1.

Which of the following complications is thought to be the most common cause of

appendicitis?
1. A fecalith
2. Bowel kinking
3. Internal bowel occlusion
4. Abdominal bowel swelling
2. Which of the following terms best describes the pain associated with appendicitis?
1. Aching
2. Fleeting
3. Intermittent
4. Steady
3. Which of the following nursing interventions should be implemented to manage a
client with appendicitis?
1. Assessing for pain
2. Encouraging oral intake of clear fluids
3. Providing discharge teaching
4. Assessing for symptoms of peritonitis
4. Which of the following definitions best describes gastritis?
1. Erosion of the gastric mucosa
2. Inflammation of a diverticulum
3. Inflammation of the gastric mucosa
4. Reflux of stomach acid into the esophagus
5. Which of the following substances is most likely to cause gastritis?
1. Milk
2. Bicarbonate of soda, or baking soda
3. Enteric coated aspirin
4. Nonsteriodal anti-imflammatory drugs
6. Which of the following definitions best describes diverticulosis?

1. An inflamed outpouching of the intestine

2. A noninflamed outpouching of the intestine
3. The partial impairment of the forward flow of intestinal contents
4. An abnormal protrusion of an organ through the structure that usually holds it.
7. Which of the following types of diets is implicated in the development of
diverticulosis?
1. Low-fiber diet
2. High-fiber diet
3. High-protein diet
4. Low-carbohydrate diet
8. Which of the following mechanisms can facilitate the development of diverticulosis
into diverticulitis?
1. Treating constipation with chronic laxative use, leading to dependence on laxatives
2. Chronic constipation causing an obstruction, reducing forward flow of intestinal contents
3. Herniation of the intestinal mucosa, rupturing the wall of the intestine
4. Undigested food blocking the diverticulum, predisposing the area to bacterial invasion.
9. Which of the following symptoms indicated diverticulosis?
1. No symptoms exist
2. Change in bowel habits
3. Anorexia with low-grade fever
4. Episodic, dull, or steady midabdominal pain
10. Which of the following tests should be administered to a client suspected of having
diverticulosis?
1. Abdominal ultrasound
2. Barium enema
3. Barium swallow
4. Gastroscopy
1. A patient with chronic alcohol abuse is admitted with liver failure. You closely
monitor the patients blood pressure because of which change that is associated with the
liver failure?

1. Hypoalbuminemia
2. Increased capillary permeability
3. Abnormal peripheral vasodilation
4. Excess rennin release from the kidneys
2. Youre assessing the stoma of a patient with a healthy, well-healed colostomy. You
expect the stoma to appear:
1. Pale, pink and moist
2. Red and moist
3. Dark or purple colored
4. Dry and black
3. Youre caring for a patient with a sigmoid colostomy. The stool from this colostomy is:
1. Formed
2. Semisolid
3. Semiliquid
4. Watery
4. Youre advising a 21 y.o. with a colostomy who reports problems with flatus. What
food should you recommend?
1. Peas
2. Cabbage
3. Broccoli
4. Yogurt
5. You have to teach ostomy self care to a patient with a colostomy. You tell the patient
to measure and cut the wafer:
1. To the exact size of the stoma.
2. About 1/16 larger than the stoma.
3. About 1/8 larger than the stoma.
4. About 1/4 larger than the stoma.
40. Your teaching Anthony how to use his new colostomy. How much skin should remain
exposed between the stoma and the ring of the appliance?

1. 1/16
2. 1/4
3. 1/2
4. 1
41. Claire, a 33 y.o. is on your floor with a possible bowel obstruction. Which
intervention is priority for her?
1. Obtain daily weights.
2. Measure abdominal girth.
3. Keep strict intake and output.
4. Encourage her to increase fluids.
42. Your patient has a GI tract that is functioning, but has the inability to swallow foods.
Which is the preferred method of feeding for your patient?
1. TPN
2. PPN
3. NG feeding
4. Oral liquid supplements
43. Youre patient is complaining of abdominal pain during assessment. What is your
priority?
1. Auscultate to determine changes in bowel sounds.
2. Observe the contour of the abdomen.
3. Palpate the abdomen for a mass.
4. Percuss the abdomen to determine if fluid is present.
44. Before bowel surgery, Lee is to administer enemas until clear. During
administration, he complains of intestinal cramps. What do you do next?
1. Discontinue the procedure.
2. Lower the height of the enema container.
3. Complete the procedure as quickly as possible.
4. Continue administration of the enema as ordered without making any adjustments.
45. Leigh Ann is receiving pancrelipase (Viokase) for chronic pancreatitis. Which
observation best indicates the treatment is effective?

