Exam 9/19

Question 1

The trajectory of chronic illness includes (select all that apply)

a. periods of crisis.

b. episodes of exacerbations and stability.

c. a gradual return to an acceptable way of life.

d. a straight trajectory without overlapping phases.

e. symptoms that can be controlled by proper treatment.

Answer 1

a. periods of crisis.

b. episodes of exacerbations and stability.

c. a gradual return to an acceptable way of life.

e. symptoms that can be controlled by proper treatment.

Question 2

A patient is ordered cardiac rehabilitation following cardiac bypass surgery. The nurse recognizes this as

a. primary prevention for atelectasis.

b. secondary prevention for atherosclerosis.

c. tertiary prevention to reduce the progression of heart disease.

d. a recommended treatment to prevent deep vein thrombosis.

Answer 2

c. tertiary prevention to reduce the progression of heart disease.

Question 3

Demographic trends among older Americans in the United States suggests

a. there are fewer people living past age 85.

b. more frailty in persons between 65 and 75 years.

c. a growth in racial and ethnically diverse populations.

d. women having a decreased life expectancy when compared to men.

Answer 3

c. a growth in racial and ethnically diverse populations.

Question 4

A nurse is discharging an older adult patient who is homeless. Which actions demonstrate the nurse’s understanding of the needs of this population? (select all that apply)

a. instructs the patient to check his blood pressure daily

b. asks the patient if they have a social worker or case manager

c. inquires if the patient has concerns about staying in the local shelter

d. asks the physician if enoxaparin can be changed to an oral anticoagulant

e. informs the patient that the hospital will call with his culture test results next week

Answer 4

b. asks the patient if they have a social worker or case manager

c. inquires if the patient has concerns about staying in the local shelter

d. asks the physician if enoxaparin can be changed to an oral anticoagulant

Question 5

Which action is aligned with the 4M model of an age-friendly health system?

a. Silencing a bed alarm so the patient can sleep at night

b. Assessing if the patient needs a mobility device, such as a walker

c. Asking for haloperidol for a patient with dementia who is pulling on their IV

d. Telling the patient that they need to eat their dinner in order to avoid a feeding tube

Answer 5

b. Assessing if the patient needs a mobility device, such as a walker

Question 6

In which situation would the nurse suspect elder mistreatment?

a. Patient admitted with recurrent syncope

b. Creatinine of 1.1 mg/dL and BUN of 10 mg/dL

c. Sacral pressure injury on a patient who lives at home

d. Patient with dementia who becomes more confused at night

Answer 6

c. Sacral pressure injury on a patient who lives at home

Question 7

Which action is a priority for a newly admitted patient?

a. checking for pressure ulcers

b. planning for post-discharge needs

c. administering an influenza vaccine

d. assessing the patient’s mental status

Answer 7

d. assessing the patient’s mental status

Question 8

Nursing interventions directed at health promotion in the older adult are mainly focused on

a. performing IADLs.

b. symptom management.

c. reducing risk for illness or injury.

d. assessing if the patient has an advanced directive.

Answer 8

c. reducing risk for illness or injury.

Question 9

A patient with obesity (BMI 42.1 kg/m2) is scheduled for a laparoscopic cholecystectomy in an outpatient surgery setting. Which information would the nurse include in the plan of care?

a. The patient will be in the hospital for several days.

b. Surgery will involve removing a part of the liver.

c. The setting is not appropriate for the planned procedure.

d. Special equipment may be needed for the patient’s care.

Answer 9

d. Special equipment may be needed for the patient’s care.

Question 10

The patient reports that she has noticed a skin reaction when wearing disposable gloves. Which action would the nurse take?

a. Notify the surgeon so that the surgery can be canceled.

b. Ask further questions to assess for a possible latex allergy.

c. Notify the OR staff at once so they can use latex-free supplies.

d. No action is needed because the patient’s reaction has no bearing on surgery.

Answer 10

b. Ask further questions to assess for a possible latex allergy.

Question 11

Which intervention would the nurse prioritize to aid a preoperative patient in coping with the fear of postoperative pain?

a. Inform the patient that pain medication will be available.

b. Teach the patient to use guided imagery to help manage pain.

c. Describe the type of pain expected after the patient’s surgery.

d. Explain the pain management plan and the use of a pain rating scale.

