ADULT HEALTH NR 325 ACTUAL PAPER
2026 QUESTIONS WITH SOLUTIONS
GRADED A+
◉1. The nurse is performing an assessment of an 80-year-old
patient. Which information obtained by the nurse will be of most
concern?
a. Decreased appetite
b. Difficulty chewing food
c. Unintentional weight loss
d. Complaints of indigestion. Answer: ANS: C
Unintentional weight loss is not a normal finding in older patients
and may indicate a problem such as cancer or depression. Poor
appetite, difficulty in chewing, and complaints of indigestion are
common in older patients. These will need to be addressed, but are
not of as much concern as the weight loss
◉2. To promote bowel evacuation in a patient with chronic
complaints of constipation, the nurse will suggest that the patient
should attempt defecation
a. in the mid-afternoon.
b. after eating breakfast.
,c. right after getting up in the morning.
d. immediately before the first daily meal.. Answer: ANS: B
These reflexes are most active after the first daily meal. Arising in
the morning, the anticipation of eating, and physical exercise do not
stimulate these reflexes.
◉3. When a patient has a history of a total gastrectomy, the nurse
will monitor for clinical manifestations of
a. constipation.
b. dehydration.
c. elevated total cholesterol.
d. cobalamin (vitamin B12) deficiency.. Answer: ANS: D
The patient with a total gastrectomy does not secrete intrinsic factor,
which is needed for cobalamin (vitamin B12) absorption. Because
the stomach absorbs only small amounts of water and nutrients, the
patient is not at higher risk for dehydration, elevated cholesterol, or
constipation.
◉4. The nurse will monitor a patient who has an obstruction of the
common bile duct for
a. melena.
b. steatorrhea.
c. decreased serum cholesterol levels.
d. increased serum indirect bilirubin levels.. Answer: ANS: B
,A common bile duct obstruction will reduce the absorption of fat in
the small intestine, leading to fatty stools. Gastrointestinal (GI)
bleeding is not caused by common bile duct obstruction. Serum
cholesterol levels are increased with biliary obstruction. Direct
bilirubin level is increased with biliary obstruction.
◉5. During change-of-shift report, the nurse receives the following
information about a patient who is scheduled for a colonoscopy.
Which information should be communicated to the health care
provider before sending the patient for the procedure?
a. The patient has a permanent pacemaker to prevent bradycardia.
b. The patient is worried about discomfort during the examination.
c. The patient has had an allergic reaction to shellfish and iodine in
the past.
d. The patient refused to drink the ordered polyethylene glycol
(GoLYTELY).. Answer: ANS: D
If the patient has had inadequate bowel preparation, the colon
cannot be visualized and the procedure should be rescheduled.
Because contrast solution is not used during colonoscopy, the iodine
allergy is not pertinent. A pacemaker is a contraindication to
magnetic resonance imaging (MRI), but not to colonoscopy. The
nurse should instruct the patient about the sedation used during the
examination to decrease the patient's anxiety about discomfort.
, ◉6. When the nurse is obtaining a history from a patient who is
admitted with jaundice, which statement is most indicative of a need
for patient teaching?
a. "I used cough syrup several times a day last week."
b. "I take a baby aspirin every day to prevent strokes."
c. "I need to take an antacid for indigestion several times a week"
d. "I use acetaminophen (Tylenol) every 4 hours for chronic pain.".
Answer: ANS: D
Chronic use of high doses of acetaminophen can be hepatotoxic and
may have caused the patient's jaundice. The other patient
statements require further assessment by the nurse, but do not
indicate a need for patient education.
