Adequate nutrition is required for healing after treatment for recurrent aphtous ulcers (RAU). Which client
response indicates that nursing teaching has been effective?
A. “I've ordered a snack of milk and pretzels.”
B. “I‘ll try to drink orange juice twice per day.”
C. “I ordered my sandwich on a crusty roll.”
D. “I'd like scrambled eggs and a banana for breakfast
The nurse is caring for four clients. Which is at the highest risk for development of oral cancer?
A. 32-year-old client with ankle fracture
B. 41-year-old with human papilloma virus (HPV) infection
C. 60-year-old who quit smoking 20 years ago
D. 83-year-old who lives in a warm climate during the winter
A client with a bleeding peptic ulcer develops sudden, severe upper abdominal pain, becomes diaphoretic and
draws his knees over his abdomen. Which finding should the nurse report immediately?
A. Increased amylase levels.
B. A rigid, board-like abdomen.
C. Vomiting tar like feces.
D. Bowel sounds increased in frequency and pitch.
A client with peptic ulcer disease has a nasogastric tube. Suddenly he complains of severe abdominal pain and
the nurse notes that his abdomen is rigid. What action should be implemented first?
Administer the next scheduled dose of intravenous H2 blocker
Assess the client’s vital signs.
Irrigate the nasogastric tube with normal saline
Administer a prescribed PRN antacid
A 68-year-old male has been admitted to the hospital with abdominal pain, anemia and melena. He complains
of feeling weak and dizzy. He needs to urinate and move his bowels. The nurse should intervene by:
A. Helping him to the bed side commode
B. Offering him the bedpan and the urinal
C. Transferring him to BR in a wheelchair
D. Asking a male UAP to transfer him to BR for privacy
The healthcare provider prescribes high-protein, high-fat, low-carbohydrate diet with limited fluids during
meals for a client recovering from gastric surgery. The client asks the nurse what the purpose is for this type of
diet. Which rationale should be included in the nurse's explanation to this client?
A. It is quickly digested.
B. It does not cause diarrhea.
C. It does not dilate the stomach.
D. It is slow to leave the stomach.
A stressed client, who smokes 13 cigarettes/day, consumes fast-food, and is a strong drinker of coffee, is
consulting to the healthcare facility for heartburn, specially after ingesting spicy food. The triage nurse should
recommend:
Avoid spicy food and increase consume of dairy
Consume Decaf instead of regular coffee
Schedule an appointment for a physical
Use over the count omeprazole every day until relief of symptoms
The nurse notices that a patient has had a black, tarry stool and recalls that a possible cause would be:
a. gallbladder disease.
b. overuse of laxatives.
c. upper gastrointestinal bleeding.
d. localized bleeding around the anus
,In a paracentesis 3 liters of fluid are removed. Which assessment parameter is most critical for the nurse to
monitor following the procedure?
A. Pedal pulses.
B. Breath sounds.
C. Gag reflex.
D. Blood pressure.
What finding is a priority in a patient with peptic ulcer disease (PUD)?
Tarry stools 3 times during the day
Dizziness when sitting in bed
Epigastric pain 2 hours after meals
Loss of 10 pounds of weight since the last month
The nurse is teaching a client with advanced COPD who was prescribed theophylline. Which client statement
indicates that additional teaching is required?
I need to avoid caffeinated products
I need to get my blood drug levels checked periodically
I need to report anorexia and sleeplessness
I take cimetidine for my heartburn
After a subtotal gastrectomy, care of the client’s nasogastric tube and drainage system should include which of
the following nursing interventions?
Irrigate the tube with 30 ml of sterile water every hour, if needed.
Reposition the tube if it is not draining well
Monitor the client for nausea or vomits
Turn the machine to high suction of the drainage is sluggish on low suction.
A client is to take one daily dose of ranitidine (Zantac) at home to treat her peptic ulcer. The nurse knows that
the client understands proper drug administration of ranitidine when she says that she will take the drug at
which of the following times?
