Med Surg 1 NCLEX style Questions- GI
Which of the following associated disorders may the client with crohns disease exhibit? A. Ankylosing spondylitis B. Colon cancer C. malabsorption D. Lactase deficiency
C. Malabsorption
Your patient takes NSAIDS for her degenerative joint disease, has developed peptic ulcer disease. Which drug is useful in preventing NSAID induced PUD? A. Calcium Carbonate (TUMS) B. Famotidine (Pepcid) C. Misoprostol (Cytotec) D. Sucralfate
C. Misoprostol (Cytotec)
Your patient has a GI tract that is functioning , but has the inability to swallow foods. Which is the perfered method of feeding for your patient? A. TPN B. PPN C. NG feeding D. Oral Liquid Supplements
C. NG feeding
A client with rectal cancer may exhibit which of the following symptoms? A. Abdominal fullness B. Gastric fullness C. Rectal bleeding D. Right upper quadrant pain
C. Rectal bleeding
A 53 year old patient has undergone partial gastrectomy for adenocarcinoma of the stomach. An NG tube is in place and is connected to low continuous suction. During the immediate postoperative period, you expect the gastric secretions to be which color? A. brown B. Clear C. Red D. Yellow
C. Red
The client with a new colostomy is concerned about the odor from the stool in the ostomy drainage bag. The nurse teaches the client to include which of the following foods in the diet to reduce odor? A. Yogurt B. Broccoli C. Cucumbers D. Eggs
A. Yogurt
Type A chronic gastritis can be distinguished from type B by its ability to: A. Cause atrophy of the parietal cells B. Affect only the antrum of the stomach C. Thin lining of the stomach walls D. Decrease gastric secretions
A. Cause atrophy of the parietal cells
The nurse instructs the ileostomy client to do which of the following as a part of essential care of the stoma? A. Cleanse the peristomal skin meticulously B. Take in high-fiber foods such as nuts C. Message the area below the stoma D. Limit fluid intake to prevent diarrhea
A. Cleanse the peristomal skin meticulously
Fistulas are most common with which of the following bowel disorders? A. Crohns disease B. Diverticulitis C. Diverticulosis D. Ulcerative colitis
A. Crohns disease
Christina is receiving an eternal feeding that requires a concentration of 80 mL of supplement whith 20 ml of water. How much water do you mix with an 8 oz (240ml) can of feeding? A. 60 ml B. 70 ml C. 80 ml D. 90 ml
A. 60 mL
Which of the following complications is thought to be the most common cause of appendicitis? A. A fecalith B. Bowel kinking C. Internal bowel occlusion D. Abdominal bowel swelling.
A. A felicath
A client with which of the following conditions may be likely to develop rectal cancer? A. Adenomatous polyps B. Diverticulitis C. Hemorrhoids D. Peptic ulcer disease
A. Adenomatous polyps
You are developing a care plan on Sally, a 67 yr old pt with hepatic encephalopathy. Which of the following do you include? A. Administering a lactulose enema as ordered B. Encouraging a protein rich diet C. Administering sedatives as necessary. D. Encouraging ambulation at least 4x per day
A. Administering a lactulose enema as ordered
Hepatic encephalopathy develops when the blood levels of which substance increases? A. Ammonia B. Amylase C. Calcium D. Potassium
A. Ammonia
Which of the following areas is the most common site of fistulas in clients with crohns disease? A. Anorectal B. Ileum C. Rectovaginal D. Transverse colon
A. Anorectal
You're caring for Betty with liver cirrhosis. Which of the following assessment findings leads you to suspect hepatic encephalopathy in her? a Asterixis b Chvostek's sign c Trousseau's sign d Hepatojugular reflex
A. Asterixis
Annabelle is being discharged with a colostomy, and youre teaching hr about colostomy care. Which statement correctly describes a health stoma? A. At first, the stoma may bleed slightly when touched B. The stoma should appear dark blue and have blueish hue C. A burning sensation under the stoma faceplate is normal D.The stoma should remain swollen away from the abdomen
A. At first, the stoma may bleed slightly when touched
Gail is scheduled for a cholecystectomy. After completion of preoperative teaching, Gail states,"If I lie still and avoid turning after the operation, I'll avoid pain. Do you think this is a good idea?" What is the best response? A) "You'll need to turn from side to side every 2 hours." B) "It's always a good idea to rest quietly after surgery." C) "The doctor will probably order you to lie flat for 24 hours." D) "Why don't you decide about activity after you return from the recovery room?
A) "You'll need to turn from side to side every 2 hours."
