1. Nurse Berlinda is assigned to a 41-year-old client who has a diagnosis of chronic pancreatitis. The nurse reviews the laboratory result, anticipating a laboratory report that indicates a serum amylase level of:

a. 45 units/Lb. 100 units/Lc. 300 units/Ld. 500 units/L 

2. A male client who is recovering from surgery has been advanced from a clear liquid diet to a full liquid diet. The client is looking forward to the diet change because he has been “bored” with the clear liquid diet. The nurse would offer which full liquid item to the client?

a. Teab. Gelatinc. Custardd. Popsicle 

3. Nurse Juvy is caring for a client with cirrhosis of the liver. To minimize the effects of the disorder, the nurse teaches the client about foods that are high in thiamine. The nurse determines that the client has the best understanding of the dietary measures to follow if the client states an intension to increase the intake of:

a. Porkb. Milkc. Chickend. Broccoli 

4. Nurse Oliver checks for residual before administering a bolus tube feeding to a client with a nasogastric tube and obtains a residual amount of 150 mL. What is appropriate action for the nurse to take?

a. Hold the feedingb. Reinstill the amount and continue with administering the feedingc. Elevate the client’s head at least 45 degrees and administer the feedingd. Discard the residual amount and proceed with administering the feeding 

5. A nurse is inserting a nasogastrictube in an adult male client. During the procedure, the client begins to cough and has difficulty breathing. Which of the following is the appropriate nursing action?

a. Quickly insert the tubeb. Notify the physician immediatelyc. Remove the tube and reinsert when the respiratory distress subsidesd. Pull back on the tube and wait until the respiratory distress subsides 

6. Nurse Ryan is assessing for correct placement of a nosogartric tube. The nurse aspirates the stomach contents and check the contents for pH. The nurse verifies correct tube

placement if which pH value is noted?

a. 3.5b. 7.0c. 7.35d. 7.5 

7. A nurse is preparing to remove a nasogartric tube from a female client. The nurse should instruct the client to do which of the following just before the nurse removes the tube?

a. Exhaleb. Inhale and exhale quicklyc. Take and hold a deep breathd. Perform a Valsalva maneuver 

8. Nurse Joy is preparing to administer medication through a nasogastric tube that is connected to suction. To administer the medication, the nurse would:

a. Position the client supine to assist in medication absorptionb. Aspirate the nasogastric tube after medication administration to maintain patencyc. Clamp the nasogastric tube for 30 minutes following administration of the medicationd. Change the suction setting to low intermittent suction for 30 minutes after medication administration 

9. A nurse is preparing to care for a female client with esophageal varices who has just has a Sengstaken-Blakemore tube inserted. The nurse gathers supplies, knowing that which of the following items must be kept at the bedside at all times?

a. An obturatorb. Kelly clampc. An irrigation setd. A pair of scissors 

10. Dr. Smith has determined that the client with hepatitis has contracted the infection form contaminated food. The nurse understands that this client is most likely experiencing what type of hepatitis?

a. Hepatitis Ab. Hepatitis Bc. Hepatitis Cd. Hepatitis D 

11. A client is suspected of having hepatitis. Which diagnostic test result will assist in confirming this diagnosis?

a. Elevated hemoglobin levelb. Elevated serum bilirubin level

c. Elevated blood urea nitrogen leveld. Decreased erythrocycle sedimentation rate 

12. The nurse is reviewing the physician’s orders written for a male client admitted to the hospital with acute pancreatitis. Which physician order should the nurse question if noted on the client’s chart?

a. NPO statusb. Nasogastric tube insertedc. Morphine sulfate for paind. An anticholinergic medication 

13. A female client being seen in a physician’s office has just been scheduled for a barium swallow the next day. The nurse writes down which instruction for the client to follow before the test?

a. Fast for 8 hours before the testb. Eat a regular supper and breakfastc. Continue to take all oral medications as scheduledd. Monitor own bowel movement pattern for constipation 

14. The nurse is performing an abdominal assessment and inspects the skin of the abdomen. The nurse performs which assessment technique next?

