Part 1 Flashcards

1
Q

Which diagnostic results support the diagnosis of peptic ulcer disease (PUD)? (Select all that apply.)
A. Positive for H. pylori bacteria
B. Low hematocrit (Hct)
C. Low hemoglobin (Hgb)
D. Low white blood cell (WBC) level
E. Low potassium of 3.4 mEqlL

A

C. Low hemoglobin (Hgb)
B. Low hematocrit (Hct)
A. Positive for H. pylori bacteria

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2
Q

You provided health education to Rudy about GERD You asked him to list 4 ways to prevent or alleviate signs and symptoms of GERD Which of the following statements is INCORRECT?

A. “I will try to lie down after eating a meal to help decrease
pressure on the lower esophageal sphincter.”
B. “It is important I avoid eating right before bedtime .. “
C. “I’m disappointed that ,1 will have to limit my intake of peppermint
and spearmint because J love eating those types of hard candies.”
D. “It 1s best to try to consume small meals throughout the day than
eat 3 large ones.”

A

A. “I will try to lie down after eating a meal to help decrease pressure on the lower esophageal sphincter.”

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3
Q

Which of the following statements about cholecystitis is NOT correct?

A. After surgical removal of the gallbladder, some people continue to have pain that feels similar to cholecystitis pain.
B. Patients with acalculous cholecystitis, a type of acute
cholecystitis without gallstones, may not be diagnosed quickly
because- they are-usually very ill with numerous other conditions and symptoms.
C. Under certain Circumstances, surgical removal of the gallbladder
may be delayed 6 weeks or more following a cholecystitis attack.
D. Pain from chronic cholecystitis is usually more severe than pain
from acute cholecystitis.

A

D. Pain from chronic cholecystitis is usually more severe than pain from acute cholecystitis.

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4
Q

You are providing education to a group of nursing students about the care of a patient with appendicitis~ Which statement by a nursing student requires re-education about your teaching?

A. “The nurse should monitor the patient for signs and symptoms of
peritonitis which includes- increased heart rate, respirations,
temperature, abdominal distention, and intense abdomin:al pain.”
B. “Noh-pharmacological techniques for a pattent with appendicitis
include application of heat to the abdomen and the side-lying
position.”
C. “After an appe-ndectomy, the patient may have a nasogastric tube
to remove stomach fluids and swallowed air.”
D. “It is normal for some patients to have shoulder pain after a
laparoscopic appendectomy.”

A

B. “Non-pharmacological techniques for a patient with appendicitis include application of heat to the abdomen and the side-lying position.”

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5
Q

Kembo, a 34 year old male patient, expresses concerns over having black stool. The fecal occult test is negative. Which response by the nurse is most appropriate?

A. This is probably a false negative; we should rerun the test.
B. You should schedule a colonoscopy as soon as possible.
C. Sometimes severe stress can alter stool color.
D. Do you take “iron supplements?

A

D. Do you take iron supplements?

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6
Q

Client PJ presents with complaints of nausea, vomiting, and abdominal pain for the last 12 hours~ He states to nurse MJ, “I have had gastritis before and think. I might have it again.” Which of the following statements from client PJ would lead the nurse to have an impression that it is something other than gastritis?

A. “My healthcare provider told me I have h.ad H. pylori before·”
B. ‘‘I drink 6 packs of beer every night”
C. “I hurt my knee at work last week and have been taking 400mg of
Ibuprofen every 6 hours ever since”
D. “The pain is a 7/10 in the lower rjght part of my abdomen:”

A

D. “The pain is a 7/10 in the lower right part of my abdomen:”

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7
Q

Which of the following may signal a life-threatening complication of acute cholecystitis?

A. Nausea and vomiting
B. Pain extend-ing into the lower part of right shoulder blade or back
C Abdom”inal muscles on the right side becomi·ng stiff
D. Symptoms persisting be·yond 2-3 d,ays, with increasing paTn

A

B. Pain extend-ing into the lower part of right shoulder blade or back

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8
Q

Which of the following upholds the autonomy of a patient who is being diagnosed with a GI disorder?

A. Inform him about the details-of the condition
B. Provide a blanket during abdominal exam
c. Secure the consent before doing a test
D. Follow the appropriate cultural beliefs of the patient

A

C. Secure the consent before doing a test

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9
Q

Which of the following tests will be performed to a client suspected of having colonic diverticulosis?

A. Barium swallow
B. Gastroscopy
C. Abdom~inal ultrasound
D. Barium enema

A

Barium enema

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10
Q

Which nursing intervention is most effective in promoting normal defecation for a patient who has muscle weakness in the legs that prevents ambulation?