Answer 11

d. Explain the pain management plan and the use of a pain rating scale.

Question 12

A 59-year-old man scheduled for a herniorrhaphy in 2 days reports that he takes an anticoagulant agent daily. Which action would the nurse take?

a. Inform the surgeon since the procedure may have to be rescheduled.

b. Tell the patient to continue to take the drug up to the day before surgery.

c. Ask the patient if he has any side effects from taking this drug supplement.

d. Notify the anesthesia care provider since this drug may interfere with anesthetics.

Answer 12

a. Inform the surgeon since the procedure may have to be rescheduled.

Question 13

A 17-year-old patient with a leg fracture who is scheduled for surgery is an emancipated minor. She has a statement from the court for verification. Which action would the nurse take?

a. Witness the patient signing the permit after the surgeon obtains consent.

b. Call a parent or legal guardian to sign the permit since the patient is under 18.

c. Notify the hospital attorney that an emancipated minor is consenting for surgery.

d. Obtain verbal consent since written consent is not necessary for emancipated minors.

Answer 13

a. Witness the patient signing the permit after the surgeon obtains consent.

Question 14

A patient is scheduled for surgery requiring general anesthesia at an ambulatory surgical center. The nurse asks him when he ate last. He replies that he had a light breakfast a couple of hours before coming to the surgery center. Which action would the nurse take?

a. Tell the patient to come back tomorrow since he ate a meal.

b. Have the patient void before giving any preoperative medication.

c. Proceed with the preoperative checklist, including site identification.

d. Notify the anesthesia care provider of when and what the patient last ate.

Answer 14

d. Notify the anesthesia care provider of when and what the patient last ate.

Question 15

Which preoperative considerations would the nurse plan for the care of an older adult? (Select all that apply.)

a. Using only large-print educational materials.

b. Speaking louder for patients with hearing aids.

c. Recognizing that sensory deficits may be present.

d. Providing warm blankets to prevent hypothermia.

e. Teaching important information early in the morning.

Answer 15

c. Recognizing that sensory deficits may be present.

d. Providing warm blankets to prevent hypothermia.

Question 16

A patient who takes metformin 500 mg every morning for control of type 2 diabetes asks if she should take her medication the day of surgery. Which recommendation would the nurse make?

a. Skip her medication the day of surgery.

b. Get instructions from the surgeon about medication adjustments.

c. Take her usual morning dose at bedtime the night before surgery.

d. Take her medication as usual with a sip of water in the morning.

Answer 16

c. Take her usual morning dose at bedtime the night before surgery.

Question 17

1. Which items would the nurse wear for proper attire in the semirestricted area of the surgery department?

a. Street clothing

b. Surgical attire and head cover

c. Street clothing and shoe covers

d. Surgical attire, head cover, shoe covers

Answer 17

d. Surgical attire, head cover, shoe covers

Question 18

2. Which activities might the nurse perform in the role of a scrub nurse during surgery? (select all that apply)

a. Checking electrical equipment

b. Preparing the instrument table

c. Assisting with draping the patient

d. Passing instruments to the surgeon and assistants

e. Documenting activities occurring in the operating room

Answer 18

b. Preparing the instrument table

c. Assisting with draping the patient

d. Passing instruments to the surgeon and assistants

Question 19

3. The nurse is caring for a patient undergoing surgery for a knee replacement. Which factors are critical to the patient’s safety during the procedure? (select all that apply)

a. Universal protocol is followed.

b. The ACP is an anesthesiologist.

c. The patient has adequate health insurance.

d. The patient’s family is in the surgery waiting area.

e. The patient’s allergies are conveyed to the surgical team.

Answer 19

a. Universal protocol is followed.

e. The patient’s allergies are conveyed to the surgical team.

Question 20

4. Which action is the nurse’s primary responsibility for the care of the patient undergoing surgery?

a. Developing a patient-centered plan of nursing care

b. Carrying out tasks related to surgical policies and procedure

c. Ensuring that the patient has been assessed for safe administration of anesthesia

d. Performing a preoperative history and physical assessment to identify patient needs

Answer 20

a. Developing a patient-centered plan of nursing care

Question 21

5. Which action would the nurse take when scrubbing at the scrub sink?

a. Scrub from elbows to hands

b. Scrub without mechanical friction

c. Scrub for a minimum of 10 minutes

d. Hold the hands higher than the elbows

Answer 21

d. Hold the hands higher than the elbows

Question 22

7. Why is IV induction for general anesthesia the method of choice for most patients?

a. The patient is not intubated.

b. The agents are nonexplosive.

c. Induction is rapid and controlled.

d. Emergence is longer but with fewer complications.

