Exam 1 Practice Questions
A client who had developed jaundice 2 months earlier is brought to the ED after attending a party and developing excruciating pain that radiated over the abdomen and into the back. Upon assessment, which additional symptom would the nurse expect this client to have? Weight loss Bile-stained vomiting Hypertension Warm, dry skin
Bile-stained vomiting
Which foods should be avoided following acute gallbladder inflammation? Mashed potatoes Coffee Cooked fruits Cheese
Cheese
Which is a true statement regarding regional enteritis (Crohn's disease)? It is characterized by pain in the lower left abdominal quadrant. It has a progressive disease pattern. The lesions are in continuous contact with one another. The clusters of ulcers take on a cobblestone appearance.
The clusters of ulcers take on a cobblestone appearance.
Which is the most common presenting symptom of colon cancer? Anorexia Fatigue Change in bowel habits Weight loss
change in bowel habits
The nurse recognizes that blood shed in sufficient quantities into the upper GI tract produces which color of stool? bright red green tarry black milky white
tarry black
The nurse knows that serum amylase concentration returns to normal within which time frame 48hrs 36hrs 24hrs 12hrs
48 (48 - 72hrs)
A client with acute pancreatitis has been started on total parenteral nutrition (TPN). Which action should the nurse perform after administration of the TPN? - monitor for reports of n/v - measure abdominal girth every shift - auscultate the abdomen for bowel sounds every 4 hours - measure blood glucose concentration every 4-6 hours
measure blood glucose concentration every 4-6 hours
Which condition is the major cause of morbidity and mortality in clients with acute pancreatitis? Tetany Pancreatic necrosis MODS Shock
pancreatic necrosis
A nurse is preparing a client for endoscopic retrograde cholangiopancreatography (ERCP). The client asks what this test is used for. Which statements by the nurse explains how ERCP can determine the difference between pancreatitis and other biliary disorders? Select all that apply. (A) "It can evaluate the presence and location of ductal stones and aid in stone removal." (B) "It can assess the anatomy of the pancreas and the pancreatic and biliary ducts." (C) "It can detect unhealthy tissues in the pancreas and assess for abscesses and pseudocysts." (D) "It can assess for ecchymosis in the body." (E) "It is used in the diagnostic evaluation of acute pancreatitis."
(A) "It can evaluate the presence and location of ductal stones and aid in stone removal." (B) "It can assess the anatomy of the pancreas and the pancreatic and biliary ducts." (C) "It can detect unhealthy tissues in the pancreas and assess for abscesses and pseudocysts."
The nurse is monitoring a client's postoperative course after an appendectomy. The nurse's assessment reveals that the client has vomited, has abdominal tenderness and rigidity, and has tachycardia. The nurse reports to the physician that the client has signs/symptoms of which complication? Pelvic abscess Hemorrhage Ileus Peritonitis
peritonitis
The nurse is caring for client scheduled to undergo radical neck dissection. During preoperative teaching, the nurse states that an associated complication is venous engorgement. neck distension. clavicle fracture. shoulder drop.