1. There is no skin breakdown.

2. Her appetite improves.
3. She loses more than 10 lbs.
4. Stools are less fatty and decreased in frequency.
46. Ralph has a history of alcohol abuse and has acute pancreatitis. Which lab value is
most likely to be elevated?
1. Calcium
2. Glucose
3. Magnesium
4. Potassium
47. 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:
1. Giving pain medication Q6H.
2. Flushing the NG tube with sterile water.
3. Positioning her in high Fowlers position.
4. Keeping her NPO until the return of peristalsis.
48. Sitty, a 66 y.o. 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 surgery. Which finding do you report to the doctor?
1. Blanched stoma
2. Edematous stoma
3. Reddish-pink stoma
4. Brownish-black stoma
49. 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?
1. Restrict fluids
2. Encourage ambulation
3. Increase sodium in the diet
4. Give antacids as prescribed

50. Katrina is diagnosed with lactose intolerance. To avoid complications with lack of
calcium in the diet, which food should be included in the diet?
1. Fruit
2. Whole grains
3. Milk and cheese products
4. Dark green, leafy vegetables
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/L
B. 100 units/L
C. 300 units/L
D. 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. Tea
B. Gelatin
C. Custard
D. 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 intention to increase the intake of:
A. Pork
B. Milk
C. Chicken
D. 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 feeding

B. Reinstill the amount and continue with administering the feeding
C. Elevate the clients head at least 45 degrees and administer the feeding
D. Discard the residual amount and proceed with administering the feeding
5. A nurse is inserting a nasogastric tube 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 tube
B. Notify the physician immediately
C. Remove the tube and reinsert when the respiratory distress subsides
D. Pull back on the tube and wait until the respiratory distress subsides
6. Nurse Ryan is assessing for correct placement of a nasogastric 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. 3.5
B. 7.0
C. 7.35
D. 7.5
7. A nurse is preparing to remove a nasogastric 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. Exhale
B. Inhale and exhale quickly
C. Take and hold a deep breath
D. 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 absorption
B. Aspirate the nasogastric tube after medication administration to maintain patency
C. Clamp the nasogastric tube for 30 minutes following administration of the medication
D. 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 obturator
B. Kelly clamp
C. An irrigation set
D. A pair of scissors
10. Dr. Smith has determined that the client with hepatitis has contracted the
infection from contaminated food. The nurse understands that this client is most likely
experiencing what type of hepatitis?
A. Hepatitis A
B. Hepatitis B
C. Hepatitis C
D. Hepatitis D
11. A client is suspected of having hepatitis. Which diagnostic test result will assist in
confirming this diagnosis?
A. Elevated hemoglobin level
B. Elevated serum bilirubin level
C. Elevated blood urea nitrogen level
D. Decreased erythrocyte sedimentation rate
12. The nurse is reviewing the physicians orders written for a male client admitted to
the hospital with acute pancreatitis. Which physician order should the nurse question if
noted on the clients chart?
A. NPO status
B. Nasogastric tube inserted
C. Morphine sulfate for pain
D. An anticholinergic medication
13. A female client being seen in a physicians 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 test

B. Eat a regular supper and breakfast
C. Continue to take all oral medications as scheduled
D. 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 size
B. Palpates the liver at the right rib margin
C. Listens to bowel sounds in all for quadrants
D. Percusses the right lower abdominal quadrant
15. Polyethylene glycol-electrolyte 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 infusion
B. Administer an enema
C. Cancel the diagnostic test
D. 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 A
B. Vitamin B12
C. Vitamin C
D. Vitamin E
17. The nurse is reviewing the medication record of a female client with acute gastritis.
Which medication, if noted on the clients 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 tube
B. Irrigate the T tube
C. Notify the physician
D. 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. Bradycardia
B. Numbness in the legs
C. Nausea and vomiting
D. 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 reactions
B. Heals the gastric mucosa
C. Reduces the stimulus to acid secretions
D. Decreases food absorption in the stomach