Answer 22

c. Induction is rapid and controlled.

Question 23

6. Which factors in positioning a patient for surgery increase the risk of patient injury? (select all that apply)

a. Loss of pain perception

b. Incorrect musculoskeletal alignment

c. Vasoconstriction of the peripheral vessels

d. Hypovolemia contributing to decreased perfusion

e. Inability to sense pressure over bony prominences

Answer 23

a. Loss of pain perception

b. Incorrect musculoskeletal alignment

d. Hypovolemia contributing to decreased perfusion

e. Inability to sense pressure over bony prominences

Question 24

1. Which actions would the nurse prioritize when admitting a patient to the PACU?

a. Assess the surgical site, noting presence and character of drainage.

b. Assess the amount of urine output and the presence of bladder distention.

c. Assess for airway patency and quality of respirations and obtain vital signs.

d. Review results of intraoperative laboratory values and medications received.

Answer 24

c. Assess for airway patency and quality of respirations and obtain vital signs.

Question 25

2. A patient is admitted to the PACU after major abdominal surgery. During the initial assessment the patient tells the nurse, “I think I am going to throw up.” Which is the priority intervention?

a. Increase the rate of the IV fluids.

b. Give antiemetic medication as ordered.

c. Obtain vital signs, including O2 saturation.

d. Position patient in lateral recovery position.

Answer 25

d. Position patient in lateral recovery position.

Question 26

3. After admitting a postoperative patient to the clinical unit, which assessment data require attention first?

a. O2 saturation of 85%

b. Respiratory rate of 13/min

c. Temperature of 100.4°F (38°C)

d. Blood pressure of 90/60 mm Hg

Answer 26

a. O2 saturation of 85%

Question 27

4. A 70-kg postoperative patient has an average urine output of 25 mL/hr during the first 8 hours. Which interventions would the nurse prioritize? (Select all that apply.)

a. Obtain a bladder ultrasound scan.

b. Perform a straight catheterization.

c. Continue to monitor this normal finding.

d. Evaluate the patient’s fluid volume status.

Answer 27

a. Obtain a bladder ultrasound scan.

Question 28

5. Which factors would the nurse include in discharge criteria for a Phase II patient? (select all that apply)

a. Nausea and vomiting controlled.

b. Ability to drive themselves home.

c. No respiratory depression present.

d. Written discharge instructions understood.

e. Opioid pain medication given 45 minutes ago.

Answer 28

a. Nausea and vomiting controlled.

c. No respiratory depression present.

d. Written discharge instructions understood.

e. Opioid pain medication given 45 minutes ago.

Question 29

1. The nurse in urgent care suspects an ankle sprain when a patient describes

a. being hit by another soccer player during a game.

b. having ankle pain after sprinting around the track.

c. dropping a 10-lb weight on his lower leg at the health club.

d. twisting his ankle while running bases during a baseball game.

Answer 29

d. twisting his ankle while running bases during a baseball game.

Question 30

2. A patient with a humeral fracture is returning for a 4-week checkup. The nurse explains that initial evidence of healing on x-ray is indicated by

a. formation of callus.

b. complete bony union.

c. hematoma at the fracture site.

d. presence of granulation tissue.

Answer 30

a. formation of callus.

Question 31

3. A patient with a comminuted fracture of the tibia is to have an open reduction with internal fixation (ORIF) of the fracture. The nurse explains that ORIF is indicated when

a. the patient cannot tolerate prolonged immobilization.

b. the patient cannot tolerate the surgery for a closed reduction.

c. other nonsurgical methods cannot achieve adequate alignment.

d. a temporary cast would be too unstable to provide normal mobility.

Answer 31

c. other nonsurgical methods cannot achieve adequate alignment.

Question 32

4. The nurse suspects a neurovascular problem based on assessment of

a. exaggerated strength with movement.

b. increased redness and heat below the injury.

c. decreased sensation distal to the fracture site.

d. purulent drainage at the site of an open fracture.