a. Palpates the abdomen for sizeb. Palpates the liver at the right rib marginc. Listens to bowel sounds in all for quadrantsd. Percusses the right lower abdominal quadrant 

15. Polyethylene glycol-electrlyte solution (GoLYTELY) is prescribed for the female client scheduled for a colonoscopy. The client begins to experience diarrhea following administration of the solution. What action by the nurse is appropriate?

a. Start an IV infusionb. Administer an enemac. Cancel the diagnostic testd. Explain that diarrhea is expected 

16. The nurse is caring for a male client with a diagnosis of chronic gastritis. The nurse monitors the client knowing that this client is at risk for which vitamin deficiency?

a. Vitamin Ab. Vitamin B12c. Vitamin Cd. Vitamin E 

17. The nurse is reviewing the medication record of a female client with acute gastritis.

Which medication, if noted on the client’s record, would the nurse question?

a. Digoxin (Lanoxin)b. Furosemide (Lasix)c. Indomethacin (Indocin)d. Propranolol hydrochloride (Inderal) 

18. The nurse is assessing a male client 24 hours following a cholecystectomy. The nurse noted that the T tube has drained 750 mL of green-brown drainage since the surgery. Which nursing intervention is appropriate?

a. Clamp the T tubeb. Irrigate the T tubec. Notify the physiciand. Document the findings 

19. The nurse is monitoring a female client with a diagnosis of peptic ulcer. Which assessment findings would most likely indicate perforation of the ulcer?

a. Bradycardiab. Numbness in the legsc. Nausea and vomitingd. A rigid, board-like abdomen 

20. A male client with a peptic ulcer is scheduled for a vagotomy and the client asks the nurse about the purpose of this procedure. Which response by the nurse best describes the purpose of a vagotomy?

a. Halts stress reactionsb. Heals the gastric mucosac. Reduces the stimulus to acid secretionsd. Decreases food absorption in the stomach 

21. The nurse is caring for a female client following a Billroth II procedure. Which postoperative order should the nurse question and verify?

a. Leg exercisesb. Early ambulationc. Irrigating the nasogastric tubed. Coughing and deep-breathing exercises 

22. The nurse is providing discharge instructions to a male client following gastrectomy and instructs the client to take which measure to assist in preventing dumping syndrome?

a. Ambulate following a mealb. Eat high carbohydrate foodsc. Limit the fluid taken with meald. Sit in a high-Fowler’s position during meals 

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

a. Sweating and pallorb. Bradycardia and indigestionc. Double vision and chest paind. Abdominal cramping and pain 

24. The nurse is preparing a discharge teaching plan for the male client who had umbilical hernia repair. What should the nurse include in the plan?

a. Irrigating the drainb. Avoiding coughingc. Maintaining bed restd. Restricting pain medication 

25. The nurse is instructing the male client who has an inguinal hernia repair how to reduce postoperative swelling following the procedure. What should the nurse tell the client?

a. Limit oral fluidb. Elevate the scrotumc. Apply heat to the abdomend. Remain in a low-fiber diet 

26. The nurse is caring for a hospitalized female client with a diagnosis of ulcerative colitis. Which finding, if noted on assessment of the client, would the nurse report to the physician?

a. Hypotensionb. Bloody diarrheac. Rebound tendernessd. A hemoglobin level of 12 mg/dL 

27. The nurse is caring for a male client postoperatively following creation of a colostomy. Which nursing diagnosis should the nurse include in the plan of care?

a. Sexual dysfunctionb. Body image, disturbedc. Fear related to poor prognosisd. Nutrition: more than body requirements, imbalanced 

28. The nurse is reviewing the record of a female client with Crohn’s disease. Which stool characteristics should the nurse expect to note documented in the client’s record?

a. Diarrheab. Chronic constipation

c. Constipation alternating with diarrhead. Stools constantly oozing form the rectum 

29. The nurse is performing a colostomy irrigation on a male client. During the irrigation, the client begins to complain of abdominal cramps. What is the appropriate nursing action?

