in six small daily meals high in protein and fat.

Dumping syndrome after a Billroth II procedure occurs when high-carbohydrate foods are ingested over a period of less than 20 minutes. A nursing measure that will prevent or minimize dumping syndrome is

vitamin B12 deficiency.

Following a gastrectomy, the nurse would anticipate that the patient would need to be assessed for

Hepatitis A

It has been determined that a client with hepatitis has contracted the infection from contaminated food. What type of hepatitis is this client most likely experiencing?

Disturbed body image.

The patient, age 32, has ulcerative colitis, and his condition is deteriorating. An ileostomy is scheduled. After the procedure, this patient may be at risk for

Nasogastric

Treatment measures have been implemented for a client with bleeding esophageal varices and have been unsuccessful. The health care provider states that a Sengstaken-Blakemore tube will be used to control the resulting hemorrhage. The nurse prepares for insertion via which of the following routes?

"This opioid will cause very deep sleep, which is what my husband needs."

Which statement by the spouse of a client with end-stage liver failure indicates the need for additional teaching by the multidisciplinary team regarding the management of pain?