Medsurg exam 4 practices questions

an obese male has sought advice from the nurse about the possible efficacy of medications in his efforts to lose weight. What should the nurse teach the patient about pharmacologic interventions for the treatment of obesity? a. medications are usually reserved for people who have had unsuccessful bariatric surgery b. medications may be of some use, but they don't tend to resolve obesity on their own c. medications are an excellent option for individuals who prefer not to exercise or reduce their food intake d. medications have the potential to reduce hunger but they rarely result in weight loss

b

An elderly patient is suspected of having a chronic gastrointestinal bleed. The initial test that would address this possibility is: A.A PET scan B.Stool testing C.An upper GI series D.A lower GI series

b

Which of the following methods is the most accurate indication of correct GI tube placement? A.Instillation of air with simultaneous abdominal auscultation B.Abdominal X-ray C.Aspiration of gastric contents d. Gentle traction on the tube

b

Which of the following health problems may potentially have an etiology that results from the patient's pre-existing malabsorption syndrome? A.Type 1 diabetes B.Colon cancer C.Osteoporosis D.Stroke

c

the nurse is conducting a community education program on colon cancer. Which statement should the nurse include in the program? a. colon cancer has no hereditary component b. it is the third most common cancer in the US c. the incidence of colon cancer decreases with age d. the lifetime risk of developing colon cancer is 1 in 10

b

A nurse is conducting a health promotion class. What would the nurse describe as the best method to prevent the transmission of the hepatitis A virus? A.Following proper hand washing techniques B.Avoiding chemicals that are toxic to the liver C.Using a condom during sexual contact D.Wearing a mask when in large crowds

a

A patient has just been diagnosed with gastric cancer and the nurse is taking a history on this patient. What would be a priority question to ask? A.What is your smoking and alcohol history? B.What is your work history? C.What is your level of fatigue? D.What is your family history of smoking and alcohol use?

a

A patient with a history of heavy alcohol use is receiving lactulose for the treatment of hepatic encephalopathy. What is a desired outcome of this treatment? A.Two to three soft bowel movements daily B.Watery diarrhea several times daily C.Prevention of constipation D.Maintenance of fecal continence

a

A patient complains of abdominal pain unrelieved by defecation, that typically occurs after meals along with diarrhea. What does the nurse recognize as the most likely diagnosis? a.Ulcerative colitis b.Regional enteritis c.Cholecystitis d.Diverticulosis

b

A patient has a bowel perforation from a recent surgery and now has been diagnosed with peritonitis. The patient has hypoactive bowel wounds, a temp of 100.5, and an elevated WBC count. What is the most serious potential complication of peritonitis for which the nurse should monitor? a.Nausea b.Diarrhea c.Sepsis d.Abdominal tenderness

c

A patient has been experiencing heartburn in recent months. The nurse knows that a diagnostic workup for peptic ulcer disease will prioritize: A.Family history B.Medication assessment C.Assessing for overconsumption of spicy foods D.Testing for Helicobacter pylori

d

A patient has presented to the emergency department with signs and symptoms that are characteristic of acute pancreatitis. What assessment question is most likely to relate to the etiology of the problem? A.Do you have type 1 diabetes or type 2 diabetes? B.Are you a smoker? C.Have you ever been diagnosed with hepatitis? D.How much alcohol do you typically drink?

d

The nurse recognizes that most nutrients and electrolytes are absorbed by which organ? a.Esophagus b.Stomach c.Colon d. Small intestine

d

which symptoms will a nurse observe most commonly in clients with pancreatitis? a. increased and painful urination b. increased appetite and weight gain c. black, tarry stool and dark urine d. severe, radiating abdominal pain

d

Is the following statement true or false? A patient who has GERD is likely to benefit from taking over-the-counter antacids after each meal

false

Is the following statement true or false? Constipation is among the most common complications of tube feedings and appropriate nursing interventions to prevent this problem are necessary.

false

Is the following statement true or false? The first line of intervention for a patient who is experiencing constipation should be a stimulant laxative

false

Is the following statement true or false? The patient with peptic ulcer disease should be encouraged to eat five to six small meals each day rather than three larger meals.

false

Is the following statement true or false? Both Crohn disease and ulcerative colitis exclusively affect the colon and rectum

false Ulcerative colitis affects the rectum and descending colon, but Crohn disease usually affects the patient's ileum and ascending colon