a. Notify the physicianb. Stop the irrigation temporarilyc. Increase the height of the irrigationd. Medicate for pain and resume the irrigation 

30. The nurse is teaching a female 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 intakeb. Place heat on the abdomenc. Perform the irrigation in the eveningd. Reduce the amount of irrigation solution

<< Back to Questions

1.    Answer C. The normal serum amylase level is 25 to 151 units/L. With chronic cases of pancreatitis, the rise in serum amylase levels usually does not exceed three times the normal value. In acute pancreatitis, the value may exceed five times the normal value. Options A and B are within normal limits. Option D is an extremely elevated level seen in acute pancreatitis. 

2.    Answer C. Full liquid food items include items such as plain ice cream, sherbet, breakfast drinks, milk, pudding and custard, soups that are strained, and strained vegetable juices. A clear liquid diet consists of foods that are relatively transparent. The food items in options A, B, and D are clear liquids. 

3.    Answer A. The client with cirrhosis needs to consume foods high in thiamine. Thiamine is present in a variety of foods of plant and animal origin. Pork products are especially rich in this vitamin. Other good food sources include nuts, whole grain cereals, and legumes. Milk contains vitamins A, D, and B2. Poultry contains niacin. Broccoli contains vitamins C, E, and K and folic acid 

4.    Answer A. Unless specifically indicated, residual amounts more than 100 mL require holding the feeding. Therefore options B, C, and D are incorrect. Additionally, the feeding is not discarded unless its contents are abnormal in color or characteristics. 

5.    Answer D. During the insertion of a nasogastric tube, if the client experiences difficulty breathing or any respiratory distress, withdraw the tube slightly, stop the tube advancement, and wait until the distress subsides. Options B and C are unnecessary. Quickly inserting the tube is not an appropriate action because, in this situation, it may be likely that the tube has entered the bronchus. 

6.    Answer A. If the nasogastric tube is in the stomach, the pH of the contents will be acidic. Gastric aspirates have acidic pH values and should be 3.5 or lower. Option B indicates a slightly acidic pH. Option C indicates a neutral pH. Option D indicates an alkaline pH. 

7.    Answer C. When the nurse removes a nasogastric tube, the client is instructed to take and hold a deep breath. This will close the epiglottis. This allows for easy withdrawal through the esophagus into the nose. The nurse removes the tube with one smooth, continuous pull. 

8.    Answer C. If a client has a nasogastric tube connected to suction, the nurse should wait up to 30 minutes before reconnecting the tube to the suction apparatus to allow adequate time for medication absorption. Aspirating the nasogastric tube will remove the medication just administered. Low intermittent suction also will remove the medication just administered. The client should not be placed in the supine position because of the risk for aspiration. 

9.    Answer C. When the client has a Sengstaken-Blakemore tube, a pair of scissors must be kept at the client’s bedside at all times. The client needs to be observed for sudden respiratory distress, which occurs if the gastric balloon ruptures and the entire tube moves upward. If this occurs, the nurse immediately cuts all balloon lumens and removes the tube. An obturator and a Kelly clamp are kept at the bedside of a client with a tracheostomy. An irrigation set may be kept at the bedside, but it is not the priority item. 

10.    Answer A. Hepatitis A is transmitted by the fecal-oral route via contaminated food or infected food handlers. Hepatitis B, C, and D are transmitted most commonly via infected blood or body fluids. 

11.    Answer B. Laboratory indicators of hepatitis include elevated liver enzyme levels, elevated serum bilirubin levels, elevated erythrocyte sedimentation rates, and leukopenia. An elevated blood urea nitrogen level may indicate renal dysfunction. A hemoglobin level is unrelated to this diagnosis. 

12.    Answer C.  Meperidine (Demerol) rather than morphine sulfate is the medication of choice to treat pain because morphine sulfate can cause spasms in the sphincter of Oddi. Options A, B, and D are appropriate interventions for the client with acute pancreatitis. 

