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

the purpose of the procedure what to expect during the procedure how long the procedure will take preparation required prior to the surgery

The length of endoscopies varies and it is also the least important education tool for the patient.

Q.2)All are complications of endoscopic procedures EXCEPT? A. B. C. D. perforation aspiration hemorrhage paracentesis

Paracentesis is a diagnostic tool, not a complication.

Q.3)Which patient is most susceptible for acquiring secondary stomatitis? A. B. C. D. an AIDs patient suffering from pneumonia an 65 y/o obese female a 45 y/o male suffering from colon cancer a 50 y/o male with CHF

Secondary stomatitis results from infection by oppourtunistic viruses or bacteria. In this case, the patient with AIDs is, likely, the most immunosuppressed.
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:

Q.4) A. B. C. D. a canker sore of the oral soft tissues an acute stomach infection acid indigestion an early sign of peptic ulcer disease

Aphthous stomatitis refers to a canker sore of the oral soft tissues, including the lips, tongue, and inside of the cheeks. Q.5)Which item is unneccessary when examing the oral cavity of a patient with candidiasis? A. B. C. D. gloves penlight gown tongue blade

Q.6) A. B. C. D.

Which of the following is an inappropriate nursing diagnosis for a client with malignant tumors of the oral cavity? Impaired oral mucous membranes Deficient fluid volume Acute pain Risk for ineffective airway clearance

Q.7)client should they assess first? A.

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

The newly admitted client with acute abdominal pain

B. C. D.

The client who needs an abdominal dressing changed (POD 3) The client receiving continuous tube feedings who needs the tube-feeding residual checked The sleeping client who received pain medication 1 hour ago
The graduate nurse and her preceptor should assess the new admission with acute abdominal pain first because he just arrived on the floor and might be unstable. Next, they should change the abdominal dressing for the postoperative client or measure feeding tube residual in the client with continuous tube feedings.

Q.8)Gastroesophageal reflux disease is the abnormal _____ of the lower esophageal sphincter. A. B. C. D. relaxation constriction abscence reduction

Q.9)Which foods should a patient with GERD stay away from (multiple answers)? A. B. C. D. E. Burger King double cheeseburger lettuce candy canes chocolate espresso white bread

Q.10)To prevent gastroesophageal reflux in a client with hiatal

discharge instruction?

hernia, the nurse should provide which

A. B. C. D.

Lie down after meals to promote digestion Avoid coffee and alcoholic beverages Take antacids with meals Limit fluid intake with meals

To prevent reflux of stomach acid into the esophagus, the nurse should advise the client to avoid foods and beverages that increase stomach acid, such as coffee and alcohol.

Q.11)Which of the following is not a common symptom of GERD? A. B. C. D. dyspepsia regurgitation dysphagia hyposalivation

Hypersalivation, aka water brash, occurs in response to reflux, not hyposalivation.

Q.12)Which drug class isn't used to treat GERD? A. B. C. D. antacids histamine receptor antagonists beta blockers proton pump inhibitors

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

B. C. D.

NSAID use prescence of H. pylori hypertension

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

Q.14)expects this client's stools to be: A. B. C. D. coffee-ground-like clay-colored black and tarry bright red

Black, tarry stools are a sign of bleeding high in the GI tract, as from a gastric ulcer, and result from the action of digestive enzymes on the blood.

Q.15)Which diagnostic test would be used first to evaluate a client with upper GI bleeding? A. B. C. D. Endoscopy Upper GI series Hemoglobin (Hb) levels and hematocrit (HCT Arteriography
Hemoglobin and hematocrit are typically performed first in clients with upper GI bleeding to evaluate the extent of blood loss. Endoscopy is then performed to directly visualize the upper GI tract and locate the source of bleeding.

