NC2 - Final Exam Questions
D (B = otitis media)
A client is expected of having Ménière's disease. Which of the following is an expected finding? -A) presence of purulent lesion in the external ear canal -B) feeling pressure in the ear -C) bulging red bilateral tympanic membranes -D) unilateral hearing loss
B
A client w/ hx IV drug use has hepatitis and presents with jaundice and arthroalgias. What type of hepatitis does the client likely have? a) Hep A b) Hep B c) Hep C d) Hep E
D (NEVER RECAP NEEDLES!!)
A nurse is administering an IM injection to a client who has hepatitis C. Before placing the syringe and needle in a puncture-resistant container, which of the following actions should the nurse take? -A) Recap the needle -B) Place the cap on the bedside table and slide the needle into the cap -C) Wrap the needle with gauze -D) Dispose of the needle uncapped
D (Beta blocker is given prophylactically for patients with portal hypertension)
A nurse is admitting a client who has bleeding esophageal varices. The nurse should expect a prescription for which of the following medications? -A) Propanolol -B) Metoclopramide -C) Ranitidine -D) Vasopressin
D
A nurse is admitting a client who has hepatitis C. Which of the following precautions should the nurse implement? -A) Droplet -B) Contact -C) Airborne -D) Standard
B (Improperly maintained tattoo machine - blood to blood transmission)
A nurse is assessing clients in a health clinic for risk factors for contracting hepatitis. Which of the following clients is at risk for developing hepatitis C? -A) A client who eats raw shellfish -B) A client who has multiple tattoos -C) A client who works in a child care center -D) A client who has recently traveled to a underdeveloped country
A
A nurse is caring for a client who has liver cirrhosis with ascites, bleeding esophageal varices, and portal hypertension. The nurse recognizes which of the following laboratory findings as indicating the client's gastrointestinal (GI) tract is digesting and absorbing blood? -A)Elevated blood urea nitrogen -B) Elevated HbA1c -C) Decreased chloride -D) Decreased bilirubin
A, B, C
A nurse is caring for a client who is has a small bowel obstruction from adhesions. Which of the following findings are consistent with a diagnosis? Select all that apply. -A) Emesis greater than 500 mL with a fecal odor -B) Report of spasmodic abdominal pain -C) High pitched bowel sounds -D) Abdomen flat with rebound tenderness to palpation -E) Laboratory findings indicate metabolic acidosis
C, D
A nurse is caring for a client with a new diagnosis of cataracts. Which of the following symptoms should the nurse expect? Select all that apply. -A) eye pain —B) floaters -C) blurred vision -D) white pupils -E) bilateral red reflex
B
A nurse is caring for a patient with diabetes mellitus and reports a gradual loss of peripheral vision. The nurse should recognize this as a manifestation of which of the following diseases? -A) cataracts -B) open angle glaucoma -C) macular degeneration -D) angle closure glaucoma
B, C, D
A nurse is completing an admission assessment for a client has a small bowel obstruction. Which of the following findings should the nurse report to the provider? Select all that apply. -A) emesis prior to insertion of the nasogastric tube -B) urine specific gravity 1.040 -C) hematocrit 60% -D) blood potassium 3.0 -E) White blood cell count 10,000
C, D, E
A nurse is completing an assessment of a client who has a gastric ulcer. Which of the following findings should she expect? -A) client reports pain relieved by eating -B) client states the pain often occurs at night -C) client states the pain occurs 30 minutes to 1 hour after the meal -D) client reports a sensation of bloating -E) client experiences pain upon palpation of the epigastric region
A, B, C (B b/c skim means low fat)
A nurse is completing nutrition teaching for a client who has pancreatitis. Which of the following statements by the client indicates an understanding of the teaching? Select all that apply. -A) I plan to eat small frequent meals -B) I will use skim milk when cooking -C) I will eat foods that are easy to digest with limited spices -D) I plan to drink regular cola -E) I will limit my alcohol and intake to 2 drinks per day
A, C, D, E (D because NG tube - mouth breathing)
A nurse is planning care for a client who has a small bowel obstruction and an NG tube in place. Which of the following interventions should the nurse include? Select all that apply. -A) document the NG drainage with the clients output -B) irrigate the NG tube every eight hours -C) assess bowel sounds -D) provide oral hygiene every two hours -E) monitor NG tube replacement
A, C, D (A b/c trying to reduce ascites)
A nurse is planning care for a client who has cirrhosis of the liver. Which of the following actions should the nurse include in the plan? (Select all that apply.) -A) Administer furosemide. -B) Administer warfarin. -C) Implement a low-sodium diet. -D) Measure the client's abdominal girth. -E) Encourage weight lifting during physical therapy.
