---> Nursing Sample Exam about Gastrointestinal Disorders (21-25)

16. Nursing assessment of a client with peritonitis (acute or chronic inflammation of the peritoneum) reveals hypotension, tachycardia, and signs and symptoms of dehydration. The nurse also expects to find:

a. tenderness and pain in the right upper abdominal quadrant.

b. jaundice and vomiting.

c. severe abdominal pain with direct palpation or rebound tenderness.

d. rectal bleeding and a change in bowel habits.

17. When caring for a client with hepatitis B, the nurse should monitor closely for the development of which finding associated with a decrease in hepatic function?

a. Jaundice

b. Pruritus of the arms and legs

c. Fatigue during ambulation

d. Irritability and drowsiness

18. 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 closes the eyes when the abdomen is exposed.

b. The client avoids talking about the recent surgery.

c. The client asks the spouse to leave the room.

d. The client touches the altered body part.

19. A client with viral hepatitis A is being treated in an acute care facility. Because the client requires enteric precautions, the nurse should:

a. place the client in a private room.

b. wear a mask when handling the client's bedpan.

c. wash the hands after touching the client.

d. wear a gown when providing personal care for the client

20. 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.

Answers and Rationale

---> Nursing Sample Exam about Gastrointestinal Disorders (11-15)

---> Nursing Sample Exam about Gastrointestinal Disorders (16-20)

11. A client with dysphagia is being prepared for discharge. Which outcome indicates that the client is ready for discharge?

a. The client doesn't exhibit rectal tenesmus.

b. The client is free from esophagitis and achalasia.

c. The client reports diminished duodenal inflammation.

d. The client has normal gastric structures.

12. A client had a nephrectomy 2 days ago and is now complaining of abdominal pressure and nausea. The first nursing action should be to

a. auscultate bowel sounds.

b. palpate the abdomen.

c. change the client's position.

d. insert a rectal tube.

13. A client is evaluated for severe pain in the right upper abdominal quadrant, which is accompanied by nausea and vomiting. The physician diagnoses acute cholecystitis and cholelithiasis. For this client, which nursing diagnosis takes top priority?

a. Pain related to biliary spasms

b. Deficient knowledge related to prevention of disease recurrence

c. Anxiety related to unknown outcome of hospitalization

d. Imbalanced nutrition: Less than body requirements related to biliary inflammation

14. 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. hyperglycemia.

b. fluid volume excess.

c. aspiration.

d. constipation.

15. 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."

Answers and Rationale

---> Nursing Sample Exam about Gastrointestinal Disorders (6-10)

---> Gastrointestinal Nursing (11-15)

6. 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 of the following is one such factor?

a. Increased intestinal motility

b. Decreased abdominal strength

c. Increased intestinal bacteria

d. Decreased production of hydrochloric acid

7. The nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which finding suggests that the client has developed hyperglycemia?

a. Kussmaul's respirations

b. Increased urine output

c. Decreased appetite

d. Diaphoresis

8. A client with inflammatory bowel disease undergoes an ileostomy. On the first day after surgery, the nurse notes that the client's stoma appears dusky. How should the nurse interpret this finding?

a. Blood supply to the stoma has been interrupted.

b. This is a normal finding 1 day after surgery.

c. The ostomy bag should be adjusted.

d. An intestinal obstruction has occurred.

9. A client with recent onset of epigastric discomfort is scheduled for an upper GI series (barium swallow). When teaching the client how to prepare for the test, which instruction should the nurse provide?

a. "Eat a low-residue diet for 2 days before the test."

b. "Eat a clear liquid diet for 2 days before the test."

c. "Take a potent laxative the day before the test."

d. "Avoid eating or drinking anything for 6 to 8 hours before the test."

10. A client with mild diarrhea, fever, and abdominal discomfort is being evaluated for inflammatory bowel disease (IBD). Which statement about IBD is true?

a. Diarrhea is the most common sign of IBD.

b. Transmural inflammation with fistula formation occurs in ulcerative colitis, one form of IBD.

c. Abscesses may occur in IBD as poor nutrition causes breakdown of cells in the GI tract.

d. Bowel cancer is common in clients with a history of Crohn's disease, one form of IBD.

Answers and Rationale

---> Gastrointestinal Nursing (1-5)

---> Gastrointestinal Nursing (6-10)

1. What laboratory finding is the primary diagnostic indicator for pancreatitis?

a. Elevated blood urea nitrogen (BUN)

b. Elevated serum lipase

c. Elevated aspartate aminotransferase (AST)

d. Increased lactate dehydrogenase (LD)

2. When evaluating a client for complications of acute pancreatitis, the nurse would observe for:

a. increased intracranial pressure.

b. decreased urine output.

c. bradycardia.

d. hypertension.