shoulder drop
Clients diagnosed with esophageal varices are at risk for hemorrhagic shock. Which is a sign of potential hypovolemia? Warm moist skin Bradycardia Hypotension Polyuria
hypotension
Which response is a parasympathetic response in the GI tract? increased peristalsis decreased motility blood vessel constriction decreased gastric secretion
increased peristalsis
The nurse prepares to administer the lavage solution to a client having a colonoscopy completed. The nurse stops and notifies the physician when noting that the client has which condition? pulmonary hypertension congestive heart failure inflammatory bowel disease chronic obstructive pulmonary disease
inflammatory bowel disease
A client admitted with severe epigastric abdominal pain radiating to the back is vomiting and reports difficulty breathing. Upon assessment, the nurse determines that the client is experiencing tachycardia and hypotension. Which actions are priority interventions for this client? SATA Administer pain-relieving medication Administer electrolytes Assist the client to a semi-Fowler position Administer a low-fat diet Administer plasma
Administer pain-relieving medication Administer electrolytes Assist the client to a semi-Fowler position Administer plasma
The nurse caring for a client with diverticulitis is preparing to administer the client's medications. The nurse anticipates administration of which category of medication because of the client's diverticulitis? Antiemetic Anti-inflammatory Antianxiety Antispasmodic
Antispasmodic
The nurse is planning care for a client following an incisional cholecystectomy for cholelithiasis. Which intervention is the highest nursing priority for this client? Assisting the client to turn, cough, and deep breathe every 2 hours Assisting the client to ambulate the evening of the operative day Performing range-of-motion (ROM) leg exercises hourly while the client is awake Teaching the client to choose low-fat foods from the menu
Assisting the client to turn, cough, and deep breathe every 2 hours
When caring for a client with advanced cirrhosis and hepatic encephalopathy, which assessment finding should the nurse report immediately? Anorexia for more than 3 days Constipation for more than 2 days Change in the client's handwriting and/or cognitive performance Weight loss of 2 pounds in 3 days
Change in the client's handwriting and/or cognitive performance
Which is a clinical manifestation of cholelithiasis? Nonpalpable abdominal mass Epigastric distress before a meal Abdominal pain in the upper left quadrant Clay-colored stools
Clay-colored stools
Which is one of the primary symptoms of irritable bowel syndrome (IBS)? Abdominal distention Bloating Pain Diarrhea
Diarrhea
What information should the nurse include in the teaching plan for a client being treated for diverticulosis? Use laxatives or enemas at least once a week Drink at least 8 to 10 large glasses of fluid every day Avoid daily exercise; indulge only in mild activity Avoid unprocessed bran in the diet
Drink at least 8 to 10 large glasses of fluid every day
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? Apply triamcinolone acetonide spray Dust with nystatin powder Apply barrier powder Dry skin thoroughly after washing
Dry skin thoroughly after washing
A client has an elevated serum ammonia concentration and is exhibiting changes in mental status. The nurse should suspect which condition? Hepatic encephalopathy Asterixis Cirrhosis Portal hypertension
Hepatic encephalopathy
Which is a gerontological consideration associated with the pancreas? Increased amount of fibrous material Increased rate of pancreatic secretion Increased calcium absorption Increased bicarbonate output
Increased amount of fibrous material
Which is the most common cause of esophageal varices? Asterixis Jaundice Ascites Portal hypertension
Portal HTN
The nurse conducts education related to test preparation for a client scheduled to undergo an abdominal ultrasonography. The nurse should give the client which instruction? Do not consume anything sweet for 24 hours before the test. Restrict eating of solid food for 8 to 12 hours before the test. Do not undertake any strenuous exercise for 24 hours before the test. Avoid exposure to sunlight for at least 6 to 8 hours before the test.
Restrict eating of solid food for 8 to 12 hours before the test.
Which category of laxatives draws water into the intestines by osmosis? Fecal softeners (e.g., docusate) Bulk-forming agents (e.g., psyllium) Stimulants (e.g., bisacodyl) Saline agents (e.g., magnesium hydroxide)
Saline agents (magnesium hydroxide)
A nurse is teaching a client about the cause of acute pancreatitis. The nurse evaluates the teaching as effective when the client correctly identifies which condition as a cause of acute pancreatitis? Self-digestion of the pancreas by its own proteolytic enzymes Calcification of the pancreatic duct, leading to its blockage Fibrosis and atrophy of the pancreatic gland Use of loop diuretics to increase the incidence of pancreatitis
Self-digestion of the pancreas by its own proteolytic enzymes
A nursing instructor is explaining the pathophysiology and clinical manifestations of pancreatitis to a group of nursing students. The instructor evaluates the teaching as effective when a student correctly identifies which symptom as that most commonly reported by clients with pancreatitis? Increased and painful urination Increased appetite and weight gain Severe, radiating abdominal pain Tarry, black stools and dark urine
Severe, radiating abdominal pain
The presence of mucus and pus in the stools suggests which condition? Disorders of the colon Small-bowel disease Ulcerative colitis Intestinal malabsorption
Ulcerative Colitis
A client reporting shortness of breath is admitted with a diagnosis of cirrhosis. A nursing assessment reveals an enlarged abdomen with striae, an umbilical hernia, and 4+ pitting edema of the feet and legs. What is the most important data for the nurse to monitor? Hemoglobin Bilirubin Temperature Albumin
Albumin