Is the following statement true or false? A patient with uncompensated cirrhosis is likely to exhibit increased abdominal girth and pedal edema

true

Is the following statement true or false? Serum bilirubin levels would be among the most relevant laboratory findings for a patient who has jaundice

true

Is the following statement true or false? The symptoms of dumping syndrome are precipitated by hypertonic intestinal contents

true

The exocrine functions of the pancreas are differentiated from the endocrine functions by the fact that exocrine functions involve: A.Secretion of enzymes B.Insulin synthesis C.Initiation of peristalsis D.Bile synthesis

a

Your patient has been admitted for treatment of a gastric ulcer. Which medication would be contraindicated? a.Erythromycin- an antibiotic b.Prilosec- a PPI c.Flagyl- an antimicrobial agent d.Acetaminophen - a non-narcotic analgesic

a

a nurse is assessing a clients stoma on postop day 3. the nurse notes that the stoma has a shiny appearance and a bright red color. How should the nurse best respond to this assessment finding? a. document the stoma as healthy and well perfused b. irrigate the ostomy to clear possible obstruction c. document a nursing diagnosis of impaired skin integrity d. contact the provider to report the finding

a

a nurse is providing care for a client who has a diagnosis of irritable bowel syndrome. When planning the clients care, the nurse should collaborate with the client and prioritize what goal? a. client will accurately identify foods that trigger symptoms b. client will demonstrate appropriate care of his illeostomy c. client will demonstrate appropriate use of standard infection control precautions d. client will adhere to recommended guidelines for mobility and activity

a

a patient with a diagnosis of peptic ulcer disease has just been prescribed omeprazole (prilosec). How should the nurse best describe this medications therapeutic action? a. this medication will reduce the amount of acid secreted in your stomach b. this medication will make the lining of your stomach more resistant to damage c. this medication will specifically address the pain that accompanies peptic ulcer disease d. this medication will help your stomach lining repair itself

a

the nurse is conducting discharge teaching for a client with diverticulosis. Which instruction should the nurse include in the teaching? a. drink 8-10 glasses of fluid daily b. use laxatives weekly c. avoid exercise daily d. avoid unprocessed bran

a

the nurse is providing care to a patient with gross ascites who is maintaining a position of comfort in high semi-fowlers position. What is the nurses priority assessment of this patient? a. resp. assessment related to increased thoracic pressure b. skin assessment related to increased bile salts c. peripheral vascular assessment related to immobility d. urinary output related to increased sodium retention

a

when caring for a client with acute pancreatitis, the nurse should use which comfort measure? a. position the client on the side with knees flexed b. encourage frequent visits from family and friends c. administer frequent oral feedings d. administer pain meds once per shift as ordered to prevent drug addiction

a

which is the most common cause of esophageal varices? a. portal hypertension b. asterixis c. ascites d. jaundice

a

a client is in the hospital for the treatment of peptic ulcer disease. The client reports vomiting and a sudden severe pain in the abdomen. The nurse then assesses a board-like abdomen. What does the nurse suspect these symptoms indicate? a. ineffective treatment for peptic ulcer b. reaction to the medication given for the ulcer c. gastric penetration d. perforation of the peptic ulcer

d

a nurse is caring for a client hospitalized with an exacerbation of chronic gastritis. What health promotion topic should the nurse emphasize? a. strategies for maintaining an alkaline gastric environment b. safe technique for self-suctioning c. techniques for positioning correctly to promote gastric healing d. strategies for avoiding irritating foods and beverages

d

a nurse is caring for a client newly diagnosed with hepatitis A. Which statement by the client indicates the need for further teaching? a. i'll be very careful when preparing food for my family b. how did this happen? i've been faithful my entire marriage c. i'll wash my hands often d. i'll take my medication as ordered

b

A patient returns to their room following a diagnostic colonoscopy after radiologic evidence of diverticulosis. They report an increase in abdominal pain, fever, and chills. Which clinical condition is most concerning to the nurse? a.Colon Cancer b.Hemorrhoids c.Bowel perforation d.Anal fissure

c

A patient with cancer of the tongue has had a radical neck dissection. What nursing assessment would be the highest priority for this patient? A.Assessment of acute pain and anxiety B.Assessment of tissue integrity and color of the operative site C.Assessment of respiratory status and airway clearance D.Assessment of self-esteem and body image

c

C. diff infection has been moving through an extended-care facility and several of the elderly residents have been experiencing severe diarrhea. One sick resident has told the nurse that he is now experiencing extreme fatigue and muscle cramps and his heart feels like it occasionally skins a beat. the nurse should facilitate a stat assessment of the residents a. cardiac biomarkers b. Hgb and hematocrit c. potassium levels d. calcium levels