Answer 32

c. decreased sensation distal to the fracture site.

Question 33

5. A patient with a stable, closed humeral fracture has a temporary splint with bulky padding applied with an elastic bandage. The nurse suspects early compartment syndrome when the patient has

a. increasing edema of the limb.

b. muscle spasms of the lower arm.

c. bounding pulse at the fracture site.

d. pain when passively extending the fingers.

Answer 33

d. pain when passively extending the fingers.

Question 34

6. The nurse would monitor a patient with a pelvic fracture for

a. changes in urine output.

b. petechiae on the abdomen.

c. a palpable lump in the buttock.

d. sudden increase in blood pressure.

Answer 34

a. changes in urine output.

Question 35

7. The nurse teaches the patient with an above-the-knee amputation that the residual limb should not be routinely elevated because this position promotes

a. hip flexion contracture.

b. clot formation at the incision.

c. skin irritation and breakdown.

d. increased risk for wound dehiscence.

Answer 35

a. hip flexion contracture.

Question 36

9. A patient is scheduled for total ankle replacement. The nurse should tell the patient that after surgery he should avoid

a. lifting heavy objects.

b. sleeping on the back.

c. abduction exercises of the affected ankle.

d. improve or maintain ROM.

Answer 36

d. improve or maintain ROM.

Question 37

8. A patient with osteoarthritis is scheduled for total hip arthroplasty. The nurse explains the purpose of this procedure is to (select all that apply)

a. fuse the joint.

b. replace the joint.

c. prevent further damage.

d. improve or maintain ROM.

e. decrease the amount of destruction in the joint.

Answer 37

b. replace the joint.

d. improve or maintain ROM.

Question 38

9. A patient is scheduled for total ankle replacement. The nurse should tell the patient that after surgery he should avoid

a. lifting heavy objects.

b. sleeping on the back.

c. abduction exercises of the affected ankle.

d. bearing weight on the affected leg for 6 weeks.

Answer 38

d. bearing weight on the affected leg for 6 weeks.

Question 39

1. In assessing the joints of a patient with osteoarthritis, the nurse understands that Heberden nodes

a. are often red, swollen, and tender.

b. indicate osteophyte formation at the DIP joints.

c. are the result of pannus formation at the PIP joints.

d. occur from deterioration of cartilage caused by proteolytic enzymes.

Answer 39

b. indicate osteophyte formation at the DIP joints.

Question 40

2. Assessment findings that the nurse would expect in a patient with rheumatoid arthritis who has articular involvement include (select all that apply)

a. bamboo-shaped fingers

b. metatarsal head dislocation in feet

c. noninflammatory pain in large joints

d. asymmetric involvement of small joints

e. morning stiffness lasting 60 minutes or more

Answer 40

b. metatarsal head dislocation in feet

e. morning stiffness lasting 60 minutes or more

Question 41

3. Which drug would the nurse prepare to administer to the patient with acute gout?

a. Colchicine

b. Allopurinol

c. Sulfasalazine

d. Cyclosporine

Answer 41

a. Colchicine

Question 42

4. The nurse should teach the patient with ankylosing spondylitis the importance of

a. avoiding extremes in environmental temperatures.

b. regularly exercising and maintaining proper posture.

c. maintaining the patient’s usual physical activity during flares.

d. applying hot and cool compresses for relief of local symptoms.

Answer 42

b. regularly exercising and maintaining proper posture.

Question 43

6. Which drug would the nurse plan to administer to the patient with Sjögren syndrome with the goal of improving symptoms of dry eyes?

a. Etanercept (Enbrel)

b. Pilocarpine (Salagen)

c. Cyclosporine (Restasis)

d. Cyclobenzaprine (Flexeril)

Answer 43

c. Cyclosporine (Restasis)

Question 44

5. In teaching a patient with systemic lupus erythematosus about the disorder, the nurse knows the pathophysiology includes

a. circulating immune complexes formed from IgG autoantibodies reacting with IgG.

b. an autoimmune T-cell reaction that results in destruction of the deep dermal skin layer.

c. immunologic dysfunction leading to chronic inflammation in the cartilage and muscles.

d. the production of a variety of autoantibodies directed against components of the cell nucleus.

