Pass point-gastrointestinal NCLEX EXAM REVIEW QUESTIONS AND NSWERS

Pass point-gastrointestinal Question 1 See full question A nurse is caring for a client with gastroenteritis. The nurse administers an as-needed dose of kaolin and pectin mixture as ordered. The nurse should complete which assessment 30 minutes after administering the medication? You Selected: • Perform a pain assessment. Correct response: • Determine if the client has had any more loose stools. Explanation: Question 2 See full question A client has had a nasogastric tube connected to low intermittent suction. The client is at risk for: You Selected: • muscle cramping. Correct response: • muscle cramping. Explanation: Remediation: Question 3 See full question The nurse is developing a plan of care for a client with Crohn’s disease who is receiving total parenteral nutrition (TPN). Which interventions should the nurse include? Select all that apply. You Selected: • Monitor vital signs once a shift. • Weigh the client daily. • Monitor the IV infusion rate hourly. Correct response: • Weigh the client daily.• Monitor the IV infusion rate hourly. • Tape all IV tubing connections securely. Explanation: Remediation: Question 4 See full question A client with peptic ulcer disease is taking ranitidine. What is the expected outcome of this drug? You Selected: • Reduce acid concentration. Correct response: • Limit gastric acid secretion. Explanation: Remediation: Question 5 See full question The nurse develops a plan of care for a client with a t-tube. Which nursing intervention should be included? You Selected: • Inspect skin around the t-tube daily for irritation. Correct response: • Inspect skin around the t-tube daily for irritation. Explanation: Remediation: Question 6 See full question Which expected outcome about nutrition would be appropriate for a client who has had a total gastrectomy for gastric cancer? The client will: You Selected: • learn to self-administer enteral feedings every 4 hours. Correct response: • maintain adequate nutrition through oral or parenteral feedings. Explanation: Remediation:Question 7 See full question A client with a history of alcohol abuse comes to the emergency department and complains of abdominal pain. Laboratory studies help confirm a diagnosis of acute pancreatitis. The client's vital signs are stable, but the client's pain is worsening and radiating to his back. Which intervention takes priority for this client? You Selected: • Administering morphine I.V. as ordered Correct response: • Administering morphine I.V. as ordered Explanation: Remediation: Question 8 See full question The client has been taking magnesium hydroxide to control hiatal hernia symptoms. The nurse should assess the client for which condition most commonly associated with the ongoing use of magnesium-based antacids? You Selected: • constipation Correct response: • diarrhea Explanation: Remediation: Question 9 See full question A nurse is assessing the abdomen of a client who was admitted tothe emergency department with suspected appendicitis. Identify the area of the abdomen that the nurse would palpate last. You Selected:• Your selection and the correct area, market by the green box. Explanation: Remediation: Question 10 See full question A client recently diagnosed with hepatitis C states: “Now that you know what is wrong with me, you can just get me those new drugs to take care of it, right?” The nurse should tell the client: You Selected: • “The treatment is complex. There are new antiviral drugs available that may make treatment more effective and help you tolerate it better.” Correct response: “The treatment is complex. There are new antiviral drugs available that may make treatment more effective and help you tolerate it better.” Question 1 See full question A nurse is caring for a client who just had an appendectomy. The client is receiving opioid analgesics routinely for pain. The nurse should focus her follow-up assessment on which complication? You Selected: • Diarrhea Correct response: • Constipation Explanation: Remediation: Question 2 See full questionA physician orders morphine for a client who complains of postoperative abdominal pain. For maximum pain relief, when should the nurse anticipate administering morphine? You Selected: • Before the pain becomes severe Correct response: • Before the pain becomes severe Explanation: Remediation: Question 3 See full question The nurse is checking the client's chart for possible contraindications, before administering meperidine, 50 mg I.M., to a client with pain after an appendectomy. The nurse should hold the meperidine when she sees an order for what type of drug? You Selected: • An antibiotic Correct response: • A monoamine oxidase (MAO) inhibitor Explanation: Remediation: Question 4 See full question A client is scheduled to undergo an exploratory laparoscopy. The registered nurse (RN) asks the licensed practical nurse (LPN) to prepare the client for surgery. The RN must confirm that the LPN has specialized training before delegating which task? You Selected: • Weighing the client Correct response: • Initiating I.V. therapy, as ordered Explanation: Question 5 See full question A client who is legally blind must undergo a colonoscopy. The nurse is helping the physician obtain informed consent. When obtaining informed consent from a client who is visually impaired, the nurse should take which step?You Selected: • Read the consent form to the client and ask him if he has any questions. Correct response: • Read the consent form to the client and ask him if he has any questions. Explanation: Remediation: Question 6 See full question The nurse assesses a client with diverticulitis and suspects peritonitis when which of the following symptoms is noted? You Selected: • rigid abdominal wall Correct response: • rigid abdominal wall Explanation: Remediation: Question 7 See full question A nurse is assessing a client who has a potential