ANSWERS RATED A+
✔✔After the patient has undergone an esophagogastroduodenoscopy (EGD), which is
the nursing priority.
A. Provide warm saline gargles for relief of sore throat
B. Assess the patient's bowel sounds
C. Keep the patient NPO until the gag reflex returns
D. Address the patient's anxieties about the results of the EGD - ✔✔C. Keep the patient
NPO until the gag reflex returns
✔✔Which clinical manifestations of inflammatory bowel disease are common to both
patients with ulcerative colitis (UC) and Crohn's disease (select all that apply)?
A. Restricted to rectum
B. Strictures are common.
C. Bloody, diarrhea stools
D. Cramping abdominal pain
E. Lesions penetrate intestine. - ✔✔B. Strictures are common.
C. Bloody, diarrhea stools
D. Cramping abdominal pain
✔✔The nurse provides postoperative care to a patient who underwent peripheral artery
bypass surgery. Thirty minutes after the initial assessment, the nurse reassesses the
patient and detects a change in the Doppler sound over a pulse. What action should the
nurse take?
A. Contact the health care provider
B. Administer an oral anticoagulant
C. Measure the ankle-brachial index
D. Recheck the pulse in another 30 minutes - ✔✔A. Contact the health care provider
✔✔A patient who has undergone peripheral artery bypass surgery report increased pain
and tingling in the extremities. The nurse notes the loss of a previously palpable pulse
and cyanosis. Which condition is consistent with these findings?
A. Blockage of the graft
B. Compartment syndrome
C. Thoracic aortic aneurysms
D. Superficial vein thrombosis - ✔✔A. Blockage of the graft
✔✔The nurse provides discharge teaching for a patient's caregiver about stoma care,
one week after the patient underwent ostomy surgery. Which statement made by the
caregiver indicates effective learning?
A. I will observe the stoma color every four hours
B. I will measure the size of the stoma using a properly calibrated scale
C. I will contact the health care provider if the stoma color is rosy pink to red
,D. I will contact the health care provider if the swelling of the stoma persists for more
than a week after surgery. - ✔✔A. I will observe the stoma color every four hours
✔✔A patient with a gastric ulcer develops abdominal pain, a rigid board like abdomen,
and shallow grunting respirations. Which procedure would the nurse expect to be
planned for the patient.
A. Vagotomy
B. Endoscopy
C. Laparoscopy
D. Pyloroplasty - ✔✔C. Laparoscopy
✔✔A patient who is admitted to the hospital with a duodenal ulcer develops signs of
acute duodenal perforation. Which action would the nurse expect to take first.
A. Administer an H2 blocker
B. Administer pain medication
C. Insert an NG tube
D. Prepare the patient for a laparoscopic surgery - ✔✔C. Insert an NG tube
✔✔The nurse provides teaching to a patient with Raynaud's phenomenon about how to
prevent recurrent episodes. Which actions would the nurse instruct the patient to avoid?
Select all that apply.
A. Wearing gloves
B. Drinking caffeinated coffee
C. Exposure to sun
D. Emotional upsets
E. Cigarette smoking - ✔✔B. Drinking caffeinated coffee
D. Emotional upsets
E. Cigarette smoking
✔✔A patient is admitted with GI bleeding. Which findings would support the nurse's
conclusion that the patient is in shock? Select all that apply.
A. Warm skin
B. Rapid, weak pulse
C. Slow capillary refill
D. High BP
E. Increased temperature - ✔✔B. Rapid, weak pulse
C. Slow capillary refill
✔✔A patient is hospitalized with abdominal pain, nausea, and vomiting. A bowel
obstruction is suspected. The nurse expects which assessment findings?
A. Diarrhea and absent bowel sounds
B. Abdominal distention and high-pitched bowel sounds above the obstruction
C. Localized abdominal pain and generalized hypoactive bowel sounds
D. High pitched and hypoactive bowel sounds below the area of obstruction - ✔✔B.
Abdominal distention and high-pitched bowel sounds above the obstruction
, ✔✔The nurse is assessing the client diagnosed with long-term peripheral artery
disease. Which assessment data support the diagnosis?
A. Hairless skin on legs
B. Brittle flaky toenails
C. Petechiae on the soles of feet
D. Nonpitting ankle edema - ✔✔A. Hairless skin on legs
The lack of oxygen rich blood will cause the loss of hair on the tops of the feet and the
lower legs
✔✔The client is being admitted with Coumadin (Warfarin) toxicity. Which laboratory
data should the nurse monitor?
A. Blood urea nitrogen (BUN)
B. Unfractionated heparin (UFH)
C. International normalized ratio (INR)
D. Partial thromboplastin time (PTT) - ✔✔C. International normalized ratio (INR)
✔✔The client is receiving a low molecular weight heparin subcutaneously to prevent
DVT following a hip replacement and complains of small purple hemorrhagic area on
the upper abdomen. Which action should the nurse implement?
A. Notify the HCP immediately
B. Check the client's PTT levels
C. Explain this results from the medication
D. Assess the client's vital signs - ✔✔C. Explain this results from the medication
This is not hemorrhaging, and the client should be reassured that this is a side effect of
the medication
✔✔With peripheral arterial disease, leg pain during rest can be reduced by:
A. Elevating the limb above heart level
B. Lowering the limb so it is dependent
C. Massaging the limb after application of cold compresses
D. Placing the limb in a plane horizontal to the body - ✔✔B. Lowering the limb so it is
dependent
Lower the legs will help blood flow to the limb by allowing gravity to help. A cold
compress with cause vasoconstriction. Elevating the limb or placing it in a plane
horizontal to the body will further decrease blood flow to the limb.
✔✔A significant cause of venous thrombosis is:
A. Altered blood coagulation
B. Stasis of blood
C. Vessel wall injury