Your teaching Anthony how to use his new colostomy. How much skin should remain exposed between the stoma and the ring in the applaince? A. 1/16'' B. 1/4'' C. 1/2'' D. 1''
A. 1/16''
Youre caring for a patient with a sigmoid colostomy. The stool from this colostomy is: A. Formed B. Semisolid C. Semiliquid D. Watery
A. Formed
Radiation therapy is used to treat colon cancer before surgery for which of the following reasons? A. Reducing the size of the tumor B. Eliminating the malignant cells C. Curing the cancer D. Helping the bowel heal after the surgery
A. reducing the size of the tumor
Care for the postoperative client after gastric resection should focus on which of the following problems? A. Body image B. Nutritional needs C. Skin Care D. Spiritual needs
B. nutritional needs
Which of the following interventions should be included in the medical management of crohns disease? A. increasing oral intake of fiber B. Administer laxitives C. Using long term steroid terapy D. Increasing physical therapy
C. using long term steroid therapy
The nurse is reviweing the physicians orders written for a client admitted with acute pancreatitis. Which physicians order would the nurse question if noted on the client's chart? A.NPO status B. Insert a nasogastric tube C. An anticholinergic medication D. Morphine for pain
D. Morphine for pain
Which of the following lab results would be expected in a client with peritonitis? A. Partial thromboplastin time above 100 seconds B. hemoglobin level below 10 mg C. Potassium level above 5.5 mEq D. White blood cell count above 15,000
D. White blood cell count above 15,000
Michael, a 42 y.o. man is admitted to the med-surg floor with a diagnosis of acute pancreatitis. His BP is 136/76, pulse 96, Resps 22 and temp 101. His past history includes hyperlipidemia and alcohol abuse. The doctor prescribes an NG tube. Before inserting the tube, you explain the purpose to patient. Which of the following is a most accurate explanation? a "It empties the stomach of fluids and gas." b "It prevents spasms at the sphincter of Oddi." c "It prevents air from forming in the small intestine and large intestine." d "It removes bile from the gallbladder."
a "It empties the stomach of fluids and gas."
Which of the following symptoms indicated diverticulosis? A. No symptoms exist B. Change in bowel habits C. anorexia with low grade fever D. Episodic, dull, or steady midabdominal pain
A. No symptoms exist
A 29 yr old pt has an acute episode of ulcerative colitis . What diagnostic test confirms this diagnosis? A. Barium Swallow B. Stool examination C. Gastric Analysis D. Sigmoidoscopy
D. Sigmoidoscopy
Which of the following terms best describes pain associated with appendicitis? A. Aching B. Fleeting C. Intermittent D. Steady
D. Steady
Your patient recently had abd surgery and tells you that he feels a popping sensation in his incision during a cough spell, followed by severe pain. You anticipate an evisceration. Which supplies should you take to his room? A. Suture kit B. Sterile water and suture kit C. Sterile water and sterile dressings D. Sterile saline solution and sterile dressings
D. Sterile saline solution and sterile dressings
Crohns disease can be described as a chronic relapsing disease. Which of the following areas in the GI system may be involved with this disease? A. Th length of the large colon B. Only the sigmoid colon C. The entire large colon through the layers of the mucosa and submucosa. D. The small intestine and colon; affecting the entire thickness of the bowel
D. The small intestine and colon; affecting the entire thickness of the bowel
You're doing preoperative teaching with Gertrude who has ulcerative colitis who needs surgery to create an ileoanal reservoir. Which information do you include? a. A reservoir is created that exits through the abdominal wall. b. A second surgery is required 12 months after the first surgery. c. A permanent ileostomy is created. d. The surgery occurs in two stages.
D. The surgery occurs in two stages
which of the following associated disorders may a client with ulcerative colitis exhibit? A. Gallstones B. Hydronephrosis C. Nephrolethiasis D. Toxic megacolon
D. Toxic megacolon
Anthony, a 60 yr old patient has just undergone a bowel resection with a colostomy. During the first 24 hrs, which of the following observations about the stoma should you report to the doctor? A. Pink color B. Light edema C. Small amount of oozing D. Trickles of bright red blood
D. Trickles of bright red blood
Colon cancer is most closely associated with which of the following conditions? A. Appendicitis B. Hemorrhoids C. Hiatal hernia D. Ulcerative colitis
D. Ulcerative colitis
Which of the following mechanisms can facilitate the development of diverticulosis into diverticulitits? A. Treating constipation with chronic laxitive use leading to dependence B. Chronic constipation causing an obstruction, reducing, reducing forwards flow of intestinal contents. C. Herniation of the intestinal mucosa, rupturing the wall of the intestine D. Undigested food blocking the diverticulum, predisposing teh area to bacterial invasion
D. Undigested food blocking the diverticulum, predisposing teh area to bacterial invasion
You are advising a 21 yr old w a colostomy who reports problems with flatus. What food should you recommend? A. Peas B. Cabbage C. Broccoli D. Yogurt.