Before meals
With meals
At bedtime
When pain occurs
A client has been on long-term therapy with esomeprazole. What is essential for the nurse to ask the client?
Are you drinking plenty of water with the medication?
Are you taking the medication after meals?
Have you had a bone density test recently?
Have you had your blood pressure taken regularly?
The nurse is preparing a client diagnosed with peptic ulcer disease for a barium study of the stomach and
esophagus. Which nursing intervention is the priority for this client?
1. Obtain informed consent from the client for the diagnostic procedure.
2. Discuss the need to increase oral fluid intake after the procedure.
3. Explain to the client that he or she will have to drink a white, chalky substance.
4. Tell the client not to eat or drink anything prior to the procedure
At 0830, the day shift nurse is preparing to administer medications to the client NPO for an endoscopy. Which
medication should the nurse question administering?
1. Digoxin 0.125 mg PO every day.
2. Furosemide 40 mg PO bid.
3. Ranitidine 150 mg in 250 mL NS IV continuous infusion every 24 hours.
4. Vancomycin 850 mg IVPB every 24 hours.
5. Mylanta 30 mL PO PRN heartburn.
,The client is diagnosed with esophageal bleeding. Which of the following assessment data warrants immediate
intervention by the nurse?
1. The client’s hemoglobin/hematocrit is 11.4/32.
2. The client’s abdomen is soft to touch and non-tender.
3. The client’s vital signs are T 99, AP 114, RR 18, B/P 88/60.
4. The client’s nasogastric tube has coffee ground drainage.
The client 2 days postoperative from a laparoscopic cholecystectomy tells the office nurse, “My right shoulder
hurts so bad I can’t stand it.” Which statement is the
nurse’s best response?
1. “This is a result of the carbon dioxide gas used in surgery.”
2. “Call 911 and go to the emergency department immediately.”
3. “Increase the pain medication the surgeon ordered.”
4. “You need to ambulate in the hall to walk off the gas pains.”
The male client is 30 minutes post-procedure liver biopsy. Which action by the unlicensed assistive personnel
(UAP) requires the nurse to intervene?
1. The UAP offered the client a urinal to void.
2. The UAP gave the client a glass of water.
3. The UAP turned the client on the left side.
4. The UAP took the client’s vital signs.
After teaching a client with irritable bowel syndrome (IBS), a nurse assesses the client’s understanding. Which
menu selection indicates that the client correctly understands the dietary teaching?
a. Ham sandwich on white bread, cup of applesauce, glass of diet cola
b. Baked tilapia with brown rice, steamed broccoli, glass of orange juice
c. Grilled cheese sandwich, small banana, cup of hot tea with lemon
d. Broiled chicken, mashed potatoes, cup of coffee with low-fat milk
The emergency department nurse is assessing a client with a known inguinal hernia. Which assessment findings
indicate that the hernia may have strangulated? Select all that apply.
A. Fever
B. Tachycardia
C. Abdominal distention
D. Mild abdominal pain
E. Nausea and vomiting
The nurse is preparing a discharge teaching plan for the client who had an umbilical hernia repair. Which of the
following would the nurse include in the plan?
1. Restricting pain medication
2. Maintaining bedrest
3. Avoiding coughing
4. Irrigating the drain
The community nurse is talking with a group of individuals about colorectal cancer (CRC) risk factors. Which
community participant is at the highest risk for development of CRC?
A. 43-year-old lacto-vegetarian
B. 30-year-old with Crohn's disease
C. 69-year-old with no family history of cancer
D. 46-year-old with grand parent who died of CRC
Three days after a colon resection, the nurse is assessing a client with a nasogastric tube (NGT) to intermittent
suction. What assessment is the best to determine proper placement of the NGT?
A. Auscultate epigastric sounds while insufflating air through NGT.
B. Percuss abdomen for stomach distention.
, C. Check residual and test the pH.
D. Review the X-ray report done when NGT was inserted.
The nurse administers a tube feeding to a patient with a baseline decreased mental status. Immediately after
completing the tube feeding, it is MOST important for the nurse to place the client in which of the following
positions?