C
A nurse is planning care for a client who has end-stage cirrhosis of the liver with encephalopathy. Which of the following interventions should the nurse plan to implement to decrease the client's ammonia level? -A) Administer diuretics -B) Restrict the client's intake of fluid -C) Reduce the client's intake of protein -D) Administer vitamin K
A, B, E (E b/c concerned about GIB)
A nurse is planning care for a patient with acute gastritis. Which of the following intervention should the nurse include in the plan of care? Select all that apply. -A) evaluate I&Os -B) monitor lab reports of electrolytes -C) provide three large meals a day -D) administer ibuprofen for pain -E) observe stool characteristics
A
A nurse is providing teaching for a patient with a new diagnosis of dry macular degeneration. What instruction should she include in the teaching? -A) increase intake of deep yellow and orange vegetables -B) administer eyedrops twice daily -C) avoid bending at the waist -D) where an eyepatch at night
A, B
A nurse is teaching a client who has a duodenal ulcer and a new prescription for esomeprazole. Which of the following information should the nurse include in the teaching? Select all that apply. -A) take the medication one hour before a meal -B) limit NSAIDs when taking this medication -C) expect skin flushing when taking this medication -D) increase fiber intake when taking this medication -E) chew the medication thoroughly before swallowing
C
A nurse is teaching a client who has hepatitis A about preventing transmission of the virus. Which of the following strategies should the nurse include in the teaching? -A) Avoid eating at fast food restaurants. -B) Avoid serving raw foods. -C) Practice effective hand hygiene. -D) Wear barrier protection during vaginal intercourse
C (Will NEVER be able to donate blood or organs. High carb diet)
A nurse is teaching self-management to a client who has hepatitis B. Which of the following Instructions should the nurse include in the teaching? -A)You may donate blood 6 months after completing the medication regimen -B) Consume a high-protein diet -C) Rest frequently throughout the day. -D) Take acetaminophen every 4 hr, as needed, for discomfort
D (Standard precautions is enough)
A nurse on the unit is admitting a client who has hepatitis B with ascites. Which of the following action should be included in the plan of care? -A) initiate contact precautions -B) weigh the client weekly -C) measure abdominal girth at the base of the rib cage -D) provide a high calorie high carbohydrate diet
Rest the Bowel
Common intervention among GI disorders
A
Chron's is a condition of malabsorption caused by what pathology? -A: Inflammation of all layers of intestinal mucosa -B: Infectious Disease -C: Gastric Resection
D
The nurse is caring for client following a partial gastrectomy who has a nasogastric tube. What action is most appropriate? -A: Provide continuous section for a levin -B: Maintain suction while assessing bowel sounds -C: Reposition nasogastric tube as needed -D: Irrigate nasogastric tube only with physician order
High Carb, Low Fat
Diet for pancreatitis?
A, B, E
Immersed in the emergency department is completing an assessment of a patient who has suspected stomach perforation due to a peptic ulcer. Which of the following manifestations should she expect to find? Select all that apply. -A) rigid abdomen -B) tachycardia -C) elevated blood pressure -D) circumoral cyanosis -E) rebound tenderness
All of the Above
The common causes of cirrhosis are (select all that apply): -A) Copper toxicity -B) Protein malabsorption -C) Hepatitis infections -D) Drug-induced -E) Hemochromatosis -F) Alcohol
A
The nurse is caring for a client with a nasogastric tube. What data indicates that peristalsis is returning? -A:No nausea and vomiting -B: Decrease gastric output -C: Client feels hungry -D: Absent bowel sounds
D (Aspirate gastric content - hoarseness, sore throat)
The nurse is caring for a client with gastrointestinal reflux disease. What manifestation can occur due to aspiration of gastric content? -A: Regurgitation -B: Pain with swallowing -C: Heartburn -D: Hoarseness
C, D
The nurse is caring for a pt who has ascites as a result of hepatic dysfunction. What intervenion can the nurse provide to determine if the asictes is increasing? (Select all that apply) a) Measure urine output every 8 hours b) Assess and document VS q 4h c) Measure abdominal girth daily d) Perform daily weights e) Monitor # of BM per day
A
What digestive structure completes the digestion of food and vitamins? -A: Small intestine -B: Large intestine -C: Stomach -D: Mouth
D
What digestive structure functions to absorb water and secrete mucous? -A: Stomach -B: Anus -C: Esophagus -D: Large Intestine
B
What is the priority nursing dx for a pt with chronic pancreatitis? -A: Disturbed body image -B: Imbal Nutr: Less -C: Nausea -D: Anxiety
RUQ
What quadrant is the pancreas located in?
D (shows decreasing LOC)
When caring for a pt with hep B, the nurse should closely monitor for the development of which of the following findings associated w/ a decrease in hepatic function? a) Icterus b) Pruritis of arms and legs c) Fatigue during ambulation d) Irritability & drowsiness
Low fiber - reduce inflammation
Which diet is recommended in a client with Crohn's disease: Low fiber or high fiber? Why?
B, C (Ascites indicates general liver dysfunction but does not necessarily indicate hepatic encephalopathy)
Which of the following findings indicate hepatic encephalopathy? Select all that apply -A) anorexia -B) change in orientation -C) asterixis -D) ascites
A, B, E (A is correct because you need to conserve energy with this disorder)
Which of the following instruction should the nurse include when teaching a client with hepatitis B about home care? Select all that apply. -A) limit physical activity -B) avoid alcohol -C) take acetaminophen for comfort -D) wear a mask when in public places -E) small frequent meals should be eaten
B (want a high protein diet)
Which of the following instructions should the nurse include in the teaching to a client with Crohn's disease? -A) decrease intake of calorie dense foods -B) drink canned protein supplements -C) increase intake of high fiber foods -D) eat high residue foods
B, C (Hct would be low because of blood loss, folic acid and albumin would be low because of malabsorption)
Which of the following laboratory results would be a elevated in a client with Crohn's disease? Select all that apply. -A) Hct -B) ESR -C) WBC -D) Folic Acid -E) Albumin
A, B, D (not opioids because they need to be metabolized in the liver - so the liver must be healthy)
Which of the following medications can the nurse expect to administer to a client with cirrhosis? -A) diuretic -B) beta blocker -C) opioid analgesic -D) lactulose -E) sedative
C (d - worried about GIB)
Which of the following statements by the client indicates understanding of the teaching about famitodine? -A) this med coats the lining of my stomach -B) this medication should stop the pain right away -C) I will take my pill at bedtime -D) I will monitor for bleeding from my nose
D
Which serum blood test is most useful to dx jaundice? -A: PTT -B: Ammonia -C: Amylase -D: Alkaline Phosphotase
Higher Risk for Adhesions (See pic), Which Can Lead to Bowel Obstructions
Why is it important to ask a client about having a hx of GI surgeries or trauma to GI tract?