D. Yogurt
if the client had IBS, which of the following diagnostic tests would determine if the diagnosis is Crohns disease or Ulcerative colitis A. Abdominal computed tomography B. Abdominal x ray C. Barium swallowing D. Colonoscopy with biopsy
D. colonoscopy with biospy
Your patient, a post op darainage of a pelvic abscess secondary to diverticulitis, begins to cough violenly during drinking water. His wound has ruptured and a small segment of the bowel is protruding. What is your priority? A. Ask the patient what happened, call the doctor, and cover the are with a water soaked bedshet B. Obtain vital signs , call the doctor, and obtain emergency orders C. Have a CAN hold the wound together while you obtain vital signs , call the doctor an flex teh patient's knees D. have the doctor called while you remain witht eh patient, flex the patient's knees, and cover the wound with sterile towels soaked in sterile saline solution
D. have the doctor called while you remain witht eh patient, flex the patient's knees, and cover the wound with sterile towels soaked in sterile saline solution
A client presents to the emergency room, reporting that he has been vomiting every 30-40 minutes for the past 8 hrs. Frequent vomiting puts him at risk for which of the following? A. Metabolic acidosis with hyperkalemia B. Metabolic acidosis with hypokalemia C. Metabolic alkalosis with hyperkalemia D. Metabolic alkalosis with hypokalemia
D. metabolic alkalosis with hypokalemia
The nurse is caring for a hospitalized client with a diagnosis of ulcerative colitis. Which finding, if noted on assessment of the client, would the nurse report to the physician? A. Bloody diarrhea B. Hypertension C. A hemoglobin of 12 gl D. Rebound tenderness
D. rebound tenderness
Which of teh following symptoms may be exhibited by a client with crohns disease? A. bloody diarrhea B. Narrow stools C. N/V D. Steatorrhea
D. steatorrhea
which area of the alimemtary canal is the most common location for crohns disease? A. Ascending colon B. Descending colon C. Sigmoid colon D. Terminal Ileum
D. terminal ileum
Which of the following treatments is used for rectal cancer but not for colon cancer? A.Chemotherapy B. Colonoscopy C. Radiation D. Surgical resection
C. Radiation
Which of the following factors is believed to be linked to crohns disease? A. Constipation. B. Diet C. hereditary D. Lack of exercise
C. Hereditary
Which of the following medications is most effective for treating the pain associated with IBS? A. Acetaminophen B. Opiates C. steroids D. Stool softeners
C. Steroids
You have a patient with achalasia (incomplete muscle relaxation of the GI tract, especially sphincter muscles). Which medication do you anticipate to administer? A. Isosorbide dinitrate (Isordil) B. Digoxin (Lanoxin) C. Captopril (Capoten) D. Propanolol (Inderal)
A. Isosorbide dinitrate (Isordil)
When teaching a community group about measures to prevent colon cancer, which instruction should the nurse include? A. Limit fat intake to 20-25 % of your daily calories B. Include 15-20 g of fiber to your diet daily C. Get an annual rectal exam after age 35 D. Undergo sigmoidoscoy annually after age 50.
A. Limit fat intake to 20-25 % of your daily calories
Which of the following types of diets is implicated in the development of diverticulosis? A. Low fiber diet B. High fiber diet C. High protein diet D. Low carb diet
A. Low fiber diet
Which of the following diets is most commonly associated with colon cancer? A. Low-fiber, high fat B. Low fat, high fiber C. Low protien, high carbs D. Low carbs, high protein
A. Low fiber, high fat
The student nurse is teaching the family of a patient with liver failure. You instruct them to limit which foods in the patient's diet? A. Meats and beans B. Butter and gravies C. Potatoes and pastas D. Cakes and pastries/
A. Meats and beans
You're caring for Jane, a 57 y.o. patient with liver cirrhosis who develops ascites and requires paracentesis. Before her paracentesis, you instruct her to: A.Empty her bladder. B. Lie supine in bed. C. Remain NPO for 4 hours. D. Clean her bowels with an enema
A. Empty her bladder
You're caring for a 28yo woman w hep B. She's concerned abt the duration of her recovery. Which response isnt approapriate? A. Encourage her to not worry about the future B. Encourage her to express her feelings abt the illness C. Discuss effects of hepatitis B on future health problems D. Provide avenues for financial counseling if she expresses the need
A. Encourage her to not worry about the future
The client being seen in a physicians 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? A. Fast for 8 hours before the test B. Eat a regular supper and breakfast C. Continue to take all oral meds as scheduled D. Monitor bowel movement pattern for constipation.
A. Fast for 8 hours before the test
Which of the following aspects is the primary focus of nursing management for a client with peritonitis? A. Fluid and electrolyte balance B. Gastric irrigation C. Pain management D. Psychosocial issues
A. Fluid and electrolyte balance
Elmer is scheduled for a proctoscopy and has an I.V. The doctor wrote an order for 5mg of I.V diazepam (valium). Which order is correct regarding diazepam? A. Give diazepam in the IV port close to the vein B. Mix diazpam w 5 ml of dextrose 5% in water and giver over 15 min C. Give diazepam rapidly to IV to prevent the bloodstream from diluting the drug mixture D. Question the order bc I.V. admin of diazepam is contraindicated
A. Give diazepam in the IV port close to the vein
A patient with chronic alcohol abuse is admitted with liver failure. You closely monitor the pts blood pressure because of which change that is associate with the liver failure? A. Hypoalbuminemia B. Increased capillary permeability C. Abnormal peripheral vasodilation D. Excess renin release from kidneys
A. Hypoalbuminemia
Which stoma would you expect a malodorous, enzyme rich, caustic liquid output that is yellow, green, or brown? A. Ileostomy B. Ascending colonoscopy C. Transverse colonoscopy D. Descending colonoscopy
A. Ileostomy
The nurse is teaching a client how to perform a colostomy irrigation. To enhance the effectiveness of the irrigation and fecal returns, what measure should the nurse instruct the client to do? A. Increase fluid intake B. Reduce the amount of irrigation solution C. Perform the irrigation in the evening D. Place heat on the abdomen.