A. Give the patient a pillow to brace against the abdomen while
bearing down.
B. Elevate the head of the bed 45 degrees 60 minutes after
breakfast.
C. Admin·ister a soap suds enema every· 2 ho.urs.
D. Use a mobility device to place the patient on a bedside
commode.

A

Use a mobility device to place the patient on a bedside commode

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11
Q

A nurse is performing an abdominal assessment to a patient with pain in the right iliac region. Which of the following is incorrect?

A. Warming of hands before touching the abdomen
B. Close the curtain during the whole procedure
C. Check for presence of visible masses before tapping the
abdomen
D. Start palpating at the right lower quadrant .going to the left

A

Start palpating at the right lower quadrant going to the left

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12
Q

________Occurs due to inadequate, excessive, or imbalanced nutrition.al intake. This includes being underweight or overweight or lacking specific nutrients.

A. Irritable Bowel Diseases
B. Malnutrition
C.. Malabsorptiom
D. Irritable Bowel Syndrome

A

Malnutrition

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13
Q

The nurse is working with a client who has PUD. Which of the following laboratory results is important to monitor with this condition?

A. Hemoglobin and Hematocrit
B. Lactic acid
C. Procalcitonin
D. Magnesium

A

Hemoglobin and Hematocri

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14
Q

A surgical nurse is emptying an ileostomy pouch for a patient. Which assessment finding would she report immediately?

A. Liquid consistency of stool
B. Noxious odor from the stool
C. Presence of blood in the stool
D. Continuous output from the stoma

A

Presence of blood in the stool

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15
Q

After a barium enema, the patient should be informed to:

A. Maintain NPO status
B. C. Drink more fluids
C. Eat banana and apple

A

Drink more fluids

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16
Q

A nurse is performing an abdominal assessment and inspects the skin of the abdomen. Which of the following should be performed next?

A. Palpates the abdomen for size
B. Palpates the liver at the right rib margin
C. Listens to bowel sounds in all four quadrants
D. Percusses the right lower abdominal quadrant

A

Listens to bowel sounds in all four quadrant

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17
Q

In cases of liver problems, a medical ward nurse will check for a doctor’s request of which of the following liver enzymes? Select all that apply .

A. HDL
B. CREATININE
C. ALT
D. AST

A

ALT
AST

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18
Q

Which potential problem will be emphasised in the plan of care for Jonnel, a patient who has gastroesophageal reflux disease (GERD)?

B. Difficulty coping
A. Aspiration risk
D. Flu-id volume deficit
C. Prolonged nausea

A

Aspiration risk

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19
Q

A client informs the nurse on duty that she was using laxatives three times daily to lose weight. After stopping the use of laxatives, she had difficulty with constipation and wonders if she needs to take laxatives again. The nurse educates the patient that

A. Long-term laxative use ca.uses the boweJ to become less responsive to stimuli, and constipation may occur~
B. Natural laxatives such as mineral oil are safer than chemical laxatives for relieving constipation.
C. Laxatives cause the body; to become malnouris.hed, so when the patient begins eating again, the body absorbs all of the food, and no waste products are produced.

A

Long-term laxative use causes the bowel to become less responsive to stimuli, and constipation may occur

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20
Q

A patient has just had esophageal dilation performed to help alleviate the symptoms associated with achalasia. Which nursing intervention is appropriate after this procedure is performed?

A. Instruct the patient to swallow frequently to help control excess
secretions.
B. Assess vital signs every 2 hours postprocedure after they are
stable ..
C. Maintain NPO status for a minimum of 8 hours after the
procedure.
D. Offer only full liquids after the initial NPO period to avoid irritation
of the throat.

A

Maintain NPO status for a minimum of 8 hours after the procedure.

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21
Q

Which patient is most at risk for increased peristalsis?

A. A 40-year-old woman with major depressive disorder
B. A 5-year-old child who ignores the urge to defecate owing to
embarrassment
C. 21-year-old student nurse with a panic attack during a
preliminary exam

A

21-year-old student nurse with a panic attack during a
preliminary exam

22
Q

The nurse has attempted to administer a tap water enema for a patient with fecal impaction with no success. What is the next priority nursing action?

A. nserting a rectal tube
B. Preparin·g the patient for a second tap water enema
C. Donning gloves for digital removal of the stool
D. Positioning the patient on the left side

A

Donning gloves for digital removal of the stool

23
Q

A 36 y/o woman was admitted with a medical diagnosis of cholecystitis. The nurse would expect the history of her present illness to include intolerance to which nutrient?