Q.16)Which of the following isn't a complication of peptic ulcer disease? A. B. C. D. perforation GI bleeding pyloric obstruction pain
Pain is a symptom of PUD, not a complication

Q.17)Which of the following are goals of drug therapy in the treatment of PUD (multiple answers)? A. B. C. D. provide pain relief prevent recurrence heal ulcerations eradicate H. pylori infection

Q.18)An elderly client with Alzheimer's disease begins supplemental tube feedings through a gastrostomy
tube to provide adequate calorie intake. The nurse should be concerned most with the potential for:

A. B. C. D.

hyperglycemia fluid volume excess aspiration constipation

Of the choices listed, aspiration is the most serious potential complication of tube feedings. Dehydration not fluid volume excess is a concern because of decreased free water intake. A client who underwent abdominal surgery who has a nasogastric (NG) tube in place begins to

Q.19)complain of abdominal pain that he describes as "feeling full and uncomfortable." Which assessment
should the nurse perform first?

A. B. C. D.

Measure abdominal girth Auscultate bowel sounds Assess patency of the NG tube Assess vital signs

When an NG tube is no longer patent, stomach contents collect in the stomach giving the client a sensation of fullness

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

Q.20)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. B. C. D.

Aspiration of gastric contents and testing for a pH less than 6 Instillation of 30 ml of water while listening with a stethoscope Cessation of reflex gagging 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. B. C. D.

hyperactive hypoactive high-pitched blowing

If a paralytic ileus occurs, bowel sounds will be hypoactive or absent. Hyperactive bowel sounds may signify hunger, intestinal obstruction, or diarrhea.

Q.22) A. B. C. D.

Which of the following would you NOT teach a patient recently diagnosed with irritable bowel syndrome? identifying food intolerances and needed dietary modifications decreasing fiber intake avoiding coffee and and limiting alcohol intake stress management

Q.23) A. B. C. D.

Which of the following are appropriate nursing diagnoses for patients with colorectal cancer (multiple answers)? Altered level of consciousness Disturbed body image Deficient fluid volume Acute/ chronic pain

Q.24)Which of the following is not a complication of colorectal cancer? A. B. C. D. metastases bleeding seizures infection

Q.25)Which foods should patients with colorectal cancer avoid (multiple answers)? A. B. fish and chips boiled carrots and broccoli

C. D. E.

beef and cabbage concentrated sweets whole-grain products

Patients should avoid red meat, animal fat, fatty foods, fried meats/ fish, and concentrated sweets.

Q.26)A client has undergone a colon resection. While turning him, wound dehiscence with evisceration
occurs. The nurse's first response is to:

A. B. C. D.

call the physician place saline-soaked sterile dressings on the wound take a blood pressure and pulse take a blood pressure and pulse

The nurse should first place saline-soaked sterile dressings on the open wound to prevent tissue drying and possible infection. Then the nurse should call the physician and take the client's vital signs

Q.27)neomycin sulfate (Mycifradin). The rationale for neomycin use in this client is to: A. B. C. D. control postoperative nausea and vomiting decrease the intestinal bacteria count increase the intestinal bacteria count prevent the development of megacolon

For a client who must undergo colon surgery, the physician orders preoperative cleansing enemas and

The antibiotic neomycin sulfate (Mycifradin) is prescribed to decrease the bacterial count and reduce the risk of fecal contamination during surgery.

Q.28)Which is the least likely to cause constipation? A. B. C. D. high fiber intake being over 75 overuse of laxatives immobilization
A 72-year-old client seeks help for chronic constipation. This is a common problem for elderly clients

Q.29)due to several factors related to aging. Which is one such factor? A. B. C. D. Increased intestinal motility Decreased abdominal strength Increased gastric aid production hyperactive bowel sounds

Decreased abdominal strength, muscle tone of the intestinal wall, and motility all contribute to chronic constipation in the elderly.

Q.30)Which medication should the nurse expect to administer to a client with constipation? A. B. C. D. lorazepam (Ativan) loperamide (Imodium) flurbiprofen (Ansaid) docusate sodium (Colace)
Docusate sodium, a laxative, is used to treat constipation. It softens the stool by stimulating the secretion of intestinal fluid into the stool.