A. Include fluid intake
Youre developing the plan of care for a patient experincing dumping syndrome after a Billroth II procedure. Which dietary instructions do you include? A. Omit fluids with meals B. Increase carb intake C. Decrease protein intake D. Decrease fat intake
A. Omit fluids with meals
The nurse is doing an admission assessment on a client with a history of duodenal ulcer. To determine whether the problem us currently active, the nurse would assess the client for which of the following most frequent symptoms of duodenal ulcer? A. Pain that is relieved by food intake B. Pain that is radiated down to the right arm C. N/v D. Weight loss
A. Pain that is relieved by food intake
A client has just had surgery for colon cancer. Which of the following disorders might the client develop? A. Peritonitis B. Diverticulosis C. Partial bowel obstruction D. Complete bowel obstruction
A. Peritonitis
Jerod is experiencing an acute episode of ulcerative colitis. Which is priority for this patient? A. Replace lost fluid and sodium. B. Monitor for increased serum glucose level from steroid therapy. C. Restrict the dietary intake of foods high in potassium. D. Note any change in the color and consistency of stools.
A. Replace lost fluid and sodium.
A client has a percutaneous endoscopic gastrostomy tube inserted for tube feedings. Before starting a continuous feeding, the nurse should place the client in which position? A. Semi fowlers B. Supine C Reverse trendelenburg D. High fowlers
A. Semi fowlers
What information is correct about stomach cancer? A. Stomach pain is often a late symptom B. Surgery is often a successful treatment C. Chemotherapy and radiation are often successful treatments D. The pt can survive for an extrensive time w TPN
A. Stomach pain is often a late symptom
A patient has an acute upper GI hemorrhage. Your interventions include: A. Treating hypovolemia B. Treating hypervolemia C. Controlling the bleeding source D. Treating shock and diagnosing the bleeding source
A. Treating hypovolemia
You're preparing a patient w a malignant tumor for colorectal surgery and subsequent colostomy. The patient tells you he's anxious. What should your initial step be in working with this patient? A. determine what the patient already knows about colostomies B. Show the patient some pictures of colostomies C. Arrange for someone who has a colostomy to visit the patient D. Provide the provider with a written material about colostomy care
A. determine what the patient already knows about colostomies
Your patient, Christopher, has a diagnosis of ulcerative colitis and has severe abdominal pain aggravated by movement, rebound tenderness, fever, nausea, and decreased urine output. This may indicate which complication? A. Fistula. B. Bowel perforation. C. Bowel obstruction. D. Abscess.
B. Bowel perforation.
Which of the following symptoms is a client with colon cancer most likely to exhibit? A. A change in appetite B. A change in bowel habit C. An increase in body weight D. An increase in body temperature
B A change in Bowel habit
Which of the following best describes diverticulosis? A. An inflamed outpouching of the intestine B. A noninflamed outpouching of the intestine C. The partial impairment of the forward flow of the intestinal contents D. An abdominal protrusion of an organ through the structure that usually holds it
B. An inflammed outpouching of the intestine
Which of the following tests should be admin to a client suspected of having diverticulosis? A. Abdominal ultrasound B. Barium enema C. Barium Swallow D. Gastroscopy
B. Barium enema
Regina is a 46 yr old woman with ulcerative colitis. You expect her stools to look like: A. Watery and frothy B. Bloody and mucous C. Firm and well-formed D. Alternating constipation and diarrhea
B. Bloody and mucous
Which of the following symptoms would a client in the early stages of peritonitis exhibit? A. Abdominal distention B. Abdominal pain and rigidity C. Hyperactive bowel sounds D. Right upper quadrant pain
B. Abdominal pain and rigidity
You have to teach ostomy self care to a patient with a colostomy. You tell the patient to measure and cut the wafer: A-To the exact size of the stoma B-About 1/16" larger than the stoma C-About 1/8" larger than the stoma D-About 1/4″ larger than the stoma
B. About 1/16th larger than the stoma
Which of the folowing factors is believed to cause ulcerative collitis? A. Acidic Diet B. Altered immunity C. Chronic constipation D. Emotional stres
B. Altered immunity
Stephanie, a 28 y.o. accident victim, requires TPN. The rationale for TPN is to provide: A. Necessary fluids and electrolytes to the body. B. Complete nutrition by the I.V. route. C. Tube feedings for nutritional supplementation. D. Dietary supplementation with liquid protein given between meals.