13.    Answer A. A barium swallow is an x-ray study that uses a substance called barium for contrast to highlight abnormalities in the gastrointestinal tract. The client should fast for 8 to 12 hours before the test, depending on physician instructions. Most oral medications also are withheld before the test. After the procedure, the nurse must monitor for constipation, which can occur as a result of the presence of barium in the gastrointestinal tract. 

14.    Answer C. The appropriate sequence for abdominal examination is inspection, auscultation, percussion, and palpation. Auscultation is performed after inspection to ensure that the motility of the bowel and bowel sounds are not altered by percussion or palpation. Therefore, after inspecting the skin on the abdomen, the nurse should listen for bowel sounds. 

15.    Answer D. The solution GoLYTELY is a bowel evacuant used to prepare a client for a colonoscopy by cleansing the bowel. The solution is expected to cause a mild diarrhea and will clear the bowel in 4 to 5 hours. Options A, B, and C are inappropriate actions. 

16.    Answer B. Chronic gastritis causes deterioration and atrophy of the lining of the stomach, leading to the loss of the function of the parietal cells. The source of the intrinsic factor is lost, which results in the inability to absorb vitamin B12. This leads to the development of pernicious anemia. The client is not at risk for vitamin A, C, or E deficiency. 

17.    Answer C. Indomethacin (Indocin) is a nonsteroidal anti-inflammatory drug and can cause ulceration of the esophagus, stomach, or small intestine. Indomethacin is contraindicated in a client with gastrointestinal disorders. Furosemide (Lasix) is a loop diuretic. Digoxin is a cardiac medication. Propranolol (Inderal) is a β-adrenergic blocker. Furosemide, digoxin, and propranolol are not contraindicated in clients with gastric disorders. 

18.    Answer D. Following cholecystectomy, drainage from the T tube is initially bloody and then turns to a greenish-brown color. The drainage is measured as output. The amount of expected drainage will range from 500 to 1000 mL/day. The nurse would document the output. 

19.    Answer D. Perforation of an ulcer is a surgical emergency and is characterized by sudden, sharp, intolerable severe pain beginning in the midepigastric area and spreading over the abdomen, which becomes rigid and board-like. Nausea and vomiting may occur. Tachycardia may occur as hypovolemic shock develops. Numbness in the legs is not an associated finding. 

20.    Answer C. A vagotomy, or cutting of the vagus nerve, is done to eliminate parasympathetic stimulation of gastric secretion. Options A, B, and D are incorrect descriptions of a vagotomy. 

21.    Answer C. In a Billroth II procedure, the proximal remnant of the stomach is anastomosed to the proximal jejunum. Patency of the nasogastric tube is critical for preventing the retention of gastric secretions. The nurse should never irrigate or reposition the gastric tube after gastric surgery, unless specifically ordered by the physician. In this situation, the nurse should clarify the order. Options A, B, and D are appropriate postoperative interventions. 

22.    Answer C. Dumping syndrome is a term that refers to a constellation of vasomotor symptoms that occurs after eating, especially following a Billroth II procedure. Early manifestations usually occur within 30 minutes of eating and include vertigo, tachycardia, syncope, sweating, pallor, palpitations, and the desire to lie down. The nurse should instruct the client to decrease the amount of fluid taken at meals and to avoid high-carbohydrate foods, including fluids such as fruit nectars; to assume a low-Fowler’s position during meals; to lie down for 30 minutes after eating to delay gastric emptying; and to take antispasmodics as prescribed. 

23.    Answer A. Early manifestations of dumping syndrome occur 5 to 30 minutes after

eating. Symptoms include vertigo, tachycardia, syncope, sweating, pallor, palpitations, and the desire to lie down. 

24.    Answer B. Coughing is avoided following umbilical hernia repair to prevent disruption of tissue integrity, which can occur because of the location of this surgical procedure. Bed rest is not required following this surgical procedure. The client should take analgesics as needed and as prescribed to control pain. A drain is not used in this surgical procedure, although the client may be instructed in simple dressing changes. 