Supine with the lower extremities elevated on pillows.
High Fowler’s or semi-Fowler’s position.
Supine with the head of the bed elevated 45°.
On the right side with the head of the bed elevated.
A male client who had abdominal surgery has a nasogastric tube to suction, oxygen per nasal cannula, and
complains of dry mouth. Which action should the nurse implement?
A. Put petroleum jelly on the lips and around the nasogastric tube.
B. Allow the client to drink water and record on the I and O record.
C. Offer the client ice chips and instruct client to spit out the water.
D. Apply a water soluble lubricant to the lips, oral mucosa and nares.
The nurse is providing preoperative teaching to a patient who will undergo surgery to create a temporary
colostomy. The patient asks the nurse about the difference between colostomies and ileostomies. The best
response by the nurse is:
A. “A colostomy occurs in the GI tract, and an ileostomy occurs in the urinary tract.”
B. “A colostomy is temporary, and an ileostomy is always permanent.”
C. “A colostomy is in the large intestine, and an ileostomy is in the small intestine.”
D. “Dietary restrictions are required for the patient with an ileostomy but not a colostomy.”
The nurse working in the emergency department realizes that which of the following patients with acute
abdominal pain is most likely to have acute appendicitis?
A. an 8-month-old female
B. a 14-year-old male
C. an 85-year-old woman
D. a 70-year-old male
Assessment of the patient’s gag response is a priority nursing intervention following which of the following
procedures?
A. colon biopsy
B. small bowel biopsy
C. barium enema
D. colonoscopy
The nurse intends to participate in a health screening clinic and is preparing teaching materials about colorectal
cancer. The nurse should plan to include
which of the following in a list of risk factors for colorectal cancer?
A. age older than 30 years
B. high fiber, low fat diet
C. distant relative with colorectal cancer
D. personal history of GI polyps
The nurse understands that which of the following is a viral pathogen that frequently causes acute diarrhea in
young children?
A. giardia
B. shigella
C. rotavirus
D. salmonella
The nurse knows that acute diarrhea in children is often caused by which of
response indicates that nursing teaching has been effective?
A. “I've ordered a snack of milk and pretzels.”
B. “I‘ll try to drink orange juice twice per day.”
C. “I ordered my sandwich on a crusty roll.”
D. “I'd like scrambled eggs and a banana for breakfast
The nurse is caring for four clients. Which is at the highest risk for development of oral cancer?
A. 32-year-old client with ankle fracture
B. 41-year-old with human papilloma virus (HPV) infection
C. 60-year-old who quit smoking 20 years ago
D. 83-year-old who lives in a warm climate during the winter
A client with a bleeding peptic ulcer develops sudden, severe upper abdominal pain, becomes diaphoretic and
draws his knees over his abdomen. Which finding should the nurse report immediately?
A. Increased amylase levels.
B. A rigid, board-like abdomen.
C. Vomiting tar like feces.
D. Bowel sounds increased in frequency and pitch.
A client with peptic ulcer disease has a nasogastric tube. Suddenly he complains of severe abdominal pain and
the nurse notes that his abdomen is rigid. What action should be implemented first?
Administer the next scheduled dose of intravenous H2 blocker
Assess the client’s vital signs.
Irrigate the nasogastric tube with normal saline
Administer a prescribed PRN antacid
A 68-year-old male has been admitted to the hospital with abdominal pain, anemia and melena. He complains
of feeling weak and dizzy. He needs to urinate and move his bowels. The nurse should intervene by:
A. Helping him to the bed side commode
B. Offering him the bedpan and the urinal
C. Transferring him to BR in a wheelchair
D. Asking a male UAP to transfer him to BR for privacy
The healthcare provider prescribes high-protein, high-fat, low-carbohydrate diet with limited fluids during
meals for a client recovering from gastric surgery. The client asks the nurse what the purpose is for this type of
diet. Which rationale should be included in the nurse's explanation to this client?