diagnosis of pancreatitis. Which risk factors predispose the client to pancreatitis? Select all that apply. You Selected: • excessive alcohol use • hypertension • gallstones Correct response: • excessive alcohol use • gallstones • abdominal trauma • hyperlipidemia with excessive triglycerides Explanation: Remediation:Question 8 See full question The nurse administers a tap water enema to a client. While the solution is being infused, the client has abdominal cramping. What should the nurse do first? You Selected: • Clamp the tubing, and carefully withdraw the tube. Correct response: • Temporarily stop the infusion, and have the client take deep breaths. Explanation: Remediation: Question 9 See full question A client's abdominal incision eviscerates. The nurse should first: You Selected: • cover the incision with a dressing moistened with sterile normal saline solution. Correct response: • cover the incision with a dressing moistened with sterile normal saline solution. Explanation: Remediation: Question 10 See full question Prochlorperazine is prescribed postoperatively. The nurse should evaluate the drug's therapeutic effect when the client expresses relief from: You Selected: • abdominal distention. Correct response: • nausea. Explanation: Remediation: Question 11 See full question The nurse notes that a client with acute pancreatitis occasionally experiences muscle twitching and jerking. How should the nurse interpret the significance of these symptoms?You Selected: • The client is experiencing a reaction to meperidine. Correct response: • The client may be developing hypocalcemia. Explanation: Remediation: Question 12 See full question The nurse monitors a client with cirrhosis for the development of hepatic encephalopathy. Which would be an indication that hepatic encephalopathy is developing? You Selected: • decreased mental status Correct response: • decreased mental status Explanation: Remediation: Question 13 See full question A 36-year-old female client has been diagnosed with hemorrhoids. Which factor in the client's history would most likely be a primary cause of her hemorrhoids? You Selected: • her job as a schoolteacher Correct response: • three vaginal delivery pregnancies Explanation: Remediation: Question 14 See full question A client who has a history of Crohn's disease is admitted to the hospital with fever, diarrhea, cramping, abdominal pain, and weight loss. The nurse should monitor the client for: You Selected: • hypokalemia.Correct response: • hypokalemia. Explanation: Remediation: Question 15 See full question The nurse should teach the client with diverticulitis to integrate which measure into a daily routine at home? You Selected: • using enemas to relieve constipation Correct response: • refraining from straining and lifting activities Explanation: Remediation: Question 16 See full question Which instruction should the nurse include in the teaching plan for a client who is experiencing gastroesophageal reflux disease (GERD)? You Selected: • Limit caffeine intake to two cups of coffee per day. Correct response: • Do not lie down for 2 hours after eating. Explanation: Remediation: Question 17 See full question The nurse determines that a client’s abdominal wound has eviscerated. What should the nurse do first? You Selected: • Reinsert the protruding viscera into the abdominal cavity. Correct response: • Cover the wound with sterile saline-moistened dressings. Explanation: Remediation: Question 18 See full question A client has been hospitalized with pancreatitis for 3 days. The nurse assesses the client and documents the accompanying results. The nurse realizes these findings are a manifestation of what sign? You Selected: • Cullen's sign Correct response: • Cullen's sign Explanation: Remediation: Question 19 See full question The client with a peptic ulcer is prescribed antibiotics and bismuth salts. The nurse explains that this combination of medications will: You Selected: • eradicate the Helicobacter pylori bacteria. Correct response: • eradicate the Helicobacter pylori bacteria. Explanation: Remediation: Question 20 See full question A client develops chronic pancreatitis. What would be the appropriate home diet for a client with chronic pancreatitis? You Selected: • a low-protein, high-fiber diet distributed over four to five moderate-sized meals daily Correct response: • A low-fat, bland diet distributed over five to six small meals daily Explanation: Remediation: Question 21 See full questionWhich nursing recommendation is most appropriate for a client to decrease discomfort from hemorrhoids? You Selected: • Use warm sitz baths. Correct response: • Use warm sitz baths. Explanation: Remediation: Question 22 See full question Which statement indicates the client understands the lifestyle modifications required when managing ulcerative colitis? You Selected: • ”I will have to stop smoking.” Correct response: • ”I will have to stop smoking.” Explanation: Remediation: Question 23 See full question Because of religious beliefs, a client, who is an Orthodox Jew, refuses to eat hospital food. Hospital policy discourages food from outside the hospital. The nurse should next: You Selected: • discuss the situation and possible courses of action with the dietitian and the client. Correct response: • discuss the situation and possible courses of action with the dietitian and the client. Explanation: Remediation: Question 24 See full question A client has been diagnosed with cirrhosis. When obtaining a health history, the nurse should specifically determine if the client takes? You Selected:• Cimetidine. Correct response: • Acetaminophen. Explanation: Remediation: Question 25 See full question The nurse monitors IV replacement therapy for a client with a nasogastric (NG) tube attached to low suction in order to: You Selected: • promote urination. Correct response: • maintain fluid and electrolyte balance. Explanation: Remediation: Question 