◉7. To palpate the liver, the nurse
a. places one hand on the patient's back and presses upward and
inward with the other hand below the patient's right costal margin.
b. places one hand on top of the other and uses the upper fingers to
apply pressure and the bottom fingers to feel for the liver edge.
c. presses slowly and firmly over the right costal margin with one
hand and withdraws the fingers quickly after the liver edge is felt.
d. places one hand under the patient's lower ribs and presses the left
lower rib cage forward, palpating below the costal margin with the
other hand.. Answer: ANS: A
The liver is normally not palpable below the costal margin, the nurse
needs to push inward below the right costal margin while lifting the
2026 QUESTIONS WITH SOLUTIONS
GRADED A+
◉1. The nurse is performing an assessment of an 80-year-old
patient. Which information obtained by the nurse will be of most
concern?
a. Decreased appetite
b. Difficulty chewing food
c. Unintentional weight loss
d. Complaints of indigestion. Answer: ANS: C
Unintentional weight loss is not a normal finding in older patients
and may indicate a problem such as cancer or depression. Poor
appetite, difficulty in chewing, and complaints of indigestion are
common in older patients. These will need to be addressed, but are
not of as much concern as the weight loss
◉2. To promote bowel evacuation in a patient with chronic
complaints of constipation, the nurse will suggest that the patient
should attempt defecation
a. in the mid-afternoon.
b. after eating breakfast.
,c. right after getting up in the morning.
d. immediately before the first daily meal.. Answer: ANS: B
These reflexes are most active after the first daily meal. Arising in
the morning, the anticipation of eating, and physical exercise do not
stimulate these reflexes.
◉3. When a patient has a history of a total gastrectomy, the nurse
will monitor for clinical manifestations of
a. constipation.
b. dehydration.
c. elevated total cholesterol.
d. cobalamin (vitamin B12) deficiency.. Answer: ANS: D
The patient with a total gastrectomy does not secrete intrinsic factor,
which is needed for cobalamin (vitamin B12) absorption. Because
the stomach absorbs only small amounts of water and nutrients, the
patient is not at higher risk for dehydration, elevated cholesterol, or
constipation.
◉4. The nurse will monitor a patient who has an obstruction of the
common bile duct for
a. melena.
b. steatorrhea.
c. decreased serum cholesterol levels.
d. increased serum indirect bilirubin levels.. Answer: ANS: B
,A common bile duct obstruction will reduce the absorption of fat in
the small intestine, leading to fatty stools. Gastrointestinal (GI)
bleeding is not caused by common bile duct obstruction. Serum
cholesterol levels are increased with biliary obstruction. Direct
bilirubin level is increased with biliary obstruction.
◉5. During change-of-shift report, the nurse receives the following
information about a patient who is scheduled for a colonoscopy.
Which information should be communicated to the health care
provider before sending the patient for the procedure?
a. The patient has a permanent pacemaker to prevent bradycardia.
b. The patient is worried about discomfort during the examination.
c. The patient has had an allergic reaction to shellfish and iodine in
the past.
d. The patient refused to drink the ordered polyethylene glycol
(GoLYTELY).. Answer: ANS: D
If the patient has had inadequate bowel preparation, the colon
cannot be visualized and the procedure should be rescheduled.
Because contrast solution is not used during colonoscopy, the iodine
allergy is not pertinent. A pacemaker is a contraindication to
magnetic resonance imaging (MRI), but not to colonoscopy. The
nurse should instruct the patient about the sedation used during the
examination to decrease the patient's anxiety about discomfort.
, ◉6. When the nurse is obtaining a history from a patient who is
admitted with jaundice, which statement is most indicative of a need
for patient teaching?
a. "I used cough syrup several times a day last week."
b. "I take a baby aspirin every day to prevent strokes."
c. "I need to take an antacid for indigestion several times a week"
d. "I use acetaminophen (Tylenol) every 4 hours for chronic pain.".
Answer: ANS: D
Chronic use of high doses of acetaminophen can be hepatotoxic and
may have caused the patient's jaundice. The other patient
statements require further assessment by the nurse, but do not
indicate a need for patient education.
◉7. To palpate the liver, the nurse
a. places one hand on the patient's back and presses upward and
inward with the other hand below the patient's right costal margin.
b. places one hand on top of the other and uses the upper fingers to
apply pressure and the bottom fingers to feel for the liver edge.
c. presses slowly and firmly over the right costal margin with one
hand and withdraws the fingers quickly after the liver edge is felt.
d. places one hand under the patient's lower ribs and presses the left
lower rib cage forward, palpating below the costal margin with the
other hand.. Answer: ANS: A
The liver is normally not palpable below the costal margin, the nurse
needs to push inward below the right costal margin while lifting the