25.    Answer B. Following inguinal hernia repair, the client should be instructed to elevate the scrotum and apply ice packs while in bed to decrease pain and swelling. The nurse also should instruct the client to apply a scrotal support when out of bed. Heat will increase swelling. Limiting oral fluids and a low-fiber diet can cause constipation. 

26.    Answer C. Rebound tenderness may indicate peritonitis. Bloody diarrhea is expected to occur in ulcerative colitis. Because of the blood loss, the client may be hypotensive and the hemoglobin level may be lower than normal. Signs of peritonitis must be reported to the physician. 

27.    Answer B. Body image, disturbed relates to loss of bowel control, the presence of a stoma, the release of fecal material onto the abdomen, the passage of flatus, odor, and the need for an appliance (external pouch). No data in the question support options A and C. Nutrition: less than body requirements, imbalanced is the more likely nursing diagnosis. 

28.    Answer A. Crohn’s disease is characterized by nonbloody diarrhea of usually not more than four to five stools daily. Over time, the diarrhea episodes increase in frequency, duration, and severity. Options B, C, and D are not characteristics of Crohn’s disease. 

29.    Answer B. If cramping occurs during a colostomy irrigation, the irrigation flow is stopped temporarily and the client is allowed to rest. Cramping may occur from an infusion that is too rapid or is causing too much pressure. The physician does not need to be notified. Increasing the height of the irrigation will cause further discomfort. Medicating the client for pain is not the appropriate action in this situation. 

30.    Answer A. To enhance effectiveness of the irrigation and fecal returns, the client is instructed to increase fluid intake and to take other measures to prevent constipation. Options B, C and D will not enhance the effectiveness of this procedure.

Question Excerpt From Med Surg Nursing - GI disorders

Q.1) Which of the following is not an education tool required prior to an endoscopic procedure?

A.the purpose of the procedure

B.what to expect during the procedure

C

.how long the procedure will take

D

.preparation required prior to the surgery

Q.2) All are complications of endoscopic procedures EXCEPT?

A

.perforation

B.aspiration

C.hemorrhage

D.paracentesis

Q.3) Which patient is most susceptible for acquiring secondary stomatitis?

A.an AIDs patient suffering from pneumonia

B

.an 65 y/o obese female

C.a 45 y/o male suffering from colon cancer

D.a 50 y/o male with CHF

Q.4) When assessing a client during a routine checkup, the nurse reviews the history and notes that the

client had aphthous stomatitis at the time of the last visit. Aphthous stomatitis is best described as:

A.a canker sore of the oral soft tissues

B

.an acute stomach infection

C.acid indigestion

D.an early sign of peptic ulcer disease

Q.5) Which item is unneccessary when examing the oral cavity of a patient with candidiasis?

A.gloves

B

.penlight

C

.gown

D

.tongue blade

Q.6) Which of the following is an inappropriate nursing diagnosis for a client with malignant tumors of the oral cavity?

A.Impaired oral mucous membranes

B.Defieceint fluid volume

C.Acute pain

D.Risk for ineffective airway clearance

Q.7) The graduate nurse and her preceptor are establishing priorities for their morning assessments. Which

client should they assess first?

A.The newly admitted client with acute abdominal pain

B

.The client who needs an abdominal dressing changed (POD 3)

C.The client receiving continuous tube feedings who needs the tube-feeding residual checked

D

.The sleeping client who received pain medication 1 hour ago

Q.8) Gastroesophageal reflux disease is the abnormal _____ of the lower esophageal sphincter.

A.relaxation

B

.constriction

C.abscence

D.reduction

Q.9) Which foods should a patient with GERD stay away from (multiple answers)?

A.Burger King double cheeseburger

B.lettuce

C

.candy canes

D

.chocolate espresso

E.white bread

Q.10) To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which

discharge instruction?

A

.Lie down after meals to promote digestion

B

.Avoid coffee and alcoholic beverages

C.Take antacids with meals

D

.Limit fluid intake with meals

Q.11) Which of the following is not a common symptom of GERD?