26 See full question The nurse assigns an unlicensed assistive personnel (UAP) to provide care for a client with peptic ulcer disease. Concerned about possible ulcer perforation, the nurse should instruct the UAP to report to the nurse immediately if the client has: You Selected: • constipation. Correct response: • severe abdominal pain. Explanation: Remediation: Question 27 See full question The nurse is assessing a client’s abdominal incision 48 hours after surgery. Which finding indicates that the wound is inflamed? You Selected: • Serous-sanguineous drainage is noted from the wound drain. Correct response:• Localized warmth over the incisional area. Explanation: Remediation: Question 28 See full question A nurse is assessing a client who reports abdominal pain, nausea, and diarrhea. The nurse knows that palpating the abdomen first would: You Selected: • make it easier to hear the bowel sounds in all four quadrants. Correct response: • alter abdominal sounds from baseline. Explanation: Remediation: Question 29 See full question A client with a recent history of rectal bleeding is being prepared for a colonoscopy. Initially. The nurse knows that positioning the client lying on his/her left side with the knees bent is an appropriate intervention. The nurse recognizes that this position will: You Selected: • allow for proper visualization of the small intestine. Correct response: • allow proper visualization of the large intestine. Explanation: Remediation: Question 30 See full question A client is admitted for suspected GI disease. Assessment data reveal muscle wasting, a decrease in chest and axillary hair, and increased bleeding tendency. The nurse suspects the client has: You Selected: • appendicitis. Correct response: • cirrhosis. Explanation: Remediation: Question 31 See full question A client with a peptic ulcer is about to begin a therapeutic regimen that includes a bland diet, antacids, and famotidine. Before the client is discharged, the nurse should provide which instruction? You Selected: • "Increase your intake of fluids containing caffeine." Correct response: • "Avoid aspirin and products that contain aspirin." Explanation: Remediation: Question 32 See full question The nurse is caring for a client with cirrhosis. Which assessment findings indicate that the client has deficient vitamin K absorption caused by this hepatic disease? You Selected: • Gynecomastia and testicular atrophy Correct response: • Purpura and petechiae Explanation: Remediation: Question 33 See full question A client is admitted to the hospital for diagnostic testing to rule out colorectal cancer. Which intervention should the nurse include on the plan of care? You Selected: • Test all stools for occult blood. Correct response: • Test all stools for occult blood. Explanation: Remediation: Question 34 See full questionA nurse is caring for a client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission? You Selected: • Increased dairy products Correct response: • Nothing by mouth Explanation: Remediation: Question 35 See full question A nurse is teaching an elderly client about developing good bowel habits. Which statement by the client indicates to the nurse that additional teaching is required? You Selected: • "I should try to drink twice as much water as I am now." Correct response: • "I need to use laxatives regularly to prevent constipation." Explanation: Remediation: Question 36 See full question A nurse is monitoring a client recovering from moderate sedation that was administered during a colonoscopy. Which finding requires the nurse's immediate attention? You Selected: • Oxygen saturation (SaO2) of 89% Correct response: • Oxygen saturation (SaO2) of 89% Explanation: Remediation: Question 37 See full question A client with Crohn's disease is scheduled for a barium enema. What should the plan of care include today to prepare for the test tomorrow? You Selected:Correct response: Serve the client a regular diet. Encourage plenty of fluids. Explanation: Remediation: Question 38 See full question A client is scheduled for an ileostomy. Which would be most helpful in preparing the client psychologically for the surgery? You Selected: • Encourage the client to ask questions about managing an ileostomy. Correct response: • Provide a brief, thorough explanation of all preoperative and postoperative procedures. Explanation: Remediation: Question 39 See full question A nurse is giving instructions to a client with a new colostomy. The client states, “I am so tired today; I just cannot think.” The nurse should: You Selected: • reschedule the appointment at a time when the client is rested. Correct response: • reschedule the appointment at a time when the client is rested. Explanation: Question 40 See full question A client with chronic hepatitis C is experiencing nausea, anorexia, and fatigue. During the health history the client states that he is homosexual, drinks one to two glasses of wine with dinner, is taking St. John’s Wort for a “bit of depression,” and takes acetaminophen for frequent headaches. What should the nurse do? Select all that apply.Correct response: You Selected: • Encourage the client to obtain sufficient rest. • Instruct the client to ask the health care provider (HCP) about taking any other medications as they may interact with medications the client is currently taking. Instruct the client that the wine with meals can be beneficial for cardiovascular health. Instruct the client to ask the health care provider (HCP) about taking any other medications as they may interact with medications the client is currently taking. • Advise the client of the need for additional testing for HIV. • Encourage the client to obtain sufficient rest. Explanation: Remediation: Question 41 See full question A client is suspected of having a slow gastrointestinal bleed. The nurse should evaluate the client for which sign? You Selected: • tarry stools Correct response: • tarry