B. Complete nutrition by the I.V. route
A client with gastric cancer can expect to have surgery for resection. Which of the following should the nursing management priority for the preoperative client with gastric cancer? A. Discharge planning B. Correction of nutritional deficits C. Prevention of DVT D. instruction regarding radiation treatment
B. Correction of nutritional deficits
After abdominal surgery, your patient has a severe coughing episode that causes wound evisceration. In addition to calling the doctor, which intervention is most appropriate? A. Irrigate the wound & organs with Betadine B. Cover the wound with a saline soaked sterile dressing C. Apply a dry sterile dressing & binder D. Push the organs back & cover with moist sterile dressings
B. Cover the wound with a saline soaked sterile dressing
Findings during an endoscopic exam include a cobblestone appearance of the colon in your patient. The findings are characteristic of which disorder? A. Ulcer B. Crohn's disease C. Chronic gastritis D. Ulcerative colitis
B. Crohn's disease
The nurse is reviewing the record of a client with crohn's disease. Which of the following stool characteristics would the nurse expect to note documented on the client's record? A. Chronic constipation B. Diarrhea C. Constipation D. Stool constantly oozing from the rectum
B. Diarrhea
Which of the following complications of gastric resection should the nurse teach the client to watch for? A. Constipation B. Dumping syndrome C. Gastric Spasm D. Intestinal spasms
B. Dumping syndrome
You're caring for Lewis, a 67 y.o. patient with liver cirrhosis who develops ascites and requires paracentesis. Relief of which symptom indicated that the paracentesis was effective? A. Pruritus B. Dyspnea C. Jaundice D. Peripheral Neuropathy
B. Dyspnea
Youre preparing a teaching plan video for a 27 yr named Jeff who underwent surgery to close a temporary ileostomy. Which nutritional guideline do you include in this plan? A. there is no need to change eating habits B. Eat six small meals in a day C. Eat the largest meal in the evening D. Restrict fluid intake
B. Eat six small meals a day
After a right hemicolectomy for treatment of colon cancer, a 57 yr old client is reluctant to turn while on bed rest. Which action by the nurse would be appropriate? A. Asking a co worker to help turn the client B. Explaining to the client why turning is important C. Allowing the client to turn when he's ready to do so D. Telling the client that the physician's order states he must turn every 2 hrs
B. Explaining to the client why turning is important
The client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate post op for which of the following most frequent complications of this type of surgery? A. Inststinal obstruction B. Fluid electrolyte imbalance C. Malabsorption of fat D. Folate deficiency
B. Fluid electrolyte imbalance
A client with irritable bowel syndrome is being prepared for discharge. Which of the following meal plans should the nurse give the client? A. Low fiber, low fat B. High fiber, low fat C. Low fiber, high fat D. High fiber, high fat
B. High fiber, low fat
Matt is a 49 yr old with a haital hernia that you are about to counsel. Health care counseling for matt should include which of the following instructions? A. Restrict intake of high-carb foods B. Increase fluid intake w meals C. Increase fat intake D. Eat 3 regular meals a day
B. Increase fluid intake w meals
Before surgery, Lee is to administer enemas until clear. During administration, he complains of intestinal cramps. What do you do next? A. Discontinue the procedure B. Lower the height of the enema container C. Complete the procedure as quickly as possible D. Continue administration of the enema as ordered without making any adjustments
B. Lower the height of the enema container
Claire, a 33 y.o. is on your floor with a possible bowel obstruction. Which intervention is priority for her? A. Obtain daily weights. B. Measure abdominal girth. C. Keep strict intake and output. D. Encourage her to increase fluids.
B. Measure abdominal girth.
Your patient is complaining of abdominal pain during assessment. What is your priority? A. Ausculate to determine changes in bowel sounds. B. Observe the contour of the abdomen. C. Palpate the abdomen for mass. D. Percuss the abdomen to determine if fluid is present.,
B. Observe the contour of the abdomen.
During the first few days of recovery from ostomy surgery for ulcerative colitis, which of the following aspects should be the first priority of client care? A. Body image B. Ostomy care C. Sexual concerns D. Skin care
B. Ostomy care
An enema is prescribed for a client with suspected appendicitis. Which of the following actions should the nurse take? A. Prepare 750 ml of irrigating solution warmed to 100 *F B. Question the physician about the order C. Provide privacy and explain the procedure to the client D. Assist the client to left lateral sims position
B. Question the physician about the order
Which of the folowing symptoms is associated with ulcerative colitis? A. Dumping syndrome B. Rectal bleeding C. Soft stools D. Fistulas
B. Rectal bleeding
An intubated patient is receiving continuous enteral feedings thru a salum sump tube at 60 ml//hr. Gastric residuals have been 30-40 ml when monitored q 4h. You check the gastric residual and aspirate 220 ml. What is your first response to this finding? A. Notify the doctor immediately B. Stop the feeding, and clamp the NG tube C. discard the 220 ml and clamp the NG tube D. Give a prescribed GI stimulant such as metoclopramide (reglan)
B. Stop the feeding, and clamp the NG tube
George has a t tube in place after gallbladder surgery, Before discharge, what information or instructions should be given regarding the T tube drainage? A. If there is any drainage,notify the surgeon immediately B. The drainage ill decrease daily until the bile duct heals. C. First, the drainage is dark green, then it becomes dark yellow. D. If the drainage stops, milk the tube towards the puncture wound.
B. The drainage will decrease daily until the bile duct heals.
Arthur has a family history of colon cancer and is scheduled to have a sigmoidoscopy. He is crying as he tells you, "I know that I have colon cancer, too." Which response is most therapeutic? A "I know just how you feel." B "You seem upset." C "Oh, don't worry about it, everything will be just fine." D "Why do you think you have cancer?"