A

.dyspepsia

B

.regurgitation

C

.dysphagia

D.hyposalivation

Q.12) Which drug class isn't used to treat GERD?

A.antacids

B.histamine receptor antagonists

C.beta blockers

D.proton pump inhibitors

Q.13) Which of the following has the least important role in terms of peptic ulcer formation?

A.acid

B

.NSAID use

C

.prescence of H. pylori

D

.hypertension

Q.14) A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurse

expects this client's stools to be:

A.coffee-ground-like

B.clay-colored

C

.black and tarry

D

.bright red

Q.15) Which diagnostic test would be used first to evaluate a client with upper GI

bleeding?

A

.Endoscopy

B.Upper GI series

C.Hemoglobin (Hb) levels and hematocrit (HCT

D

.Arteriography

Q.16) Which of the following isn't a complication of peptic ulcer disease?

A

.perforation

B

.GI bleeding

C

.pyloric obstruction

D.pain

Q.17) Which of the following are goals of drug therapy in the treatment of PUD (multiple answers)?

A

.provide pain relief

B.prevent recurrence

C.heal ulcerations

D

.eradicate H. pylori infection

Q.18) An elderly client with Alzheimer's disease begins supplemental tube feedings through

agastrostomy tube to provide adequate calorie intake. The nurse should be concerned most with

the potential for:

A

.hyperglycemia

B.fluid volume excess

C.aspiration

D

.constipation

Q.19) A client who underwent abdominal surgery who has a nasogastric (NG) tube in place begins to

complain of abdominal pain that he describes as "feeling full and uncomfortable." Which assessment

should the nurse perform first?

A.Measure abdominal girth

B

.Auscultate bowel sounds

C.Assess patency of the NG tube

D

.Assess vital signs

Q.20) To verify the placement of a gastric feeding tube, the nurse should perform at least two tests. One test

requires instilling air into the tube with a syringe and listening with a stethoscope for air passing into

the stomach. Which is another test method?

A

.Aspiration of gastric contents and testing for a pH less than 6

B

.Instillation of 30 ml of water while listening with a stethoscope

C

.Cessation of reflex gagging

D.Ensuring proper measurement of the tube before insertion

Q.21) The nurse is performing an assessment on a client who has developed a paralytic ileus. The

client's bowel sounds will be:

A

.hyperactive

B

.hypoactive

C

.high-pitched

D

.blowing

Q.22) Which of the following would you NOT teach a patient recently diagnosed with irritable bowel syndrome?

A.identifying food intolerances and needed dietary modifications

B.decreasing fiber intake

C

.avoiding coffee and and limiting alcohol intake

D

.stress management

Q.23) Which of the following are appropriate nursing diagnoses for patients with colorectal cancer (multiple answers)?

A.Altered level of consciousness

B.Disturbed body image

C.Deficient fluid volume

D.Acute/ chronic pain

Q.24) Which of the following is not a complication of colorectal cancer?

A

.metastases

B

.bleeding

C.seizures

D.infection

Q.25) Which foods should patients with colorectal cancer avoid (multiple answers)?

A.fish and chips

B.boiled carrots and broccoli

C

.beef and cabbage

D

.concentrated sweets

E.whole-grain products

Q.26) A client has undergone a colon resection. While turning him,

wound dehiscence withevisceration occurs. The nurse's first response is to:

A

.call the physician

B.place saline-soaked sterile dressings on the wound

C.take a blood pressure and pulse

D.take a blood pressure and pulse

Q.27) For a client who must undergo colon surgery, the physician orders preoperative cleansing enemas

and neomycin sulfate (Mycifradin). The rationale for neomycin use in this client is to:

A

.control postoperative nausea and vomiting

B

.decrease the intestinal bacteria count

C

.increase the intestinal bacteria count

D.prevent the development of megacolon

Q.28) Which is the least likely to cause constipation?

A.high fiber intake

B.being over 75

C.overuse of laxatives

D.immobilization

Q.29) A 72-year-old client seeks help for chronic constipation. This is a common problem for elderly clients

due to several factors related to aging. Which is one such factor?