c

The patient presents with abdominal pain and distention, fever, tachycardia and diaphoresis. An abdominal x-ray shows free air under the diaphragm. The emergency department nurse should suspect which condition? a.Intestinal obstruction b.Malabsorption c.Intestinal perforation d.Acute cholelithiasis

c

A patient is complaining of right lower quadrant pain, fever, and decreased appetite. What does the nurse suspect is the most likely cause? a.Diverticulitis b.Appendicitis c.Small bowel obstruction d.Sigmoid colon cancer

b

Your patient with peptic ulcer disease is being discharged, which outcome needs to be included in the plan of care? a.Patients pain is adequately controlled with an NSAID b.The client understands and maintains lifestyle modifications c.The client takes antacids around the clock d. The client has no episodes of GI bleeding

b

a client with cirrhosis has a massive hemorrhage from esophageal varices. Ballon tamponade is used temporarily to control hemorrhage and stabilize the client. In planning care, the nurse gives. the highest priority to which goal? a. control bleeding b. maintain the airway c. relieve anxiety d. maintain fluid volume

b

a critical care nurse is closely monitoring a patient who has recently undergone surgical repair of a bleeding peptic ulcer. The nurse should prioritize assessments of which of the following signs and symptoms of a recurrence of hemorrhage? a. restlessness and cyanosis b. hypotension and tachycardia c. bradypnea and pursed lip breathing d. peripheral and pulmonary edema

b

Which of the following physiologic processes is NOT performed in the small intestine? A.Breakdown of fats into absorbable particles B.Breakdown of carbohydrates into simple sugars C.Reabsorption of water and electrolytes D.Peristalsis

c

a clients colon cancer has necessitated a hemicolectomy with the creation of a colostomy. In the 4 days since the surgery, the client has been unwilling to look at the ostomy or participate in any aspects of ostomy care. What is the nurses most appropriate response to this observation? a. arrange for the client to be seen by a social worker b. ensure that the client knows that they will be responsible for care after discharge c. acknowledge the clients reluctance and initiate discussion of the factors underlying it d. reassure the client that many people are fearful after the creation of an ostomy

c

a nurse is providing care for a client recovering from gastric bypass surgery. During assessment, the client exhibits pallor, perspiration, palpitations, headache and feelings of warmth, dizziness, and drowsiness. The client reports eating 90 minutes ago. What will the nurse suspect? a. normal reaction to surgery b. dehiscence of the surgical wound c. vasomotor symptom associated with dumping syndrome d. peritonitis

c

the nurse determines that teaching for the client with peptic ulcer disease has been effective when the client makes which statement? a. "i should stop all my medications if i develop any side effects" b. "I should continue my treatment regimen as long as I have pain" c. I have learned some relaxation strategies that decrease my stress" d. "I can buy whatever antacids are on sale because they all have the same effect"

c

the nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by H. pylori is implicated in which disease? a. pernicious anemia b. systemic infections c. peptic ulcers d. colostomy

c

the nurse is teaching a client with an ostomy how to change the pouching system. Which information should the nurse include when teaching a client with no peristomal skin irritation? a. dust with nystatin powder b. apply barrier protection c. dry skin completely after washing d. apply acetonide spray

c

What symptoms may be suggestive of an intestinal obstruction in a patient with an ileostomy? A.Continuous flow of liquid stools and belching B.Hypervolemia and hyperkalemia C.Muscle spasms and numbness of the extremities D.Nausea and abdominal distention

d

When performing an abdominal assessment on a patient with a suspected cholecystitis, how would you palpate the abdomen? a.Palpate the right upper quadrant only b.Palpate the upper quadrants only c.Defer palpation and use percussion only d.Palpate the upper right quadrant last

d

Which assessment finding does the nurse expect as a normal consequence of aging? a.Increased salivation and drooling b.Hyperactive bowel sounds and loose stools c.Increased gastric production and heartburn d.Decreased sensation to defecate and constipation

d

a nurse is caring for a client who has a diagnosis of GI bleed. During shift assessment, the nurse finds the client to be tachycardic and hypotensive. The client has an episode of hematemisis while the nurse is in the room. In addition to monitoring the clients VS and LOC, what would be a priority nursing action for the client? a. place client in a prone position b. provide the client with ice water to slow any GI bleeding c. prepare for the insertion of an NG tube d. Notify the health care provider

d

when caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain in the right shoulder. What is the initial appropriate action by the nurse? a. notify the health care provider b. irrigate the clients NG tube c. place the client in the high fowlers position d. assess the clients abdomen and VS

d