stools Explanation: Remediation: Question 42 See full question The health care provider prescribes sulfasalazine for the client with ulcerative colitis. Which instruction should the nurse give the client about taking this medication? You Selected: • Take it with a full glass (240 mL) of water. Correct response:Correct response: • Take it with a full glass (240 mL) of water. Explanation: Remediation: Question 43 See full question A client has been diagnosed with an intestinal obstruction and has a nasogastric tube set to low continuous suction. Which acid-base disturbance is this client at risk for developing? You Selected: Respiratory alkalosis Metabolic alkalosis Explanation: Remediation: Question 44 See full question The nurse is aware that client teaching has been effective about the potential toxic reactions to a vitamin B12 injection by the following statement. Select all that apply. You Selected: • "I will need to check with my physician about continued use." • "Vitamin B12 is generally free of toxicity because it is water soluble." • "Vitamin B12 will cause ringing in the ears before a toxic level is reached." Correct response: • "I may be asked to remain in the clinic for 30 minutes after my first injection." • "I will need to check with my physician about continued use." • "Vitamin B12 is generally free of toxicity because it is water soluble." Explanation: Question 45 See full questionCorrect response: A nurse is administering medications to a client diagnosed with hepatitis B. When the nurse hands the client his/her medications, the client says, "I would rather not take that pill or any others. I know there is no cure for hepatitis B." The nurse recognizes that the client is expressing feelings of hopelessness about the diagnosis. Select the best responses by the nurse. Select all that apply. You Selected: • "I'm going to let the physician talk to you." • "You seem frustrated. Would you like to talk?" • "You can lead a long and fairly healthy life if you are compliant with your medications." Correct response: • "You can lead a long and fairly healthy life if you are compliant with your medications." • "You seem frustrated. Would you like to talk?""You have the right to refuse any medications. Would you like to discuss your feelings about this disease?" Explanation: Question 46 See full question A client diagnosed with peptic ulcer disease (PUD) has an H. pylori infection. The client is following a 2week drug regimen that includes clarithromycin along with omeprazole and amoxicillin. The nurse should instruct the client to: You Selected: • take the drugs for the entire 2-week period. Correct response: • take the drugs for the entire 2-week period. Explanation: Question 47 See full question The nurse is developing a care management plan with a client who has been diagnosed with gastroesophageal reflux disease (GERD). What should the nurse should instruct the client to do? Select all that apply. You Selected: • Lie down after consuming each meal for 30 min. • Use over-the-counter (OTC) antisecretory agents rather than prescriptions. • Avoid beverages that contain caffeine. Correct response: • Avoid a diet high in fatty foods. • Avoid beverages that contain caffeine. • Avoid all alcoholic beverages. Explanation: Question 48 See full question A client had a colon resection yesterday. The client’s hemoglobin was 14.1 g/dL yesterday and today it is 7.2 g/dl. The client’s oxygen saturation is 87%. After reviewing the chart (see chart) and notifying the health care provider (HCP), the nurse should first: You Selected: • Increase the saline infusion to 150 gtts/hour.Correct response: • Administer oxygen at 2 liters per minute. Explanation: Question 49 See full question When a client has an acute attack of diverticulitis, the nurse should first: You Selected: • encourage the client to drink a glass of water every 2 hr. Correct response: • assess the client for signs of peritonitis. Explanation: Remediation: Question 50 See full question The nurse is caring for a client recently diagnosed with hepatitis C. In reviewing the client’s history, what information will be most helpful as the nurse develops a teaching plan? The client: You Selected: • has a known history of sexually transmitted disease. Correct response: • has a known history of sexually transmitted disease. Question 1 See full question For a client who must undergo colon surgery, the physician orders preoperative cleansing enemas and neomycin. The rationale for neomycin use in this client is to: You Selected: • increase the intestinal bacteria count. Correct response: • decrease the intestinal bacteria count. Explanation: Remediation: Question 2 See full questionA nurse preceptor is working with a student nurse who is administering medications. Which statement by the student indicates an understanding of the action of an antacid? You Selected: • "The action occurs in the small intestine, where the drug coats the lining and prevents further ulceration." Correct response: • "The action occurs in the stomach by increasing the pH of the stomach contents and decreasing pepsin activity." Explanation: Question 3 See full question An enterostomy nurse is providing an in-service session on caring for colostomies. Which statement by a nurse indicates the need for further teaching? You Selected: • "I can place an odor-relieving tablet in the bag when changing the appliance to reduce odors." Correct response: • "I can make a small pin hole in the bag to let the gas out, so I don't have to change the appliance frequently." Explanation: Remediation: Question 4 See full question A graduate nurse and her preceptor are establishing priorities for their morning assessments. Which client should they assess first? You Selected: • The sleeping client who received pain medication 1 hour ago Correct response: • The newly admitted client with acute abdominal pain Explanation: Question 5 See full question A client with a