A. It is quickly digested.
B. It does not cause diarrhea.
C. It does not dilate the stomach.
D. It is slow to leave the stomach.
A stressed client, who smokes 13 cigarettes/day, consumes fast-food, and is a strong drinker of coffee, is
consulting to the healthcare facility for heartburn, specially after ingesting spicy food. The triage nurse should
recommend:
Avoid spicy food and increase consume of dairy
Consume Decaf instead of regular coffee
Schedule an appointment for a physical
Use over the count omeprazole every day until relief of symptoms
The nurse notices that a patient has had a black, tarry stool and recalls that a possible cause would be:
a. gallbladder disease.
b. overuse of laxatives.
c. upper gastrointestinal bleeding.
d. localized bleeding around the anus
,In a paracentesis 3 liters of fluid are removed. Which assessment parameter is most critical for the nurse to
monitor following the procedure?
A. Pedal pulses.
B. Breath sounds.
C. Gag reflex.
D. Blood pressure.
What finding is a priority in a patient with peptic ulcer disease (PUD)?
Tarry stools 3 times during the day
Dizziness when sitting in bed
Epigastric pain 2 hours after meals
Loss of 10 pounds of weight since the last month
The nurse is teaching a client with advanced COPD who was prescribed theophylline. Which client statement
indicates that additional teaching is required?
I need to avoid caffeinated products
I need to get my blood drug levels checked periodically
I need to report anorexia and sleeplessness
I take cimetidine for my heartburn
After a subtotal gastrectomy, care of the client’s nasogastric tube and drainage system should include which of
the following nursing interventions?
Irrigate the tube with 30 ml of sterile water every hour, if needed.
Reposition the tube if it is not draining well
Monitor the client for nausea or vomits
Turn the machine to high suction of the drainage is sluggish on low suction.
A client is to take one daily dose of ranitidine (Zantac) at home to treat her peptic ulcer. The nurse knows that
the client understands proper drug administration of ranitidine when she says that she will take the drug at
which of the following times?
Before meals
With meals
At bedtime
When pain occurs
A client has been on long-term therapy with esomeprazole. What is essential for the nurse to ask the client?
Are you drinking plenty of water with the medication?
Are you taking the medication after meals?
Have you had a bone density test recently?
Have you had your blood pressure taken regularly?
The nurse is preparing a client diagnosed with peptic ulcer disease for a barium study of the stomach and
esophagus. Which nursing intervention is the priority for this client?
1. Obtain informed consent from the client for the diagnostic procedure.
2. Discuss the need to increase oral fluid intake after the procedure.
3. Explain to the client that he or she will have to drink a white, chalky substance.
4. Tell the client not to eat or drink anything prior to the procedure
At 0830, the day shift nurse is preparing to administer medications to the client NPO for an endoscopy. Which
medication should the nurse question administering?
1. Digoxin 0.125 mg PO every day.
2. Furosemide 40 mg PO bid.
3. Ranitidine 150 mg in 250 mL NS IV continuous infusion every 24 hours.
4. Vancomycin 850 mg IVPB every 24 hours.
5. Mylanta 30 mL PO PRN heartburn.
,The client is diagnosed with esophageal bleeding. Which of the following assessment data warrants immediate
intervention by the nurse?
1. The client’s hemoglobin/hematocrit is 11.4/32.
2. The client’s abdomen is soft to touch and non-tender.
3. The client’s vital signs are T 99, AP 114, RR 18, B/P 88/60.
4. The client’s nasogastric tube has coffee ground drainage.
The client 2 days postoperative from a laparoscopic cholecystectomy tells the office nurse, “My right shoulder
hurts so bad I can’t stand it.” Which statement is the
nurse’s best response?
1. “This is a result of the carbon dioxide gas used in surgery.”
2. “Call 911 and go to the emergency department immediately.”
3. “Increase the pain medication the surgeon ordered.”
4. “You need to ambulate in the hall to walk off the gas pains.”
The male client is 30 minutes post-procedure liver biopsy. Which action by the unlicensed assistive personnel
(UAP) requires the nurse to intervene?