A. protein
B. fat
C. vitamin c
D. carbohydrates

A

fat

24
Q

A client with a peptic ulcer has been brought into the emergency room and is being assessed by the nurse for an upper GI bleed. Which of the following signs and symptoms would the nurse expect to see with this condition? (Select all that apply)

A. Epigastric pain
B.Hematemesis
C. Swelling in the lower legs
D. Melena
E. Abdominal fullness

A

Epigastric pain
Hematemesis
Melena

25
Q

The patient with advanced cirrhosis asks why his abdomen is so swollen. As the nurse in charge, your best response is based on the knowledge that

A. decreased peristalsis in the GI tract contributes to gas formation
and distention of the bowel
B. a lack of clotting factors promotes the collection of blood in the abdominal cavity
C. portal hypertension and hypoalbuminemia cause fluid snifl into the peritoneal space.

A

portal hypertension and hypoalbuminemia cause fluid snifl into
the peritoneal space.

26
Q

Nurse Sandy is collecting data for a patient who develops jaundice and dark, amber colored urine. Which of the following is most likely the cause?

A. cholecystitis
B. bile duct obstructio_n
C. pancreatitis
D. encephalopathy

A

bile duct obstruction/

27
Q

A male patient with a recent history of rectal bleeding is being prepared for a colonoscopy. How should the nurse position him 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

A

Lying on the left side with knees bent

28
Q

Other than a radiograph, the most reliable way to assess placement of a nasogastric tube is to do which of the following?

A. Auscultate the epigastriurn while injecting air into the tube
B. Exam-ine and check pH of aspirated stomach contents
C. Pla.ce the end of the tube in water and observe for bubbling
D. Listen for air movement at the end of the tube

A

B. Examine and check pH of aspirated stomach contents/

29
Q

A patient who will undergo esophagogastroduodenoscopy will be
positioned to:

A. Trendelenburg
B. Recumbent
C. Right lateral
D. Left lateral

A

Left lateral

30
Q

Which of the following symptoms indicate diverticulosis?

A. No symptoms exist.
B. Episodic, dull, or steady midabdorninal pain~
C. Change in bowel habits.
D. Anorexia with low-grade fever.

A

A. No symptoms exist.

31
Q

Client Dovey has a chronic peptic ulcer and wants to know the difference between an acute and chronic ,peptic ulcer. How does the nurse educate client Dovey?

A. An acute ulcer is treated with H2 bfockers while a chronic ulcer is
treated with _PPls
B. An acute ulcer fasts .only a month and a chronic ulcer lasts
greater than one month
C. H. Pylori is present with a chronic ulcer but ·not with an acute
ulcer
D. An acute ulcer is a superficial erosion, while a chronic ulcer
extends through the muscular wall of the stomach

A

An acute ulcer is a superficial erosion, while a chronic ulcer extends through the muscular wall of the stomach

32
Q

A 54 year old male patient has the following symptoms: urgent and frequent bowel movements of diarrhea that contains blood with pus and mucus, low
hemoglobin/hematocrit, potassium level of 2.0. Based on the patient’s signs and symptoms, which disease does this describe?

A. Crohn’s Disease
B. Irritable- Bowel Syndrome
C. Append-iciti·s
D. Ulcerative Colitis

A

Ulcerative Colitis

33
Q

Patient Malvin has been taking magnesium hydroxide (milk of magnesia) at home in an attempt to control hiatal hernia symptoms. N4rse Olivia should assess the client for which of the following
conditions most_ commonly associated with the ongoing use of magnesium based antacids?

Diarrhea.
B. Weight gain.
C. Anorexia.
D. Constipation.

A

Diarrhea

34
Q

Teaching for a patient after a cholecystectomy on a low fat diet. He knows the patient understands the diet if which of the following menu items is selected?

A. Turkey and cheese sandwich on whole grain bread, apple, milk
B. meat.loaf, mashed potatoes with small amount of gravy, green
beans
C. cream of chLcken soup, milk, gelatin dessert
D. roasted chicken, rice, gelatin dessert

A

roasted chicken, rice, gelatin dessert

35
Q

As an admitting nurse of a patient complaining of abdominal pain during assessment. Which is your nursing priority?

A. Auscultate to determine change.s in bowel sounds.
B. Observe the contour of the abdomen.
C. Palpate the abdomen for a mass.
D. Percuss the abdomen to determine ‘if fluid is prese.nt:

A

B. Observe the contour of the abdomen.

36
Q

Nurse Clayton from the surgical assigned to a client with bruises around the umbilicus. Which sign would be concerning for peritoneal bleeding and should be checked immediately?