Q.31)Which outcome indicates effective client teaching to prevent constipation? A. B. C. D. The client verbalizes consumption of low-fiber foods The client maintains a sedentary lifestyle The client limits water intake to three glasses per day The client reports engaging in a regular exercise regimen
A regular exercise regimen promotes peristalsis and contributes to regular bowel elimination patterns. A low-fiber diet, a sedentary lifestyle, and limited water intake would predispose the client to constipation.

Q.32) A. B. C. D.

In regards to appendicitis, the location of pain in the lower, right abdominal quadrant is called: Kernig's sign Mc Burney's point Brudzinski's point Schrute's point

When preparing a client, age 50, for surgery to treat

Q.33)diagnosis of Risk A. B. C. D.

appendicitis, the nurse formulates a nursing for infection related to inflammation, perforation, and surgery. What is the

rationale for choosing this nursing diagnosis?

The appendectomy surgery is very invasive and it puts the client at a risk for infection Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix. Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage The appendix may develop gangrene and rupture, especially in a middle-aged client
A client with appendicitis is at risk for infection related to inflammation, perforation, and surgery because obstruction of the appendix causes mucus fluid to build up

Q.34)Which of the following assessment findings suggests early appendicitis? A. B. C. D. nausea and vomiting periumbilical pain tense positioning abdominal rigdity
Periumbilical pain is the initial symptom, followed by nausea and vomiting.

Q.35)Which of the following is not an appropriate nursing diagnosis related to appendicitis? A. B. C. D. Disturbed body image Acute pain Risk for infection r/t rupture Deficient knowledge

Q.36)after surgery primarily to: A. B. C. D.

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

increase respiratory effectiveness. eliminate the need for nasogastric intubation. improve nutritional status during recovery. decrease the amount of postoperative analgesia needed.
The high abdominal incision used in a cholecystectomy interferes with respirations postoperatively, increasing the risk of atelectasis.

Q.37)Which task can the nurse delegate to a nursing assistant? A. B. C. D. Irrigating a nasogastric (NG) tube Assisting a client who had surgery three days ago walk down the hallway Helping a client who just returned from surgery to the bathroom Administering an antacid to a client complaining of heartburn
Because the client had surgery three days ago, the nurse can safely delegate the task of helping the client walk down the hallway.

Q.38)How are ulcerative colitis and Chron's disease definitively diagnosed? A. B. C. D. EGD CBC stool sample colonoscopy

Q.39)What is toxic megacolon (mulitple answers)? A. B. C. D. a complication of ulcerative colitis dilation and paralysis of the colon a fistula a risk factor for pancreatitis

Q.40)should the nurse expect to be part of the care plan? Check all that apply A. B. C. D. E. Lactulose therapy High-fiber diet High-protein milkshakes Corticosteroid therapy Antidiarrheal medications

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

Corticosteroids, such as prednisone, reduce the signs and symptoms of diarrhea, pain, and bleeding by decreasing inflammation. Antidiarrheals, such as diphenoxylate (Lomotil), combat diarrhea by decreasing peristalsis.

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 Q.41)over the client and explains that he must know the client's diagnosis for insurance purposes. Which response by the nurse is best?

A. B. C. D.

"Sure, I understand how demanding insurance companies can be." "I appreciate your concern, but I can't give out any information." "Why don't you come in, and we can further discuss this issue." "He has been diagnosed with Crohn's Disease."
The nurse may not release any confidential information to unauthorized individuals, such as the client's boss. Options 1, 3, and 4 breech client confidentiality.

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. B. C.

Lying on the right side with legs straight Lying on the left side with knees bent Prone with the torso elevated

D.

Bent over with hands touching the floor

For a colonoscopy, the nurse initially should position the client on the left side with knees bent to allow proper visualization of the large intestine.

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

Q.43)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. B. C. D.

The client asks his wife to leave the room The client closes the eyes when the abdomen is exposed The client avoids talking about the recent surgery The client touches the altered body part

By touching the altered body part, the client recognizes the body change and establishes that the change is real. Closing the eyes, not looking at the abdomen when the colostomy is exposed, or avoiding talking about the surgery reflects denial.