Answer 44

d. the production of a variety of autoantibodies directed against components of the cell nucleus.

Question 45

7. Teach the patient with fibromyalgia the importance of limiting intake of which foods? (select all that apply)

a. Sugar

b. Gluten

c. Alcohol

d. Caffeine

e. Red meat

Answer 45

a. Sugar

c. Alcohol

d. Caffeine

Question 46

1. A patient is admitted to the hospital with diarrhea and dehydration. The nurse recognizes that increased peristalsis resulting in diarrhea can be related to

a. sympathetic inhibition.

b. mixing and propulsion.

c. sympathetic stimulation.

d. parasympathetic stimulation.

Answer 46

d. parasympathetic stimulation.

Question 47

2. A patient has a high blood level of indirect (unconjugated) bilirubin. One cause of this finding is that

a. the gallbladder is unable to contract to release stored bile.

b. bilirubin is not being conjugated and excreted into the bile by the liver.

c. the Kupffer cells in the liver are unable to remove bilirubin from the blood.

d. there is an obstruction in the biliary tract preventing flow of bile into the small intestine.

Answer 47

b. bilirubin is not being conjugated and excreted into the bile by the liver.

Question 48

3. As gastric contents move into the small intestine, the bowel is normally protected from the acidity of gastric contents by the

a. inhibition of secretin release.

b. secretion of mucus by goblet cells.

c. release of pancreatic digestive enzymes.

d. release of gastrin by the duodenal mucosa.

Answer 48

b. secretion of mucus by goblet cells.

Question 49

4. A patient has jaundice with pale colored stools. This is most likely related to

a. decreased bile flow into the intestine.

b. increased production of urobilinogen.

c. increased bile and bilirubin in the blood.

d. increased production of cholecystokinin.

Answer 49

a. decreased bile flow into the intestine.

Question 50

5. An 80-year-old man states that, although he adds a lot of salt to his food, it still does not have much taste. The nurse’s response is based on the knowledge that the older adult

a. should not have any changes in taste.

b. has a loss of taste buds, especially for sweet and salt.

c. has some loss of taste but no problems chewing food.

d. loses some sense of taste related to the increased ability to smell.

Answer 50

b. has a loss of taste buds, especially for sweet and salt.

Question 51

6. When the nurse is assessing the health perception–health maintenance pattern as related to gastrointestinal function, an appropriate question to ask is

a. “What is your usual bowel elimination pattern?”

b. “What percentage of your income is spent on food?”

c. “Have you traveled to a foreign country in the last year?”

d. “Do you have diarrhea when you are under a lot of stress?”

Answer 51

c. “Have you traveled to a foreign country in the last year?”

Question 52

7. When assessing the abdomen, the nurse should

a. position the patient in the supine position with the bed flat and knees straight.

b. listen for bowel sounds in the epigastrium and all 4 quadrants for 2 minutes.

c. describe bowel sounds as absent if no sound is heard in a quadrant after 2 minutes.

d. use the following order of techniques: inspection, palpation, percussion, auscultation.

Answer 52

b. listen for bowel sounds in the epigastrium and all 4 quadrants for 2 minutes.

Question 53

8. Normal physical assessment findings of the gastrointestinal system are (select all that apply)

a. nonpalpable spleen.

b. borborygmi in upper right quadrant.

c. tympany on percussion of the abdomen.

d. liver edge 2 to 4 cm below the costal margin.

e. finding of a firm, nodular edge on the rectal examination.

Answer 53

a. nonpalpable spleen.

c. tympany on percussion of the abdomen.

Question 54

9. In preparing a patient for a colonoscopy, the nurse explains that

a. a signed permit is not needed.

b. sedation will be used during the procedure.

c. one cleansing enema part of the required preparation.

d. light meals should be eaten for 3 days before the procedure.

Answer 54

b. sedation will be used during the procedure.

Question 55

1. M.J. calls the clinic and tells the nurse that her 85-year-old mother has been nauseated all day and has vomited twice. Before the nurse hangs up and calls the HCP, she should tell M.J. to

a. administer antiemetic drugs and assess her mother’s skin turgor.

b. give her mother sips of water and elevate the head of her bed to prevent aspiration.

c. offer her mother large quantities of Gatorade to decrease the risk for sodium depletion.

d. give her mother a high-protein liquid supplement to drink to maintain her nutrition needs.

