NR 325 EXAM CONTAINING CHAPTER 39:
GASTROINTESTINAL SYSTEM PRACICE
QUESTIONS WITH VERIFIED SOLUTIONS BEST
GRADED EXAM NEW MODIFIED GRADED A+
1. 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.
2. 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.
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,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.
3. 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.
4. 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.
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,d. check the patient's postbiopsy coagulation studies. --CORRECT ANSWER--
ANS: C
After a biopsy, the patient lies on the right side with the bed flat to splint the
biopsy site. Coagulation studies are checked before the biopsy. A sandbag does
not exert adequate pressure to splint the site.
5. Which information obtained by the nurse when admitting a patient who is
scheduled for an ultrasound of the gallbladder indicates that the ultrasound may
need to be rescheduled?
a. The patient has a permanent gastrostomy tube.
b. The patient took a laxative the previous evening.
c. The patient ate a low-fat bagel an hour previously.
d. The patient had a high-fat meal the previous evening. --CORRECT
ANSWER--ANS: C
Food intake can cause the gallbladder to contract and result in a suboptimal
study. The patient should be NPO for 8 to 12 hours before the test. A high-fat
meal the previous evening, laxative use, or a gastrostomy tube will not affect
the results of the study.
6. When the nurse is assessing an alert and independent older patient in the
clinic for malnutrition risk, the most appropriate initial question is,
a. "How do you get to the grocery store to buy your food?"
b. "Do you have any difficulty in preparing or eating food?"
c. "Can you tell me the foods that you have eaten over the past 24 hours?"
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, d. "Are you taking any medications that alter your taste or tolerance of foods?" -
-CORRECT ANSWER--ANS: C
This question is the most open-ended and will provide the best overall
information about the patient's daily intake and risk for poor nutrition. The other
questions may be asked, depending on the patient's response to the first
question.
7. 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
8. 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
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GASTROINTESTINAL SYSTEM PRACICE
QUESTIONS WITH VERIFIED SOLUTIONS BEST
GRADED EXAM NEW MODIFIED GRADED A+
1. 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.
2. 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.
Page 1 of 100
,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.
3. 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.
4. 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.
Page 2 of 100
,d. check the patient's postbiopsy coagulation studies. --CORRECT ANSWER--
ANS: C
After a biopsy, the patient lies on the right side with the bed flat to splint the
biopsy site. Coagulation studies are checked before the biopsy. A sandbag does
not exert adequate pressure to splint the site.
5. Which information obtained by the nurse when admitting a patient who is
scheduled for an ultrasound of the gallbladder indicates that the ultrasound may
need to be rescheduled?
a. The patient has a permanent gastrostomy tube.
b. The patient took a laxative the previous evening.
c. The patient ate a low-fat bagel an hour previously.
d. The patient had a high-fat meal the previous evening. --CORRECT
ANSWER--ANS: C
Food intake can cause the gallbladder to contract and result in a suboptimal
study. The patient should be NPO for 8 to 12 hours before the test. A high-fat
meal the previous evening, laxative use, or a gastrostomy tube will not affect
the results of the study.
6. When the nurse is assessing an alert and independent older patient in the
clinic for malnutrition risk, the most appropriate initial question is,
a. "How do you get to the grocery store to buy your food?"
b. "Do you have any difficulty in preparing or eating food?"
c. "Can you tell me the foods that you have eaten over the past 24 hours?"
Page 3 of 100
, d. "Are you taking any medications that alter your taste or tolerance of foods?" -
-CORRECT ANSWER--ANS: C
This question is the most open-ended and will provide the best overall
information about the patient's daily intake and risk for poor nutrition. The other
questions may be asked, depending on the patient's response to the first
question.
7. 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
8. 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
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