3. 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 stomatitisis 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.

4. The nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to:

a. restrict fluid intake to 1 qt (1,000 ml)/day.

b. drink liquids only with meals.

c. don't drink liquids 2 hours before meals.

d. drink liquids only between meals.

5. Why are antacids administered regularly, rather than as needed, to treat peptic ulcer disease?

a. To keep gastric pH at 3.0 to 3.5

b. To promote client compliance

c. To maintain a regular bowel pattern

d. To increase pepsin activity

Answers and Rationale

---> Gastrointestinal Nursing (6-10)

---> Oncology Nurse Test Questions (11-15)

6. After being in remission from Hodgkin's disease for 18 months, a client develops a fever of unknown origin. The physician orders a blind liver biopsy to rule out advancing Hodgkin's disease and infection. Twenty-four hours after the biopsy, the client has a fever, complains of severe abdominal pain, and seems increasingly confused. The nurse suspects that these findings result from:

a. bleeding in the liver caused by the liver biopsy.
b. perforation of the colon caused by the liver biopsy.
c. an allergic reaction to the contrast media used during the liver biopsy.
d. normal postprocedural pain, with a change in the level of consciousness resulting from the preexisting fever.

7. A client with stage II ovarian cancer undergoes a total abdominal hysterectomy and bilateral salpingo-oophorectomy with tumor resection, omentectomy, appendectomy, and lymphadenectomy. During the second postoperative day, which of the following assessment findings would raise concern in the nurse?

a. Abdominal pain
b. Hypoactive bowel sounds
c. Serous drainage from the incision
d. Shallow breathing and increasing lethargy

8. A client undergoes a laryngectomy to treat laryngeal cancer. When teaching the client how to care for the neck stoma, the nurse should include which instruction?

a. "Keep the stoma uncovered."
b. "Keep the stoma dry."
c. "Have a family member perform stoma care initially until you get used to the procedure."
d. "Keep the stoma moist."

9. A client who reports increasing difficulty swallowing, weight loss, and fatigue is diagnosed with esophageal cancer. Because this client has difficulty swallowing, the nurse should assign highest priority to:

a. helping the client cope with body image changes.
b. ensuring adequate nutrition.
c. maintaining a patent airway.
d. preventing injury.

10. The nurse is teaching a group of women to perform breast self-examination. The nurse should explain that the purpose of performing the examination is to discover:

a. cancerous lumps.
b. areas of thickness or fullness.
c. changes from previous self-examinations.
d. fibrocystic masses.

---> Answers and Rationale

---> Oncology Nurse Test Questions (1-5)

---> Oncology Nurse Test Questions (6-10)

1. A client has an abnormal result on a Papanicolaou test. After admitting that she read her chart while the nurse was out of the room, the client asks what dysplasia means. Which definition should the nurse provide?

a. Presence of completely undifferentiated tumor cells that don't resemble cells of the tissues of their origin

b. Increase in the number of normal cells in a normal arrangement in a tissue or an organ

c. Replacement of one type of fully differentiated cell by another in tissues where the second type normally isn't found

d. Alteration in the size, shape, and organization of differentiated cells

2. During chemotherapy, an oncology client has a nursing diagnosis of Impaired oral mucous membrane related to decreased nutrition and immunosuppression secondary to the cytotoxic effects of chemotherapy. Which nursing intervention is most likely to decrease the pain of stomatitis?

a. Recommending that the client discontinue chemotherapy

b. Providing a solution of hydrogen peroxide and water for use as a mouth rinse

c. Monitoring the client's platelet and leukocyte counts

d. Checking regularly for signs and symptoms of stomatitis

3. To treat cervical cancer, a client has had an applicator of radioactive material placed in the vagina. Which observation by the nurse indicates a radiation hazard?

a. The client is maintained on strict bed rest.

b. The head of the bed is at a 30-degree angle.

c. The client receives a complete bed bath each morning.

d. The nurse checks the applicator's position every 4 hours.