B. You seem upset
Develop a teaching care plan for Angie who is about to undergo a liver biopsy. Which of the following points do you include? A. Youll need to lie on your stomach during the test B. Youll need to lie on your right side after the test C. During the biopsy, you'll be asked to exhale deeply and hold it. D The biopsy is performed under general anesthesia
B. Youll need to lie on your right side after the test
You're performing an abdominal assessment on Brent who is 52 y.o. In which order do you proceed? A.Observation, percussion, palpation, auscultation B. Observation, auscultation, percussion, palpation C. Percussion, palpation, auscultation, observation D. Palpation, percussion, observation, auscultation
B. observation, auscultation, percussion, palpation
You are assessing the stoma of a patient a health, well healed colostomy. You expect the stoma to appear: A. Pale, pink and moist B. Red and moist C. Dark or purple colored D. Dry and black.
B. red and moist
The nurse has given instructions to the client with an ileostomy about foods to eat to thicken the stool. The nurse determines that the client needs further instruction if the client stated to eat which of the following foods to make the stools less watery? A. Pasta B. Rice C. Bran D. Low fat cheese
C. Bran
You're caring for Carin who has just had ileostomy surgery. During the first 24 hrs post op, how much drainage can you expect from the ileostomy? A. 100 mL B. 500 mL C. 1500 mL D. 5000 mL
C. 1500 mL
Medical management of the client with diverticulitis should include which of the following treatments? A. Reduced fluid intake B. Increased fiber in diet C. Admin of antibiotics D. Exercises to increase intra abdominal pressure
C. Admin of antibiotics
The nurse is preparing to discharge teaching plan for the client who had an umbilical hernia repair. Which of the following would the nurse include in the plan? A.Restricting pain meds B. Maintaining bedrest C. Avoiding coughing D. Irrigating the drain
C. Avoid coughing
A 30 yr old client experiences wight loss, abdominal disstention, crampy abdominal pain, and intermitttent diarrhea after birth of her 2nd child. Diagnostic tests reveal gluten induced enteropathy. Which foods must she eliminate from her diet permanently A. Milk and diary products B. Protein containing foods C. Cereal grains (except rice and corn) D. Carbohydrates
C. Cereal grains (except rice and corn)
A patient has a severe exacerbation of ulcerative colitis. Long-term meds will probably include: A. Antacids B. Antibiotics C. Corticosteroids D. Histamine 2 receptor blockers
C. Corticosteroids
In a client with crohns disease, which of the following symptoms should not be a direct result of antibiotic therapy? A. Decrease in bleeding B. decrease in temperature C. decrease in body weight D. Decrease in the number of stools
C. Decrease in body weight
Five days after undergoing surgery, a client develops a small bowel obstruction. A miller-abbott tube is inserted for bowel decompression. Which nursing diagnosis takes priority? A. Imbalanced nutrition: Less than body requirements B. Acute pain C. Deficient fluid volume D. Excess fluid volume
C. Deficient fluid volume
You're caring for Beth who underwent a Billroth II proedure (Removal of the pylorus and duodenum) for treatment of a peptic ulcer. Which findings suggest that the patient is developing dumping syndrome, a complication associated with this procedure? A. Flushed , dry skin B. Headache and bradycardia C. Dizziness and sweating D. Dyspnea and Chest Pain
C. Dizziness and sweating
The student nurse is preparing a teaching care plan to help improve nutrition in a patient with achalasia. You include which of the following: A. Swallow foods while leaning forward B. Omit fluids at mealtime C. Eat meals sitting upright D. Avoid soft and semi soft foods
C. Eat meals sitting upright
A client with gastric cancer may exhibit which of the following symptoms? A. Abdominal cramping B. Constant hunger C. feeling of fullness D. Weight gain
C. Feelings of fullness
Which of the following diagnostic tests may be performed to determine if a client has gastric cancer? A. Barium enema B. Colonoscopy C. Gastroscopy D. Serum Chemistry levels
C. Gastroscopy
Kevin has a history of peptic ulcer disease and vomits coffee-ground emesis. What does this indicate? A. He has fresh, active upper GI bleeding. B. He needs immediate saline gastric lavage. C. His gastric bleeding occurred 2 hours earlier. D. He needs a transfusion of packed RBC's.
C. His gastric bleeding occurred 2 hours earlier
Janice is waiting for discharge instructions after her herniorrhaphy. Which of the following instructions do you include? A. Eat a low fiber diet B. resume heavy lifting in 2 weeks C. Lose weight, if obese D. Resume sexual activity once discomfort is gone
C. Lose weight, if obese
Your patient with peritonitis is NPO and complaining of thirst. What is your priority? A. Increase the IV infusion rate B . Use diversion activities C. Provide frequent mouth care D. Give icechips q 15 min
C. Provide frequent mouth care
Your goal is to minimize David's risk of complications after a herniorrhaphy. You instruct the pt to: A. Avoid the use of pain meds B. Cough and deep breath Q 2h C. Splint the incision if he cant avoid sneezing or coughing D. Apply heat to the scrotal area.