Answer 55

b. give her mother sips of water and elevate the head of her bed to prevent aspiration.

Question 56

2. The nurse explains to the patient with Vincent’s infection that treatment will include

a. tetanus vaccinations.

b. viscous lidocaine rinses.

c. amphotericin B suspension.

d. topical application of antibiotics.

Answer 56

d. topical application of antibiotics.

Question 57

4. Which instructions would the nurse include in a teaching plan for a patient with mild gastroesophageal reflux disease (GERD)?

a. “The best time to take an as-needed antacid is 1 to 3 hours after meals.”

b. “A glass of warm milk at bedtime will decrease your discomfort at night.”

c. “Do not chew gum; the excess saliva will cause you to secrete more acid.”

d. “Limit your intake of foods high in protein because they take longer to digest.”

Answer 57

a. “The best time to take an as-needed antacid is 1 to 3 hours after meals.”

Question 58

3. The nurse teaching young adults about behaviors that put them at risk for oral cancer includes

a. discouraging use of chewing gum.

b. avoiding use of perfumed lip gloss.

c. avoiding use of smokeless tobacco.

d. discouraging drinking of carbonated beverages.

Answer 58

c. avoiding use of smokeless tobacco.

Question 59

5. A patient who had an esophagectomy for esophageal cancer develops increasing pain, fever, and dyspnea after starting a full-liquid diet. The nurse recognizes that these symptoms are most indicative of

a. an intolerance to the feedings.

b. extension of the tumor into the aorta.

c. leakage of fluids into the mediastinum.

d. esophageal perforation with fistula formation into the lung.

Answer 59

c. leakage of fluids into the mediastinum.

Question 60

6. The nurse monitors a patient with gastritis for pernicious anemia due to

a. chronic autoimmune destruction of cobalamin stores in the body.

b. progressive gastric atrophy from chronic breakage in the mucosal barrier and blood loss.

c. a lack of intrinsic factor normally produced by acid-secreting cells of the gastric mucosa.

d. hyperchlorhydria from an increase in acid-secreting parietal cells and degradation of RBCs.

Answer 60

c. a lack of intrinsic factor normally produced by acid-secreting cells of the gastric mucosa.

Question 61

7. The nurse is teaching the patient and family that peptic ulcers are

a. caused by a stressful lifestyle and other acid-producing factors, such as H. pylori.

b. inherited within families and reinforced by bacterial spread of Staphylococcus aureus in childhood.

c. promoted by factors that cause oversecretion of acid, such as excess diet fats, smoking, and alcohol use.

d. promoted by a combination of factors that cause erosion of the gastric mucosa, including certain drugs and H. pylori.

Answer 61

d. promoted by a combination of factors that cause erosion of the gastric mucosa, including certain drugs and H. pylori.

Question 62

8. An optimal teaching plan for an outpatient with stomach cancer receiving radiation therapy should include information about

a. cancer support groups, alopecia, and stomatitis.

b. nutrition supplements, ostomy care, and support groups.

c. prosthetic devices, wound and skin care, and grief counseling.

d. wound and skin care, nutrition, drugs, and community resources.

Answer 62

d. wound and skin care, nutrition, drugs, and community resources.

Question 63

9. The discharge teaching plan for the patient after an acute episode of upper GI bleeding includes information about the importance of (select all that apply)

a. limiting alcohol intake to 1 serving per day.

b. only taking aspirin with milk or bread products.

c. avoiding taking aspirin and drugs containing aspirin.

d. only taking drugs prescribed by the health care provider.

e. taking all drugs 1 hour before mealtime to prevent further bleeding.

Answer 63

c. avoiding taking aspirin and drugs containing aspirin.

d. only taking drugs prescribed by the health care provider.

Question 64

10. Several patients come to the urgent care center with nausea, vomiting, and diarrhea that began 2 hours ago while attending a large family reunion potluck dinner. You ask the patients specifically about foods they ingested containing

a. beef.

b. meat and milk.

c. poultry and eggs.

d. home-preserved vegetables.

Answer 64

b. meat and milk.

