NUR215 EXAM QUESTIONS AND ANSWERS A+ GRADED
ANS: C
Unintentional weight loss is not a normal finding and may indicate a problem
such as cancer or depression. Poor appetite, difficulty in chewing, and
indigestion are common in older patients. These will need to be addressed but
are not of as much concern as the weight loss.
Which information about an 80-yr-old male patient at the senior center is of most
concern to the nurse?
a. Decreased appetite
b. Occasional indigestion
c. Unintended weight loss
d. Difficulty chewing food
ANS: B
The gastrocolic reflex is most active after the first daily meal. Awakening, the
anticipation of eating, and mid-afternoon timing do not stimulate these reflexes.
An older patient reports chronic constipation. To promote bowel evacuation, when
should the nurse suggest that the patient attempt defecation?
a. In the mid-afternoon
b. After eating breakfast
c. Right after awakening in the morning
d. Immediately before the daily meal.
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.
What condition should the nurse anticipate when caring for a patient with a history of a
total gastrectomy?
a. Constipation
b. Dehydration
c. Elevated total serum cholesterol
d. Cobalamin (vitamin B12) deficiency
ANS: B
A common bile duct obstruction will reduce the absorption of fat in the small
intestine, leading to fatty stools. Gastrointestinal 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.
The nurse is caring for a patient with an obstructed common bile duct. What condition
should the nurse expect?
a. Melena
b. Steatorrhea
c. Decreased serum cholesterol level
d. Increased serum indirect bilirubin level
, ANS: A
If the patient has had inadequate bowel preparation, the colon cannot be
visualized and the procedure would 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 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.
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 declined to drink the prescribed laxative solution.
b. The patient has had an allergic reaction to shellfish and iodine.
c. The patient has a permanent pacemaker to prevent bradycardia.
d. The patient is worried about discomfort during the examination.
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.
Which statement to the nurse from a patient with jaundice indicates a need for
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 take an antacid for indigestion several times a week"
d. "I use acetaminophen (Tylenol) every 4 hours for pain."
ANS: B
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.
Which is the correct technique for the nurse to palpate the liver during a head-to-toe
physical assessment?
a. Place one hand on top of the other and use the upper fingers to apply pressure and
the bottom fingers to feel for the liver edge
b. Place one hand on the patient's back and press upward and inward with the other
hand below the patient's right costal margin.
c. Press slowly and firmly over the right costal margin with one hand and withdraw
the fingers quickly after the liver edge is felt.
d. Place one hand under the patient's lower ribs and press the left lower rib cage
forward, palpating below the costal margin with the other hand.
ANS: C
Absent bowel sounds are abnormal and require further assessment by the nurse.
The other sounds may be heard normally.
Which finding by the nurse during abdominal auscultation indicates a need for a focused
abdominal assessment?
ANS: C
Unintentional weight loss is not a normal finding and may indicate a problem
such as cancer or depression. Poor appetite, difficulty in chewing, and
indigestion are common in older patients. These will need to be addressed but
are not of as much concern as the weight loss.
Which information about an 80-yr-old male patient at the senior center is of most
concern to the nurse?
a. Decreased appetite
b. Occasional indigestion
c. Unintended weight loss
d. Difficulty chewing food
ANS: B
The gastrocolic reflex is most active after the first daily meal. Awakening, the
anticipation of eating, and mid-afternoon timing do not stimulate these reflexes.
An older patient reports chronic constipation. To promote bowel evacuation, when
should the nurse suggest that the patient attempt defecation?
a. In the mid-afternoon
b. After eating breakfast
c. Right after awakening in the morning
d. Immediately before the daily meal.
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.
What condition should the nurse anticipate when caring for a patient with a history of a
total gastrectomy?
a. Constipation
b. Dehydration
c. Elevated total serum cholesterol
d. Cobalamin (vitamin B12) deficiency
ANS: B
A common bile duct obstruction will reduce the absorption of fat in the small
intestine, leading to fatty stools. Gastrointestinal 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.
The nurse is caring for a patient with an obstructed common bile duct. What condition
should the nurse expect?
a. Melena
b. Steatorrhea
c. Decreased serum cholesterol level
d. Increased serum indirect bilirubin level
, ANS: A
If the patient has had inadequate bowel preparation, the colon cannot be
visualized and the procedure would 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 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.
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 declined to drink the prescribed laxative solution.
b. The patient has had an allergic reaction to shellfish and iodine.
c. The patient has a permanent pacemaker to prevent bradycardia.
d. The patient is worried about discomfort during the examination.
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.
Which statement to the nurse from a patient with jaundice indicates a need for
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 take an antacid for indigestion several times a week"
d. "I use acetaminophen (Tylenol) every 4 hours for pain."
ANS: B
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.
Which is the correct technique for the nurse to palpate the liver during a head-to-toe
physical assessment?
a. Place one hand on top of the other and use the upper fingers to apply pressure and
the bottom fingers to feel for the liver edge
b. Place one hand on the patient's back and press upward and inward with the other
hand below the patient's right costal margin.
c. Press slowly and firmly over the right costal margin with one hand and withdraw
the fingers quickly after the liver edge is felt.
d. Place one hand under the patient's lower ribs and press the left lower rib cage
forward, palpating below the costal margin with the other hand.
ANS: C
Absent bowel sounds are abnormal and require further assessment by the nurse.
The other sounds may be heard normally.
Which finding by the nurse during abdominal auscultation indicates a need for a focused
abdominal assessment?