4. A client suspected of having colorectal cancer will require which diagnostic study to confirm the diagnosis?

a. Stool Hematest

b. Carcinoembryonic antigen (CEA)

c. Sigmoidoscopy

d. Abdominal computed tomography (CT) scan

5. The nurse is teaching a male client to perform monthly testicular self-examinations. Which of the following points would be appropriate to make?

a. Testicular cancer is a highly curable type of cancer.

b. Testicular cancer is very difficult to diagnose.

c. Testicular cancer is the number one cause of cancer deaths in males.

d. Testicular cancer is more common in older men.

Answers and Rationale

---> Oncology Nurse Test Questions (6-10)

---> Cardiovascular Nursing Questions (21-25)

16. In a client with chronic bronchitis, which sign would lead the nurse to suspect right-sided heart failure?

a. Cyanosis of the lips

b. Bilateral crackles

c. Productive cough

d. Leg edema

17. A client comes to the physician's office for a follow-up visit 4 weeks after suffering a myocardial infarction (MI). The nurse takes this opportunity to evaluate the client's knowledge of the prescribed cardiac rehabilitation program. Which evaluation statement suggests that the client needs more instruction?

a. "Client performs relaxation exercises three times a day to reduce stress."

b. "Client's 24-hour dietary recall reveals low intake of fat and cholesterol."

c. "Client verbalizes an understanding of the need to seek emergency help if the heart rate increases markedly while at rest."

d. "Client walks 4 miles in 1 hour every day."

18. A client is taking spironolactone (Aldactone) to control her hypertension. Her serum potassium level is 6 mEq/L. For this client, the nurse's priority would be to assess her:

a. neuromuscular function.

b. bowel sounds.

c. respiratory rate.

d. electrocardiogram (ECG) results.

19. The most important reason for the nurse to encourage a client with peripheral vascular disease to initiate a walking program is because this form of exercise:

a. reduces stress.

b. aids in weight reduction.

c. increases high-density lipoprotein (HDL) level.

d. promotes collateral circulation.

20. A client with severe angina and electrocardiogram changes is seen by a nurse practitioner in the emergency department. In terms of serum testing, it's most important for the nurse to order cardiac:

a. creatine kinase.

b. lactate dehydrogenase.

c. myoglobin.

d. troponin.

Answers and Rationale

---> Cardiovascular Nursing Questions (11-15)

---> Cardiovascular Nursing Questions (16-20)

11. The nurse is assessing a client with heart failure. The breath sounds commonly auscultated in clients with heart failure are:

a. tracheal.

b. fine crackles.

c. coarse crackles.

d. friction rubs.

12. A client is admitted for treatment of Prinzmetal's angina. When developing the plan of care, the nurse keeps in mind that this type of angina is triggered by:

a. activities that increase myocardial oxygen demand.

b. an unpredictable amount of activity.

c. coronary artery spasm.

d. the same type of activity that caused previous angina episodes.

13. An elderly client who underwent total hip replacement exhibits a red, painful area on the calf of the affected leg. What test validates presence of thromboembolism?

a. Romberg's

b. Phalen's

c. Rinne

d. Homans'

14. When assessing a client who reports recent chest pain, the nurse obtains a thorough history. Which statement by the client most strongly suggests angina pectoris?

a. "The pain lasted about 45 minutes."

b. "The pain resolved after I ate a sandwich."

c. "The pain got worse when I took a deep breath."

d. "The pain occurred while I was mowing the lawn."

15. The nurse is caring for a client with acute pulmonary edema. To immediately promote oxygenation and relieve dyspnea, the nurse should:

a. administer oxygen.

b. have the client take deep breaths and cough.

c. place the client in high Fowler's position.

d. perform chest physiotherapy.

Answers and Rationale

---> Cardiovascular Nursing Questions (6-10)

---> Cardiovascular Nursing 11-15

6. Following a myocardial infarction, a client develops an arrhythmia and requires a continuous infusion of lidocaine. To monitor the effectiveness of the intervention, the nurse should focus primarily on the client's:

a. electrocardiogram (ECG).

b. urine output.

c. creatine kinase (CK) and troponin levels.

d. blood pressure and heart rate.

7. A client is recovering from coronary artery bypass graft (CABG) surgery. The nurse knows that for several weeks after this procedure, the client is at risk for certain conditions. During discharge preparation, the nurse should advise the client and family to expect which common, spontaneously resolving symptom?

a. Depression

b. Ankle edema

c. Memory lapses

d. Dizziness

8. The nurse is caring for a client with left-sided heart failure. To reduce fluid volume excess, the nurse can anticipate using:

a. antiembolism stockings.

b. oxygen.

c. diuretics.

d. anticoagulants.