A. Murphy’s sign
B. Battle’s sign
C. Grey-Turner’s sign
D. Cullen*s sign

A

D. Cullen’s sign

37
Q

Patient Oliver is admitted to the medical unit after experiencing watery diarrhea for the past week. Assessment findings include: Blood pressure = 90/54 Pulse = 102 Respiratory rate = 18 Level of consciousness =altered
Based on these findings, these healthcare providers should monitor the patient for the development of which of these problems?

A. Metaboltc alkalosis
B. Respiratory acidosis
C. Respiratory alkalos~s
D. Metabolic acidosis

A

Metabolic acidosis

38
Q

You are caring for a patient who was recently diagnosed with a hiatal hernia. The patient verbalised experiencing chronic heartburn when eatin.g a meal. All of the following are appropriate to be taught to the patient, except?

A. Ingesting small, frequent rneals
B. Raising the head of the bed
C. Taking the prescribed histamine receptor antagonist medications
D. Lying flat after eating a meal

A

Lying flat after eating a meal

39
Q

This test is done to confirm the diagnosis of achalasia.

A. Fecalysis
B. Barium swallow
C. Manometry
D. CT Scan

A

B. Manometry

40
Q

A nurse is caring for a client with an intestinal ulcer who takes lansoprazole. Which of the following adverse reactions should be monitored? (SATA)

A. Oliguria
B. Anxiety
C. Diarrhea
D. Headache
E. Nausea

A

Diarrhea
Headache
Nausea

41
Q

A nurse is caring for a patient who is being treated with misoprostol (Cytotec). Which is the MOST important for the patient to report to the physician?

A.. Becomes pregnant
B. Develops abdominal pain and headache
C. Having d-iarrhea and flatulence
D. Begins to experience nausea and vomiting

A

Becomes pregnant

42
Q

Which of the following symptoms indicate diverticulosis?

A

A. No symptoms exist.

43
Q

Which of the following does NOT play a role in the development of GERD?

A. Pregnancy
B. Usage of antihistamines or calcium channel blockers
C. Fecalith formation
D. Hiatal hernia

A

Fecalith formation

44
Q

A 54 year old male patient has the following symptoms: urgent 1 point
and frequent bowel movements of diarrhea that contains blood with
pus and mucous, low hemoglobin /hematocrit, potassium level of 2.0. Based on the patient’s signs and symptoms, which disease does this describe?

A. Crohn’s Disease
B. Irritable- Bowel Syndrome
C.. Append-iciti·s
D. Ulcerative Colitis

A

Ulcerative Colitis

45
Q

As the nurse on duty, you are reviewing the admission papers for a new resident of a long-term care facility. You noted a medical diagnosis of achalasia. Which of the following should be included in the nursing care plan? (Select all that apply).

A. Detertnine the best position for the patient during meals
B. Be sure clothing is not restrictive
C. P’lace the patient on NPO status
D. Auscultate bowel sounds n, all four quadrants

A

Determine the best position for the patient during meals
Be sure clothing is not restrictive

46
Q

Which of the following most accurately describes the rationale for administering famotidine to a client with gastritis?

A. Reduce nausea and vorniting
B. Decrease acid reflux
C. Decrease inflammation in the stomac.h
D. Alleviate chest pain

A

Decrease acid reflux

47
Q

Which among the following statements describe/s Achalasia?
Select_all that apply.

A. Affects the swallowing of both solid and liquids
B. Results -in a constricted eso.phagus
C. Chronic, incurable disease
D. Incomplete or absent relaxatio.n of the lower esopgageak sphincter

A

Results -in a constricted esophagus
Incomplete or absent relaxation of the lower esophageal sphincter

48
Q

Esophageal motility is regulated by switching the vagal signal between? Select all that apply.

A. lnhibotory postganglionic nerons that signal with ACh to caupe
contraction
B. None of the choices is correct
C. inhibitory postganglionic neurons that si.gnal throu.gh NO abd VIP
to cause SM relaxation
D. Excitatory postganglionic nerons that si’gnal with ACh to cause contraction

A

A. inhibitory postganglionic neurons that signal through NO abd VIP to cause SM relaxation
B. Excitatory postganglionic neurons that signal with ACh to cause contraction

49
Q

A student nurse is correct when he says that the enzyme in the mouth that initiates the breakdown of carbohydrates is _____

A. Lipase
B. Trypsin
C. Sucrase
D. Amylase

A

d. Amylase

50
Q

Heat application and enemas are contraindicated to patient who is suspected to have acute appendicitis. This is due to:

A. Possibility of prenancy
B. Possibrlity of fever
C. Possibility of rupturing the appendix
D. Possibility of peritonitis

A

d. Possibility of peritonitis