history of alcohol abuse was admitted with bleeding esophageal varices. After several days of treatment, the client is ready for discharge. The nurse enters the client's room to review discharge instructions with the client when he tells the nurse that he wants help to quit drinking. How should the nurse respond? You Selected: • "Let me finish reviewing your discharge instructions, then we can discuss your concerns." Correct response: • "I'll notify your physician and call the social worker so she can discuss treatment options with you." Explanation: Remediation: Question 6 See full question A client with esophageal cancer decides against placement of a jejunostomy tube. Which ethical principle is a nurse upholding by supporting the client's decision? You Selected: • Nonmaleficence Correct response: • Autonomy Explanation: Question 7 See full question A nurse presents a client with the informed consent form for an abdominal paracentesis. The client asks the nurse what the procedure involves. The nurse should: You Selected: • have the client sign the form and ask the physician explain the procedure again. Correct response: • notify the physician that the client doesn't understand the procedure. Explanation: Remediation: Question 8 See full question A client diagnosed with ulcerative colitis also experiences obsessive compulsive anxiety disorder (OCD). In helping the client understand her illness, the nurse should respond with which statement? You Selected:• "It is possible that your desire to have everything be perfect has caused stress that may have worsened your colitis, but there is no proof that either disorder caused the other." Correct response: • "It is possible that your desire to have everything be perfect has caused stress that may have worsened your colitis, but there is no proof that either disorder caused the other." Explanation: Remediation: Question 9 See full question When giving a client a tube feeding, the nurse should: You Selected: • verify position of the tube before beginning feeding. Correct response: • verify position of the tube before beginning feeding. Explanation: Remediation: Question 10 See full question A client is admitted with acute pancreatitis. The nurse should monitor which laboratory values? You Selected: • increased serum amylase and lipase levels Correct response: • increased serum amylase and lipase levels Explanation: Remediation: Question 11 See full question After teaching the parents of a child with lactose intolerance about the disorder, the nurse determines that the teaching was effective when the mother used which statement to describe the condition? You Selected: • "Inability to digest fats completely." Correct response:• "The lack of an enzyme to break down lactose." Explanation: Remediation: Question 12 See full question The nurse measures the amount of bile drainage from a t-tube and records it by which method? You Selected: • subtracting it from the total intake for each day Correct response: • charting it separately on the output record Explanation: Remediation: Question 13 See full question The nurse should monitor the client with acute pancreatitis for which complication? You Selected: • heart failure Correct response: • pneumonia Explanation: Remediation: Question 14 See full question Which finding is normal for a client during the icteric phase of hepatitis A? You Selected: • shortness of breath Correct response: • yellowed sclera Explanation: Remediation: Question 15 See full questionThe nurse is reviewing the chart information for a client with increased ascites. The data include the following: temperature 98.9° F (37.2° C), heart rate 118 bpm, shallow respirations 26/min, blood pressure 128/76 mm Hg, and SpO2 89% on room air. The nurse should first: You Selected: • assess heart sounds. Correct response: • raise the head of the bed. Explanation: Question 16 See full question A client with Crohn's disease has concentrated urine, decreased urinary output, dry skin with decreased turgor, hypotension, and weak, thready pulses. What should the nurse should do first? You Selected: • Provide parenteral rehydration therapy as prescribed. Correct response: • Provide parenteral rehydration therapy as prescribed. Explanation: Remediation: Question 17 See full question A client has been taking aluminum hydroxide 30 ml six times per day at home to treat his peptic ulcer. He tells the nurse that he has been unable to have a bowel movement for 3 days. Based on this information, the nurse would determine that the most likely cause of the client's constipation is because the client: You Selected: • has not been including enough fiber in his diet. Correct response: • is experiencing an adverse effect of the aluminum hydroxide. Explanation: Remediation: Question 18 See full question The nurse is obtaining a health history from a client who has a sliding hiatal hernia associated with reflux. The nurse should ask the client about the presence of which symptom?You Selected: • heartburn Correct response: • heartburn Explanation: Remediation: Question 19 See full question In developing a teaching plan for the client with a hiatal hernia, the nurse's assessment of which workrelated factors would be most useful? You Selected: • body mechanics used in lifting Correct response: • body mechanics used in lifting Explanation: Remediation: Question 20 See full question When preparing a client for a scheduled colonoscopy, the nurse should tell the client that this procedure will involve: You Selected: • administering an antibiotic to decrease the risk of infection. Correct response: • cleansing the bowel with laxatives or enemas. Explanation: Remediation: Question 21 See full question Which outcome is expected for a client who has undergone surgical repair of an inguinal hernia? You Selected: • The client will remain on a soft diet until the wound is healed. Correct response:• The client will verbalize understanding of instructions to