9. An increase in the creatine kinase-MB isoenzyme (CK-MB) can be caused by:

a. cerebral bleeding.

b. I.M. injection.

c. myocardial necrosis.

d. skeletal muscle damage due to a recent fall.

10. A client comes to the emergency department complaining of visual changes and a severe headache. The nurse measures the client's blood pressure at 210/120 mm Hg. However, the client denies having hypertension or any other disorder. After diagnosing malignant hypertension, a life-threatening disorder, the physician initiates emergency intervention. What is the most common cause of malignant hypertension?

a. Pyelonephritis

b. Dissecting aortic aneurysm

c. Pheochromocytoma

d. Untreated hypertension

Answers and Rationale

---> Cardiovascular Nursing 1-5

---> Cardiovascular Nursing (6-10)

1. A client with a forceful, pounding heartbeat is diagnosed with mitral valve prolapse. This client should avoid which of the following?

a. High volumes of fluid intake

b. Aerobic exercise programs

c. Caffeine-containing products

d. Foods rich in protein

2. A client is admitted to the coronary care unit with second-degree atrioventricular heart block. The nurse closely monitors the heart rate and rhythm. When interpreting the client's electrocardiogram (ECG) strip, the nurse knows that the QRS complex represents:

a. atrial repolarization.

b. ventricular repolarization.

c. atrial depolarization.

d. ventricular depolarization.

3. Cardiovascular nursing question about nurse who is preparing a client with Crohn's disease for a barium enema. What should the nurse do the day before the test?

a. Serve the client his usual diet.

b. Order a high-fiber diet.

c. Encourage plenty of fluids.

d. Serve dairy products.

4. The nurse is caring for a client with cholelithiasis. Which sign indicates obstructive jaundice?

a. Straw-colored urine

b. Reduced hematocrit

c. Clay-colored stools

d. Elevated urobilinogen in the urine

5. The physician prescribes pentoxifylline (Trental), 400 mg three times daily with meals, for a client with intermittent claudication and a history of adult-onset diabetes mellitus. The nurse knows that pentoxifylline is a:

a. hemostatic agent.

b. tissue plasminogen activator.

c. thrombolytic agent.

d. blood viscosity–reducing agent.

Answers and Rationale

 ---> Cardiovascular Nursing (6-10)

---> Fundamentals of Nursing Study Guide (21-25)

16. Which member of the health care team is responsible for obtaining informed consent from a client?

a. The primary nurse

b. The physician

c. The nurse working with the physician

d. The physician's assistant

17. The nurse prepares to perform light palpation. How is light palpation performed?

a. By indenting the skin ½" to ¾" (1.3 to 1.9 cm)

b. By indenting the skin 1" to 2" (2.5 to 5 cm)

c. By indenting the skin 1", using both hands

d. By indenting the skin 1" and then releasing the pressure quickly

18. The nurse is caring for a client on a regimen of four medications to treat tuberculosis. The nurse discovers that the client isn't taking all of his medications. What is appropriate for the nurse to say to the client?

a. "Don't you realize that resistance can develop if you don't take your medications properly?"

b. "You need to take your medication as you were instructed. Do you need supervision?"

c. "Why aren't you taking your medications? Don't you want to get better?"

d. "Taking many medications can be difficult. Tell me about the difficulties you're having."

19. The nurse is caring for a client with a history of falls. The first priority when caring for a client at risk for falls is:

a. placing the call light for easy access.

b. keeping the bed in the lowest possible position.

c. instructing the client not to get out of bed without assistance.

d. keeping the bedpan available so that the client doesn't have to get out of bed.

20. A client who speaks little English has emergency gallbladder surgery. During discharge preparation, which nursing action would best help this client understand wound care instructions?

a. Asking frequently whether the client understands the instructions

b. Asking an interpreter to relay the instructions to the client

c. Writing out the instructions and having a family member read them to the client

d. Demonstrating the procedure and having the client return the demonstration

Answers and Rationale

---> Fundamentals of Nursing Study Guide (11-15)

---> Fundamentals of Nursing Study Guide (16-20)

11. Which of the following types of solutions, when administered I.V., would cause a shift of fluid from body tissues to the bloodstream?

a. Hypotonic

b. Isotonic

c. Sodium chloride

d. Hypertonic

12. When developing a plan of care for an older adult, the nurse should consider which challenges faced by clients in this age-group?

a. Selecting vocation, becoming financially independent, and managing a home

b. Developing leisure activities, preparing for retirement, and resolving empty-nest crisis

c. Managing a home, developing leisure activities, and preparing for retirement

d. Adjusting to retirement, deaths of family members, and decreased physical strength

13. The nurse is delivering the client's 10 a.m. medications. The client is away from his room for a diagnostic study. Which action is most appropriate for the nurse to take?

a. Leave the medications on the client's bedside table.

b. Ask the client's roommate to keep the medications for the client until he returns.

c. Lock the medications in the medicine preparation area until the client returns.

d. Have the client skip that dose of medication.

