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NR 325 STUDY EXAM 3 ADULT HEALTH-
CERTIFIED QUESTIONS AND ANSWERS
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 - correct-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. - correct-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.
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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. - correct-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. - correct-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?
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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). -
correct-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." - correct-
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.
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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. - correct-
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 patient's back slightly
with the left hand. The other methods will not allow palpation of the liver.
8. When the nurse is listening to a patient's abdomen, which finding indicates a
need for a focused abdominal assessment?
a. Loud gurgles
b. High-pitched gurgles
c. Absent bowel sounds
d. Frequent clicking sounds - correct-answer -ANS: C
Absent bowel sounds are abnormal and require further assessment by the nurse.
The other sounds may be heard normally.
9. When caring for a patient following a needle biopsy of the liver at the bedside,
the nurse should
a. put pressure on the biopsy site using a sandbag.
b. elevate the head of the bed to facilitate breathing.
c. place the patient on the right side with the bed flat.
NR 325 STUDY EXAM 3 ADULT HEALTH-
CERTIFIED QUESTIONS AND ANSWERS
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 - correct-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. - correct-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.
,2|Page
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. - correct-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. - correct-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?
,3|Page
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). -
correct-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." - correct-
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.
, 4|Page
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. - correct-
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 patient's back slightly
with the left hand. The other methods will not allow palpation of the liver.
8. When the nurse is listening to a patient's abdomen, which finding indicates a
need for a focused abdominal assessment?
a. Loud gurgles
b. High-pitched gurgles
c. Absent bowel sounds
d. Frequent clicking sounds - correct-answer -ANS: C
Absent bowel sounds are abnormal and require further assessment by the nurse.
The other sounds may be heard normally.
9. When caring for a patient following a needle biopsy of the liver at the bedside,
the nurse should
a. put pressure on the biopsy site using a sandbag.
b. elevate the head of the bed to facilitate breathing.
c. place the patient on the right side with the bed flat.