Question 65

1. The most appropriate therapy for a patient with acute diarrhea caused by a viral infection is to

a. increase fluid intake.

b. administer an antibiotic.

c. administer an antimotility drug.

d. quarantine the patient to prevent spread of the virus.

Answer 65

a. increase fluid intake.

Question 66

2. A 35-year-old female patient is admitted to the emergency department with acute abdominal pain. Which medical diagnoses should you consider as possible causes of her pain? (select all that apply)

a. Gastroenteritis

b. Ectopic pregnancy

c. Gastrointestinal bleeding

d. Irritable bowel syndrome

e. Inflammatory bowel disease

Answer 66

a. Gastroenteritis

b. Ectopic pregnancy

c. Gastrointestinal bleeding

d. Irritable bowel syndrome

e. Inflammatory bowel disease

Question 67

3. Assessment findings suggestive of peritonitis include (select all that apply)

a. abdominal pain.

b. rebound tenderness.

c. a soft, distended abdomen.

d. shallow respirations with bradypnea.

e. observing that the patient is lying still.

Answer 67

a. abdominal pain.

b. rebound tenderness.

e. observing that the patient is lying still.

Question 68

4. In planning care for the patient with Crohn’s disease, the nurse recognizes that a major difference between ulcerative colitis and Crohn’s disease is that Crohn’s disease

a. often results in toxic megacolon.

b. causes fewer nutrition deficiencies than ulcerative colitis.

c. often recurs after surgery, while ulcerative colitis is curable with a colectomy.

d. is manifested by rectal bleeding and anemia more often than is ulcerative colitis.

Answer 68

c. often recurs after surgery, while ulcerative colitis is curable with a colectomy.

Question 69

5. The nurse performs an abdominal assessment of a patient with a possible bowel obstruction, knowing that manifestations of an obstruction in the large intestine are (select all that apply)

a. persistent abdominal pain.

b. marked abdominal distention.

c. diarrhea that is loose or liquid.

d. colicky, severe, intermittent pain.

e. profuse vomiting that relieves abdominal pain.

Answer 69

a. persistent abdominal pain.

b. marked abdominal distention.

Question 70

6. A patient with stage I colorectal cancer is scheduled for surgery. Patient teaching for this patient would include an explanation that

a. chemotherapy will begin after the patient recovers from the surgery.

b. both chemotherapy and radiation can be used as palliative treatments.

c. follow-up colonoscopies will be needed to ensure that the cancer does not recur.

d. a wound, ostomy, and continence nurse will visit the patient to identify the site for the ostomy.

Answer 70

c. follow-up colonoscopies will be needed to ensure that the cancer does not recur.

Question 71

7. The nurse determines a patient undergoing ileostomy surgery understands the procedure when the patient states

a. “I should only have to change the pouch every 4 to 7 days.”

b. “The drainage in the pouch will look like my normal stools.”

c. “I may not need to wear a drainage pouch if I irrigate it daily.”

d. “Limiting my fluid intake should decrease the amount of output.”

Answer 71

a. “I should only have to change the pouch every 4 to 7 days.”

Question 72

8. In contrast to diverticulitis, the patient with diverticulosis

a. has rectal bleeding.

b. often has no symptoms.

c. usually develops peritonitis.

d. has localized cramping pain.

Answer 72

b. often has no symptoms.

Question 73

10. The nurse determines that the goals of diet teaching have been met when the patient with celiac disease selects from the menu

a. scrambled eggs and sausage.

b. buckwheat pancakes with syrup.

c. oatmeal, skim milk, and orange juice.

d. yogurt, strawberries, and rye toast with butter.

Answer 73

a. scrambled eggs and sausage.

Question 73

9. A nursing intervention that is most appropriate to decrease postoperative edema and pain after an inguinal herniorrhaphy is to

a. maintain the patient on bed rest.

b. allow the patient to stand to void.

c. support the incision during coughing.

d. apply a scrotal support with an ice bag.

Answer 73

d. apply a scrotal support with an ice bag.

Question 74

11. What should a patient be taught after a hemorrhoidectomy?

a. Take mineral oil before bedtime.

b. Eat a low-fiber diet to rest the colon.

c. Use a daily oil-retention enema to empty the colon.

d. Take prescribed pain medications before a bowel movement.

Answer 74

d. Take prescribed pain medications before a bowel movement.