avoid lifting for 2 to 6 weeks after surgery. Explanation: Remediation: Question 22 See full question The client who is in Buck’s traction is constipated. A plan of care that incorporates which breakfast would be most helpful in reestablishing a normal bowel routine? You Selected: • orange juice, breakfast pastries (doughnut and Danish), and coffee Correct response: • an orange, raisin bran and milk, and wheat toast with butter Explanation: Remediation: Question 23 See full question When admitting an elderly client for nausea and vomiting that has lasted for 3 days, the nurse should assess for which clinical findings? You Selected: • bradycardia Correct response: • poor skin turgor Explanation: Remediation: Question 24 See full question A nurse is teaching a client with malabsorption syndrome about the disorder and its treatment. The client asks which part of the GI tract absorbs food. The nurse tells the client that products of digestion are absorbed mainly in the: You Selected: • small intestine. Correct response: • small intestine. Explanation: Remediation: Question 25 See full question During preparation for bowel surgery, a client receives an antibiotic to reduce intestinal bacteria. The nurse knows that hypoprothrombinemia may occur as a result of antibiotic therapy. Which of the following vitamins would be affected by this? You Selected: • Vitamin E Correct response: • Vitamin K Explanation: Remediation: Question 26 See full question When assessing a client during a routine checkup, the nurse reviews the history and notes that the client had aphthous stomatitis at the time of the last visit. Aphthous stomatitis is best described as: You Selected: • acid indigestion. Correct response: • a canker sore of the oral soft tissues. Explanation: Remediation: Question 27 See full question A client is diagnosed with a hiatal hernia. Which statement indicates effective client teaching about hiatal hernia and its treatment? You Selected: • "I'll eat three large meals every day without any food restrictions." Correct response: • "I'll eat frequent, small, bland meals that are high in fiber." Explanation: Remediation:Question 28 See full question A client with dysphagia is being prepared for discharge. Which outcome indicates that the client is ready for discharge? You Selected: • The client has normal gastric structures. Correct response: • The client is free from esophagitis and achalasia. Explanation: Remediation: Question 29 See full question A nurse on a medical surgical unit is assessing a client and obtains the following findings: abdominal discomfort, mild diarrhea, and a temperature of 100° F (37.8° C). The nurse suspects that these are symptoms often associated with: You Selected: • diverticulitis. Correct response: • inflammatory bowel disease (IBD). Explanation: Question 30 See full question When caring for a client with acute pancreatitis, the nurse should use which comfort measure? You Selected: • Administering an analgesic once per shift, as ordered, to prevent drug addiction Correct response: • Positioning the client on the side with the knees flexed Explanation: Remediation: Question 31 See full question A nurse is caring for a client immediately following an appendectomy. The nurse should assign which nursing diagnosis the highest priority? You Selected:• Acute pain Correct response: • Acute pain Explanation: Remediation: Question 32 See full question Which client requires immediate nursing intervention? The client who: You Selected: • presents with a rigid, boardlike abdomen. Correct response: • presents with a rigid, boardlike abdomen. Explanation: Remediation: Question 33 See full question A male client has just had an inguinal herniorrhaphy. Which instruction would be most appropriate to include in the discharge plan? You Selected: • Turn, cough, and deep breathe every 2 hours. Correct response: • Apply an ice bag to the scrotum. Explanation: Remediation: Question 34 See full question A 4-year-old with a history of urinary reflux returned from surgery for bilateral ureteral re-implants 2 days ago. Which assessment finding is most concerning? You Selected: • small amounts of blood-tinged urine Correct response: • decreased oral intake Explanation: Remediation: Question 35 See full question The correct procedure for auscultating the client’s abdomen for bowel sounds is to: You Selected: • place the client on the left side to aid auscultation. Correct response: • listen for 5 minutes in all four quadrants to confirm absence of bowel sounds. Explanation: Remediation: Question 36 See full question A client is recovering from a gastric resection for peptic ulcer disease. Which outcome indicates that the goal of adequate nutritional intake is being achieved 3 weeks following surgery? The client: You Selected: • experiences a rapid weight gain within 1 week. Correct response: • increases food intake and tolerance gradually. Explanation: Remediation: Question 37 See full question The nurse irrigates a client’s colostomy. If the client has abdominal cramping after receiving about 150 mL of solution during the colostomy irrigation, the nurse should: You Selected: • remove the irrigating cone or tube. Correct response: • stop the flow of solution. Explanation: Remediation: Question 38 See full questionA client who has had ulcerative colitis for the past 5 years is admitted to the hospital with an exacerbation of the disease. Which factor is of greatest significance in causing an exacerbation of ulcerative colitis? You Selected: • beginning a weight-training program Correct response: • a demanding and stressful job Explanation: Remediation: Question 39 See full question Which laboratory finding is expected when a client has diverticulitis? You Selected: • decreased platelet count Correct response: • elevated white blood cell count Explanation: Remediation: Question 40 See full question After completing assessment rounds, which client should the nurse discuss