NURS 498 Final Exam with complete
solutions graded A
After the nurse has completed teaching a client with newly diagnosed celiac disease, which of the
following breakfast choices by the client indicates good understanding of the information?
a. Corn tortilla with eggs
b. Bagel with cream cheese
c. Oatmeal with non-fat milk
d. Whole wheat toast with butter - correct answera. corn tortilla with eggs
A client with ulcerative colitis who is taking azathioprine calls the nurse in the outpatient clinic about all
of these symptoms. Which of the following symptoms is most important to communicate to the health
care provider?
a. Elevated temperature
b. Joint pain
c. Frequent headaches
d. Nausea - correct answera. elevated temperature
A nurse is developing a care plan for a client with hepatic encephalopathy. Which are the goals for the
care for this client? Select all that apply.
a. provide food and fluids high in carbohydrates
b. encourage physical activity
c. prevent constipation
d. administer lactulose to reduce blood ammonia levels
f. check the pupil reaction
g. monitor coordination while walking - correct answera. provide food and fluids high in carbohydrates
c. prevent constipation
d. administer lactulose to reduce blood ammonia levels
f. check the pupil reaction
g. monitor coordination while walking
,NURS 498 Final Exam with complete
solutions graded A
The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease about
dietary measures to implement during exacerbation episodes. Which statement made by the client
indicates a need for further instruction?
a. "I can have exacerbations and remissions with Crohn's disease."
b. "I'm going to learn some stress reduction techniques."
c. "I will need to avoid caffeinated beverages."
d. "I should increase the fibre in my diet." - correct answerd. "I should increase the fibre in my diet."
The nurse is providing discharge teaching to a client following gastrectomy and should instruct the client
to take which measures to assist in preventing dumping syndrome?
a. limit the fluid taken with meals
b. sit in a high-fowlers position during meals.
c. ambulate following a meal
d. eat high-carbohydrate foods - correct answera. limit the fluid taken with meals
The nurse is caring for a client following a gastrojejunostomy (Billroth II procedure). Which post-
operative prescription should the nurse question and verify?
a. leg exercises
b. early ambulation
c. irrigating the nasogastric tube
d. deep breathing and coughing exercises - correct answerc. irrigating the nasogastric tube
The nurse is caring for a client who returns to the surgical nursing unit following a vertical banded
gastroplasty with a nasogastric tube to low, intermittent suction and a patient-controlled analgesia
(PCA) machine for pain control. Which of the following nursing actions should be included in the
postoperative plan of care?
a. Support the surgical incision during client coughing and turning in bed.
b. Irrigate the nasogastric (NG) tube frequently with normal saline.
c. Offer sips of sweetened liquids at frequent intervals.
, NURS 498 Final Exam with complete
solutions graded A
d. Remind the client that PCA use may slow the return of bowel function. - correct answera. Support the
surgical incision during client coughing and turning in bed.
A client with a gunshot wound to the abdomen undergoes surgery, and a colostomy is formed as
illustrated. Which of the following information should the nurse include in client teaching?
a. Soft, formed stool can be expected as drainage.
b. Stool will be expelled from both ostomy stomas.
c. This type of colostomy is usually temporary.
d. Irrigations can regulate drainage from the stomas. - correct answerc. This type of colostomy is usually
temporary.
A client with cirrhosis is receiving lactulose. The nurse notes the client is more confused and has
asterixis. The nurse should:
a. assess for gastrointestinal bleeding
b. increase protein in the diet
c. monitor serum bilirubin levels
d. withhold the lactulose - correct answera. assess for gastrointestinal bleeding
A few months after bariatric surgery, an older-adult client tells the nurse, "My skin is hanging in folds. I
think I need cosmetic surgery." Which of the following responses by the nurse is best?
a. "The important thing is that your weight loss is improving your health."
b. "The skin folds will gradually disappear once most of the weight is lost."
c. "Perhaps you would like to talk to a counsellor about your body image."
d. "Cosmetic surgery is certainly a possibility once your weight has stabilized." - correct answerd.
"Cosmetic surgery is certainly a possibility once your weight has stabilized."