1. The UAP offered the client a urinal to void.
2. The UAP gave the client a glass of water.
3. The UAP turned the client on the left side.
4. The UAP took the client’s vital signs.
After teaching a client with irritable bowel syndrome (IBS), a nurse assesses the client’s understanding. Which
menu selection indicates that the client correctly understands the dietary teaching?
a. Ham sandwich on white bread, cup of applesauce, glass of diet cola
b. Baked tilapia with brown rice, steamed broccoli, glass of orange juice
c. Grilled cheese sandwich, small banana, cup of hot tea with lemon
d. Broiled chicken, mashed potatoes, cup of coffee with low-fat milk
The emergency department nurse is assessing a client with a known inguinal hernia. Which assessment findings
indicate that the hernia may have strangulated? Select all that apply.
A. Fever
B. Tachycardia
C. Abdominal distention
D. Mild abdominal pain
E. Nausea and vomiting
The nurse is preparing a discharge teaching plan for the client who had an umbilical hernia repair. Which of the
following would the nurse include in the plan?
1. Restricting pain medication
2. Maintaining bedrest
3. Avoiding coughing
4. Irrigating the drain
The community nurse is talking with a group of individuals about colorectal cancer (CRC) risk factors. Which
community participant is at the highest risk for development of CRC?
A. 43-year-old lacto-vegetarian
B. 30-year-old with Crohn's disease
C. 69-year-old with no family history of cancer
D. 46-year-old with grand parent who died of CRC
Three days after a colon resection, the nurse is assessing a client with a nasogastric tube (NGT) to intermittent
suction. What assessment is the best to determine proper placement of the NGT?
A. Auscultate epigastric sounds while insufflating air through NGT.
B. Percuss abdomen for stomach distention.
, C. Check residual and test the pH.
D. Review the X-ray report done when NGT was inserted.
The nurse administers a tube feeding to a patient with a baseline decreased mental status. Immediately after
completing the tube feeding, it is MOST important for the nurse to place the client in which of the following
positions?
Supine with the lower extremities elevated on pillows.
High Fowler’s or semi-Fowler’s position.
Supine with the head of the bed elevated 45°.
On the right side with the head of the bed elevated.
A male client who had abdominal surgery has a nasogastric tube to suction, oxygen per nasal cannula, and
complains of dry mouth. Which action should the nurse implement?
A. Put petroleum jelly on the lips and around the nasogastric tube.
B. Allow the client to drink water and record on the I and O record.
C. Offer the client ice chips and instruct client to spit out the water.
D. Apply a water soluble lubricant to the lips, oral mucosa and nares.
The nurse is providing preoperative teaching to a patient who will undergo surgery to create a temporary
colostomy. The patient asks the nurse about the difference between colostomies and ileostomies. The best
response by the nurse is:
A. “A colostomy occurs in the GI tract, and an ileostomy occurs in the urinary tract.”
B. “A colostomy is temporary, and an ileostomy is always permanent.”
C. “A colostomy is in the large intestine, and an ileostomy is in the small intestine.”
D. “Dietary restrictions are required for the patient with an ileostomy but not a colostomy.”
The nurse working in the emergency department realizes that which of the following patients with acute
abdominal pain is most likely to have acute appendicitis?
A. an 8-month-old female
B. a 14-year-old male
C. an 85-year-old woman
D. a 70-year-old male
Assessment of the patient’s gag response is a priority nursing intervention following which of the following
procedures?
A. colon biopsy
B. small bowel biopsy
C. barium enema
D. colonoscopy
The nurse intends to participate in a health screening clinic and is preparing teaching materials about colorectal
cancer. The nurse should plan to include
which of the following in a list of risk factors for colorectal cancer?
A. age older than 30 years
B. high fiber, low fat diet
C. distant relative with colorectal cancer
D. personal history of GI polyps
The nurse understands that which of the following is a viral pathogen that frequently causes acute diarrhea in
young children?
A. giardia
B. shigella
C. rotavirus
D. salmonella
The nurse knows that acute diarrhea in children is often caused by which of