C. Splint the incision if he cant avoid sneezing or coughing
The nurse is performing a colostomy irrigation on a client. During the irrigation, a client begins to complain of abdominal cramps. Which of the following is the most appropriate nursing action? A. Notify the physician B. Increase the height of the irrigation C. Stop the irrigation temporarily D. Medicate with dilaudid and resume the irrigation
C. Stop the irrigation temporarily
The nurse is monitoring a client for the early signs of dumping syndrome. Which symptom indicates this occurence? A. Abdominal cramping and pain B. Bradycardia and indigestion C. Sweating and pallor D. Double vision and chest pain
C. Sweating and pallor
In a client with diarrhea, which outcome indicates that fluid resuscitation is successful? a. The client passes formed stools at a regular interval B. The client reports a decrease in stool frequency and liquidity C. The client exhibits firm skin turgor D. The client no longer experiences perianal burning
C. The client exhibits firm skin turgor
Dark, tarry stools indicate bleeding in which location of the GI tract? A. Upper colon B. Lower colon C. Upper GI tract D. Small intestine.
C. Upper GI tract
The student nurse is participating in colorectal cancer screening program. Which patient has the fewest risk factors in colon screening? A. Janice a 45 yr old with 25 yr history of ulcerative colitis B.George, a 50 yr old whose father died of colon cancer C. Herman, a 60 yr old who follows a low fat, high fiber diet D. Sissy, a 72 yr old with history of breast cancer
C. herman a 60 yr old client who follows a low fat, high fiber diet.
Which of the following definitions best describes gastritis? A. Erosion of the gastric mucosa B. Inflammation of a diverticulum C. Inflammation of the gastric mucosa D. Reflux of stomach acid into the esophagus
C. inflammation of the gastric mucosa
Which of the following conditions is most likely to directly cause peritonitis? A. Cholelithiasis B. Gastritis C. Perforated ulcer D. Incarcerated hernia
C. perforated ulcer
The client who has undergone creation of a colostomy has a nursing diagnosis od disturbed body image. The nurse would evaluate that the client is making the most significant progress toward identified goals if the client: A. Watches the nurse empty the colostomy bag B. Looks at the ostomy site C. Reads the ostomy product literature D. Practices cutting the ostomy appliance
D. Practices cutting the ostomy appliance
The nurse is assessing for stoma prolapse in a client with a colostomy. The nurse would observe which of the following if stoma prolapse occured? A. Sunken and hidden stoma B. Dark and bluish stoma C. Narrowed and flattened stoma D. Protruding stoma
D. Protruding stoma
You're discharging Nathaniel with hepatitis B. Which statement suggests understanding by the patient? A) "Now I can never get hepatitis again." B) "I can safely give blood after 3 months." C) "I'll never have a problem with my liver again, even if I drink alcohol." D) "My family knows that if I get tired and start vomiting, I may be getting sick again."
D) "My family knows that if I get tired and start vomiting, I may be getting sick again."
Rob is a 46 y.o. admitted to the hospital with a suspected diagnosis of Hepatitis B. He's jaundiced and reports weakness. Which intervention will you include in his care? A) Regular exercise B) A low-protein diet. C) Allow patient to select his meals. D) Rest period after small, frequent meals.
D) Rest period after small, frequent meals.
Which of the following therapies is not included in the medical management of a client with peritonitis? A. Broad spectrum antibiotics B. Electrolyte replacement C. I.V. fluids D. Regular diet
D. Regular diet
A patient with Crohn's disease is admitted after 4 days of diarrhea. Which of the following urine specific gravity values do you expect to find in this patient? A. 1.005 B. 1.011 C. 1.020 D. 1.030
D. 1.030
Which of the following nursing interventions should be implemented to manage a client with appendicitis? A. Assessing for pain B. Encouraging oral intake of clear liquid C. Providing discharge teaching D. Assessing for symptoms of peritonitis
D. Assessing for symptoms of peritonitis
When teaching an elderly client how to prevent constipation, which of the following instructions should the nurse include? A. Drink 6 glasses of fruit juice each day B. Avoid grain products and nuts C. Add at least 4 grams of bran to your cereal each morning D. Be sure to get regular exercise
D. Be sure to get regular exercise
Surgical management of ulcerative colitis may be performed to treat which of the following complications? A. gastritis B. Bowel herniation C. Bowel outpouching' D. Bowel perforation
D. Bowel perforation
Sitty, a 66 yo patient underwent a colostomy for ruptured diverticulum. She did well during the surgery and returned to your med surg floor in stable condition. You assess her colostomy 2 days after the surgery. Which finding do you report to the doctor? A. Blanched stoma B. Edematous stoma C. reddish pink stoma D. Brownish black stoma
D. Brownish black stoma
Which of the following diagnostic tests should be performed annually over the age of 50 to screen for colon cancer? A. Abdominal CT scan B. Abdominal x-ray C. Colonoscropy D.Fecal Occult Blood test
D. Fecal occult blood test
Your patient has retractable gastric peptic ulcer and has has a gastric vagotomy. Which factor increases as a result of vagotomy? A. Peristalsis B. Gastric Acidity C. Gastric Motility D. Gastric pH.
D. Gastric pH
You promote hemodynamic stability in a patient with upper GI bleeding by: A. Encouraging oral fluid intake. B. Monitoring central venous pressure. C. Monitoring laboratory test results and vital signs. D. Giving blood, electrolyte and fluid replacement.