14. A client who received general anesthesia returns from surgery. Postoperatively, which nursing diagnosis takes highest priority for this client?

a. Pain related to surgery

b. Deficient fluid volume related to blood and fluid loss from surgery

c. Impaired physical mobility related to surgery

d. Risk for aspiration related to anesthesia

15. When assessing a client with cellulitis of the right leg, which of the following would the nurse expect to find?

a. Painful skin that is swollen and pale in color

b. Cold, red skin

c. Small, localized blackened area of skin

d. Red, swollen skin with inflammation spreading to surrounding tissues

Answers and Rationale

---> Fundamentals of Nursing Study Guide (6-10)

---> Fundamentals of Nursing Study Guide (11-15)

6. During an admission assessment, the nurse asks a client why he's being admitted to the facility. The client responds, "The physician found a lump in my prostate gland. I guess I have cancer." Which response by the nurse would be most therapeutic?

a. "There is no way to know whether you have cancer until a biopsy is done."

b. "It isn't unusual for a man your age to have an enlarged prostate. Try not to worry."

c. "It's important to keep a positive attitude. There is a good chance it isn't cancer."

d. "You think you have cancer?"

7. Which action would be contraindicated for a client who develops a temperature of 102° F (38.9° C).

a. Monitoring temperature every 4 hours

b. Increasing fluid intake

c. Covering the client with a light blanket

d. Providing a low-calorie diet

8. A client hospitalized with pneumonia has thick, tenacious secretions. To help liquefy these secretions, the nurse should:

a. turn the client every 2 hours.

b. elevate the head of the bed 30 degrees.

c. encourage increased fluid intake.

d. maintain a cool room temperature.

9. The nurse is giving nutritional counseling to the mother of a child with celiac disease. Which statement by the mother would indicate understanding?

a. "My son can't eat wheat, rye, oats, or barley."

b. "My son needs a diet rich in gluten."

c. "My son must avoid potatoes, rice, flour, and cornstarch."

d. "My son can safely eat frozen and packaged foods."

10. After intentionally taking an overdose of hydrocodone (Vicodin), a client is admitted to the emergency department. Activated charcoal is prescribed. Before administering the drug, the nurse should ensure that the client:

a. is able to follow commands.

b. has a nasogastric (NG) tube in place.

c. has an advance directive on file.

d. has audible bowel sounds.

Answers and Rationale

---> Fundamentals of Nursing Study Guide (11-15)

---> Fundamentals of Nursing Study Guide (6-10)

1. A home care nurse is assessing a geriatric client. What is the most common cause of medication errors in noninstitutionalized geriatric clients?

a. Knowledge deficit

b. Poor vision

c. Dementia

d. Confusion

2. Which drug delivery system relieves the nurse of the responsibility for transcribing the medication order?

a. Floor stock

b. Unit-dose

c. Individual prescription

d. Automated

3. Before administering the evening dose of a prescribed medication, the nurse on the evening shift finds an unlabeled, filled syringe in the client's medication drawer. What should the nurse do?

a. Discard the syringe to avoid a medication error.

b. Obtain a label for the syringe from the pharmacy

c. Use the syringe because it looks like it contains the same medication the nurse was prepared to give.

d. Call the day nurse to verify the contents of the syringe

4. The nurse is assisting with a subclavian vein central line insertion when the client's oxygen saturation rapidly drops. He complains of shortness of breath and becomes tachypneic. The nurse suspects a pneumothorax has developed. Further assessment findings supporting the presence of a pneumothorax include:

a. diminished or absent breath sounds on the affected side

b. paradoxical chest wall movement with respirations

c. tracheal deviation to the unaffected side.

d. muffled or distant heart sounds.

5. When monitoring a client's central venous pressure (CVP), the nurse knows that a normal CVP measurement is:

a. 2 cm water.

b. 1 mm Hg.

c. 10 mm Hg.

d. 5 cm water.

Fundamentals of Nursing Study Guide Answers and Rationale --->