The nurse is assessing a patient who has experienced severe neutropenia after chemotherapy and will
monitor for which possible signs of infection? (Select all that apply.)
a. elevated WBC count
b. chills
solutions graded A
After the nurse has completed teaching a client with newly diagnosed celiac disease, which of the
following breakfast choices by the client indicates good understanding of the information?
a. Corn tortilla with eggs
b. Bagel with cream cheese
c. Oatmeal with non-fat milk
d. Whole wheat toast with butter - correct answera. corn tortilla with eggs
A client with ulcerative colitis who is taking azathioprine calls the nurse in the outpatient clinic about all
of these symptoms. Which of the following symptoms is most important to communicate to the health
care provider?
a. Elevated temperature
b. Joint pain
c. Frequent headaches
d. Nausea - correct answera. elevated temperature
A nurse is developing a care plan for a client with hepatic encephalopathy. Which are the goals for the
care for this client? Select all that apply.
a. provide food and fluids high in carbohydrates
b. encourage physical activity
c. prevent constipation
d. administer lactulose to reduce blood ammonia levels
f. check the pupil reaction
g. monitor coordination while walking - correct answera. provide food and fluids high in carbohydrates
c. prevent constipation
d. administer lactulose to reduce blood ammonia levels
f. check the pupil reaction
g. monitor coordination while walking
,NURS 498 Final Exam with complete
solutions graded A
The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease about
dietary measures to implement during exacerbation episodes. Which statement made by the client
indicates a need for further instruction?
a. "I can have exacerbations and remissions with Crohn's disease."
b. "I'm going to learn some stress reduction techniques."
c. "I will need to avoid caffeinated beverages."
d. "I should increase the fibre in my diet." - correct answerd. "I should increase the fibre in my diet."
The nurse is providing discharge teaching to a client following gastrectomy and should instruct the client
to take which measures to assist in preventing dumping syndrome?
a. limit the fluid taken with meals
b. sit in a high-fowlers position during meals.
c. ambulate following a meal
d. eat high-carbohydrate foods - correct answera. limit the fluid taken with meals
The nurse is caring for a client following a gastrojejunostomy (Billroth II procedure). Which post-
operative prescription should the nurse question and verify?
a. leg exercises
b. early ambulation
c. irrigating the nasogastric tube
d. deep breathing and coughing exercises - correct answerc. irrigating the nasogastric tube
The nurse is caring for a client who returns to the surgical nursing unit following a vertical banded
gastroplasty with a nasogastric tube to low, intermittent suction and a patient-controlled analgesia
(PCA) machine for pain control. Which of the following nursing actions should be included in the
postoperative plan of care?
a. Support the surgical incision during client coughing and turning in bed.
b. Irrigate the nasogastric (NG) tube frequently with normal saline.
c. Offer sips of sweetened liquids at frequent intervals.
, NURS 498 Final Exam with complete
solutions graded A
d. Remind the client that PCA use may slow the return of bowel function. - correct answera. Support the
surgical incision during client coughing and turning in bed.
A client with a gunshot wound to the abdomen undergoes surgery, and a colostomy is formed as
illustrated. Which of the following information should the nurse include in client teaching?
a. Soft, formed stool can be expected as drainage.
b. Stool will be expelled from both ostomy stomas.
c. This type of colostomy is usually temporary.
d. Irrigations can regulate drainage from the stomas. - correct answerc. This type of colostomy is usually
temporary.
A client with cirrhosis is receiving lactulose. The nurse notes the client is more confused and has
asterixis. The nurse should:
a. assess for gastrointestinal bleeding
b. increase protein in the diet
c. monitor serum bilirubin levels
d. withhold the lactulose - correct answera. assess for gastrointestinal bleeding
A few months after bariatric surgery, an older-adult client tells the nurse, "My skin is hanging in folds. I
think I need cosmetic surgery." Which of the following responses by the nurse is best?
a. "The important thing is that your weight loss is improving your health."
b. "The skin folds will gradually disappear once most of the weight is lost."
c. "Perhaps you would like to talk to a counsellor about your body image."
d. "Cosmetic surgery is certainly a possibility once your weight has stabilized." - correct answerd.
"Cosmetic surgery is certainly a possibility once your weight has stabilized."
The nurse is assessing a patient who has experienced severe neutropenia after chemotherapy and will
monitor for which possible signs of infection? (Select all that apply.)
a. elevated WBC count
b. chills