D. Giving blood, electrolyte and fluid replacement.
A patient who underwent abd surgery now has a gaping incision due to delayed wound healing. Which method is correct when you irrigate a gaping abd incision with sterile normal saline solution w/o using piston syringe? A. Rapidly instill a stream of irrigation solution into the wound. B. Apply a wet to dry dressing to the wound after the irrigation C. Moisten the are around the wound with normal saline solution after the irrigation D. Irrigate continuously until the solution becomes clear or all is used.
D. Irrigate continuously until the solution becomes clear or all is used.
After an abdominal resection for colon cancer, the client returns to his room with a Jackson-Pratt drain in place. The client's spouse asks the nurse about the purpose of the drain. The best response would be for the nurse to say: A.It irrigates the incision with a saline solution B. It helps prevent bacterial infection of the incision C. It measures the amount of fluid lost after surgery D. It helps prevent the accumulation of drainage in the wound.
D. It helps prevent the accumulation of drainage in the wound.
Anna is 45 y.o. and has a bleeding ulcer. Despite multiple blood transfusions, her HGB is 7.5g/dl and HCT is 27%. Her doctor determines that surgical intervention is necessary and she undergoes partial gastrectomy. Postoperative nursing care includes: A. Giving pain medication Q6H. B. Flushing the NG tube with sterile water. C. Positioning her in high Fowler's position. D. Keeping her NPO until the return of peristalsis.
D. Keeping her NPO until the return of peristalsis.
Which of the following substances is most likely to cause gastritis? A. Milk B Bicarb of soda, baking soda C. Enteric coated aspirin D. Non steroidal anti inflammatory drugs
D. NSAIDS
Stephen is a 62 y.o. patient that has had a liver biopsy. Which of the following groups of signs alert you to a possible pneumothorax? a Dyspnea and reduced or absent breath sounds over the right lung b Tachycardia, hypotension, and cool, clammy skin c Fever, rebound tenderness, and abdominal rigidity d Redness, warmth, and drainage at the biopsy site
a Dyspnea and reduced or absent breath sounds over the right lung
Nathaniel has severe pruritus due to having hepatitis B. What is the best intervention for his comfort? a Give tepid baths. b Avoid lotions and creams. c Use hot water to increase vasodilation. d Use cold water to decrease the itching.
a Give tepid baths.
Glenda has cholelithiasis (gallstones). You expect her to complain of: a Pain in the right upper quadrant, radiating to the shoulder. b Pain in the right lower quadrant, with rebound tenderness. c Pain in the left upper quadrant, with shortness of breath. d Pain in the left lower quadrant, with mild cramping.
a Pain in the right upper quadrant, radiating to the shoulder.
Sharon has cirrhosis of the liver and develops ascites. What intervention is necessary to decrease the excessive accumulation of serous fluid in her peritoneal cavity? a Restrict fluids b Encourage ambulation c Increase sodium in the diet d Give antacids as prescribed
a Restrict fluids
Jason, a 22 y.o. accident victim, requires an NG tube for feeding. What should you immediately do after inserting an NG tube for liquid enteral feedings? a. Aspirate for gastric secretions with a syringe. b. Begin feeding slowly to prevent cramping. c. Get an X-ray of the tip of the tube within 24 hours. d. Clamp off the tube until the feedings begin.
a. Aspirate for gastric secretions with a syringe.
Ralph has a history of alcohol abuse and has acute pancreatitis. Which lab value is most likely to be elevated? a Calcium b Glucose c Magnesium d Potassium
b Glucose
Brenda, a 36 y.o. patient is on your floor with acute pancreatitis. Treatment for her includes: a Continuous peritoneal lavage. b Regular diet with increased fat. c Nutritional support with TPN. d Insertion of a T tube to drain the pancreas.
c Nutritional support with TPN
Britney, a 20 y.o. student is admitted with acute pancreatitis. Which laboratory findings do you expect to be abnormal for this patient? a Serum creatinine and BUN b Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) c Serum amylase and lipase d Cardiac enzymes
c Serum amylase and lipase
Eleanor, a 62 y.o. woman with diverticulosis is your patient. Which interventions would you expect to include in her care? a. Low-fiber diet and fluid restrictions. b. Total parenteral nutrition and bed rest. c. High-fiber diet and administration of psyllium. d. Administration of analgesics and antacids.
c. High-fiber diet and administration of psyllium
Leigh Ann is receiving pancrelipase (Viokase) for chronic pancreatitis. Which observation best indicates the treatment is effective? a There is no skin breakdown. b Her appetite improves. c She loses more than 10 lbs. d Stools are less fatty and decreased in frequency.
d Stools are less fatty and decreased in frequency.
Donald is a 61 y.o. man with diverticulitis. Diverticulitis is characterized by: a. Periodic rectal hemorrhage. b. Hypertension and tachycardia. c. Vomiting and elevated temperature. d. Crampy and lower left quadrant pain and low-grade fever.
d. Crampy and lower left quadrant pain and low-grade fever.
Katrina is diagnosed with lactose intolerance. To avoid complications with lack of calcium in the diet, which food should be included in the diet? a. Fruit b. Whole grains c. Milk and cheese products d. Dark green, leafy vegetables
d. Dark green, leafy vegetables