with the health care provider (HCP) first? You Selected: • a client with stable vital signs that has been receiving IV cipro following a cholecystectomy for 1 day and has developed a rash on the chest and arms Correct response: • a client with hepatitis whose pulse was 84 bpm and regular and is now 118 bpm and irregular Explanation: Remediation: Question 41 See full questionA client who has ulcerative colitis says to the nurse, “I cannot take this anymore; I am constantly in pain, and I cannot leave my room because I need to stay by the toilet. I do not know how to deal with this.” Based on these comments, the nurse should determine the client is experiencing: You Selected: • disturbed thought. Correct response: • difficulty coping. Explanation: Remediation: Question 42 See full question The nurse prepares to administer promethazine 35 mg IM as prescribed PRN for a client with cholecystitis who has nausea. The ampule label reads that the medication is available in 25 mg/mL. How many milliliters should the nurse administer? Record your answer using one decimal place. Your Response: • 1.4 Correct response: • 1.4 Explanation: Question 43 See full question A client has vomited several times over the past 12 hours. The nurse should recognize the risk of what complication? You Selected: • Metabolic alkalosis Correct response: • Metabolic alkalosis Explanation: Remediation: Question 44 See full question The nurse manager of a surgical unit observes a nurse providing colostomy care to a client without using any personal protective equipment (PPE). What is the most appropriate response by the nurse manager in relation to the use of PPE?You Selected: • “In the future, have the physician write an order for PPE for clients with colostomies.” Correct response: • “PPE should be used when you risk exposure to blood or bodily fluids.” Explanation: Remediation: Question 45 See full question A nurse has been asked to obtain a client’s signature on an operative consent form. When the nurse approaches the client, who is scheduled for a cholycystectomy later in the day, the client asks the nurse why the procedure is needed. Which of the following is the appropriate response by the nurse?You Selected: Correct response: Explanation: “I will ask the surgeon to come speak to you about the procedure.” “I will ask the surgeon to come speak to you about the procedure.” Remediation: Question 46 See full question At 0800, the nurse reviews the amount of t-tube drainage for a client who underwent an open cholecystectomy yesterday. After reviewing the output record (see chart), the nurse should: You Selected: • evaluate the tube for patency. Correct response: • evaluate the tube for patency. Explanation: Remediation: Question 47 See full question While taking an admission history, a client tells a nurse that he was a former IV drug abuser. Which test would be most important for this client to undergo? You Selected: • Hepatitis C virus test Correct response: • Hepatitis C virus test Explanation: Remediation: Question 48 See full question At the beginning of the shift, the nurse is assigned a client with an ascending colostomy. Which picture identifies the correct placement where the nurse will assess the stoma? You Selected:• Image B Correct response: • Image D Explanation: Remediation: Question 49 See full question The nurse is providing discharge instructions for a client who had an inguinal herniorrhaphy. The nurse should teach the client to: You Selected: • cough and deep breathe every 2 hours. Correct response: • avoid lifting items weighing more than 5 lb (2.3 kg). Explanation: Question 50 See full question A client with cholecystitis continues to have severe right upper quadrant pain. The nurse obtains the following vital signs: temperature 101.1° F (38.4° C); pulse 114 bpm; respirations 22/min; blood pressure 142/90 mm Hg. Using the SBAR (Situation-Background-Assessment-Recommendation) technique for communication, the nurse recommends to the health care provider for the client to receive: You Selected: • promethazine IM. Correct response: • hydromorphone IV. Question 1 See full question A client with pancreatitis has been receiving total parenteral nutrition (TPN) for the past week. Which nursing intervention helps determine if TPN is providing adequate nutrition? You Selected: • Ensuring that the TPN tubing has an in-line filter Correct response: • Monitoring the client's weight every dayYou Selected: Correct response: Explanation: Explanation: Remediation: Question 2 See full question Which task may a nurse delegate to a nursing assistant? Assisting a client who had surgery to ambulate in the hallway Assisting a client who had surgery to ambulate in the hallway Question 3 See full question A nurse is preparing to perform complex abdominal wound care. Which action should the nurse take while performing this task? You Selected: • Position the client on the far side of the bed. Correct response: • Raise the bed to approximately waist level. Explanation: Remediation: Question 4 See full question When the nurse is assessing the client’s abdomen, which finding best indicates that a client’s peristaltic activity is returning to normal after surgery? You Selected: • Bowel sounds are hypoactive on auscultation. Correct response: • The client passes flatus. Explanation: Remediation:Question 5 See full question The client is to take nothing by mouth after 0400. The nurse recognizes that the client has deficient knowledge when he states that he: You Selected: • ate a gelatin dessert at 0330. Correct response: • smoked a cigarette at 0600. Explanation: Remediation: Question 6 See full question When administering intermittent enteral feeding to an unconscious client, the nurse should: You Selected: • heat the formula in a microwave. Correct response: • place the client in a semi-Fowler's position. Explanation: Remediation: Question 7 See full question College freshman are participating in a