 

A

.Increased intestinal motility

B.Decreased abdominal strength

C

.Increased gastric aid production

D

.hyperactive bowel sounds

Q.30) Which medication should the nurse expect to administer to a client with

constipation?

A.lorazepam (Ativan)

B.loperamide (Imodium)

C.flurbiprofen (Ansaid)

D.docusate sodium (Colace)

Q.31) Which outcome indicates effective client teaching to prevent

constipation?

A

.The client verbalizes consumption of low-fiber foods

B.The client maintains a sedentary lifestyle

C.The client limits water intake to three glasses per day

D.The client reports engaging in a regular exercise regimen

Q.32) In regards to appendicitis, the location of pain in the lower, right abdominal quadrant is called:

A.Kernig's sign

B

.Mc Burney's point

C

.Brudzinski's point

D

.Schrute's point

Q.33) When preparing a client, age 50, for surgery to treat appendicitis, the nurse formulates a nursing

diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale

for choosing this nursing diagnosis?

A.The appendectomy surgery is very invasive and it puts the client at a risk for infection

B

.

Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the

appendix.

C.Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage

D.The appendix may develop gangrene and rupture, especially in a middle-aged client

Q.34) Which of the following assessment findings suggests early appendicitis?

A

.nausea and vomiting

B.periumbilical pain

C

.tense positioning

D.abdominal rigdity

Q.35) Which of the following is not an appropriate nursing diagnosis related to appendicitis?

A.Disturbed body image

B.Acute pain

C

.Risk for infection r/t rupture

D.Deficient knowledge

Q.36) While preparing a client for cholecystectomy, the nurse explains that incentive spirometry will be used

after surgery primarily to:

A.increase respiratory effectiveness.

B.eliminate the need for nasogastric intubation.

C

.improve nutritional status during recovery.

D

.decrease the amount of postoperative analgesia needed.

Q.37) Which task can the nurse delegate to a nursing

assistant?

A.Irrigating a nasogastric (NG) tube

B.Assisting a client who had surgery three days ago walk down the hallway

C.Helping a client who just returned from surgery to the bathroom

D.Administering an antacid to a client complaining of heartburn

Q.38) How are ulcerative colitis and Chron's disease definitively diagnosed?

A.EGD

B

.CBC

C

.stool sample

D

.colonoscopy

Q.39) What is toxic megacolon (mulitple answers)?

A.a complication of ulcerative colitis

B.dilation and paralysis of the colon

C.a fistula

D

.a risk factor for pancreatitis

Q.40) A 28-year-old client is admitted with inflammatory bowel syndrome (Crohn's disease). Which therapies

should the nurse expect to be part of the care plan? Check all that apply 

A

.Lactulose therapy

B

.High-fiber diet

C.High-protein milkshakes

D

.Corticosteroid therapy

E.Antidiarrheal medications

Q.41) 

A client is diagnosed with Crohn's disease after undergoing two weeks of testing. The client's boss

calls the medical-surgical floor requesting to speak with the nurse manager. He expresses concern

over the client and explains that he must know the client's diagnosis for insurance purposes. Which

response by the nurse is best?

A

."Sure, I understand how demanding insurance companies can be."

B

."I appreciate your concern, but I can't give out any information."

C."Why don't you come in, and we can further discuss this issue."

D

.

"He has been diagnosed with Crohn's Disease."

Q.42) A client with a recent history of rectal bleeding is being prepared for a colonoscopy. How should the

nurse position the client for this test initially?

A.Lying on the right side with legs straight

B

.Lying on the left side with knees bent

C.Prone with the torso elevated

D.Bent over with hands touching the floor

Q.43) A client has a newly created colostomy. After participating in counseling with the nurse and receiving

support from the spouse, the client decides to change the colostomy pouch unaided. Which behavior

suggests that the client is beginning to accept the change in body image?

A.The client asks his wife to leave the room

B.The client closes the eyes when the abdomen is exposed

C.The client avoids talking about the recent surgery

D

.The client touches the altered body part