study abroad program. When teaching them about hepatitis B, the nurse should instruct the students on the need for: You Selected: • single dormitory rooms. Correct response: • safe sexual practices. Explanation: Question 8 See full question When planning diet teaching for the client with a colostomy, the nurse should develop a plan that emphasizes which dietary instruction? You Selected: • A high-fiber diet will produce a regular passage of stool.You Selected: Correct response: Explanation: Correct response: • Clients should experiment to find the diet that is best for them. Explanation: Remediation: Question 9 See full question Which is an expected outcome for a client with peptic ulcer disease? The client will: verbalize the importance of monitoring hemoglobin and hematocrit every 3 months. explain the rationale for eliminating alcohol from the diet. Remediation: Question 10 See full question A client who had a splenectomy yesterday has a nasogastric (NG) tube. The expected outcome of using the NG tube is to: You Selected: • move the stomach away from where the spleen was removed. Correct response: • decrease abdominal distention. Explanation: Remediation: Question 11 See full question Immediately following endoscopy of the upper gastrointestinal tract, it is most important for the nurse to assess for: You Selected: • intake and output. Correct response:• return of the gag reflex. Explanation: Remediation: Question 12 See full question Which nursing measure would be most effective in helping the client cough and deep breathe after a cholecystectomy? You Selected: • Teach the client to use a folded blanket or pillow to splint the incision. Correct response: • Teach the client to use a folded blanket or pillow to splint the incision. Explanation: Remediation: Question 13 See full question In caring for the client with hepatitis B, which situation would expose the nurse to the virus? You Selected: • disposing of syringes and needles without recapping Correct response: • a blood splash into the nurse’s eyes Explanation: Remediation: Question 14 See full question A client is learning about caring for an ileostomy. Which statement would indicate that the client understands how to care for the ileostomy pouch? You Selected: • ”I should change my pouch immediately after lunch.” Correct response: • "I will empty my pouch when it is about one-third full.” Explanation: Remediation:You Selected: Correct response: Explanation: Question 15 See full question The nurse observes that the client’s total parenteral nutrition (TPN) solution is infusing too slowly. The nurse calculates that the client has received 300 mL less than was prescribed for the day. The nurse should: You Selected: • maintain the flow rate at the current rate and document any discrepancy in the chart. Correct response: • assess the infusion system, note the client’s condition, and notify the health care provider. Explanation: Remediation:Question 16 See full question A client with inflammatory bowel disease undergoes an ileostomy. On the first day after surgery, the nurse notes that the client's stoma appears dusky. How should the nurse interpret this finding? You Selected: • The ostomy bag should be adjusted. Correct response: • Blood supply to the stoma has been interrupted. Explanation: Remediation: Question 17 See full question A client is evaluated for severe pain in the right upper abdominal quadrant, which is accompanied by nausea and vomiting. The physician diagnoses acute cholecystitis and cholelithiasis. For this client, which nursing diagnosis takes top priority? You Selected: • Acute pain related to biliary spasms Correct response: • Acute pain related to biliary spasms Explanation: Remediation: Question 18 See full question While palpating a client's right upper quadrant (RUQ), the nurse would expect to find which structure? You Selected: • Spleen Correct response: • Liver Explanation: Remediation: Question 19 See full question Why are antacids administered regularly, rather than as needed, in peptic ulcer disease? You Selected:• To keep gastric pH at 3.0 to 3.5 Correct response: • To keep gastric pH at 3.0 to 3.5 Explanation: Remediation: Question 20 See full question A nurse is caring for a client who had gastric bypass surgery two days ago. Which assessment finding requires immediate intervention? You Selected: • The client's surgical site is reddened and swollen. Correct response: • The client's right lower leg is red, swollen, and warm to touch. Explanation: Remediation: Question 21 See full question A nurse asks a client who had abdominal surgery 3 days ago if he has moved his bowels since surgery. The client states, "I haven't moved my bowels, but I am passing gas." How should the nurse intervene? You Selected: • Apply moist heat to the client's abdomen. Correct response: • Encourage the client to ambulate at least three times per day. Explanation: Remediation: Question 22 See full question As a nurse completes the admission assessment of a client admitted for gastric bypass surgery, the client states, "Finally! I'll be thin and able to eat without much concern." Which statement by the nurse would be most appropriate? You Selected: • "How do you feel recovery will be after surgery?" Correct response:• "Can you tell me your best understanding of the procedure?" Explanation: Remediation: Question 23 See full question An elderly client asks the nurse how to treat chronic constipation. What is the best recommendation the nurse can make? You Selected: • Administer a tap-water enema weekly. Correct response: • Take a stool softener such as docusate sodium daily. Explanation: Remediation: Question 24 See full question A client is recovering from a gastric resection for peptic ulcer disease. Which outcome indicates that the goal of adequate nutritional intake is being achieved 3 weeks following surgery? The client: You Selected: • drinks 2,000 mL/day of water. Correct response: • increases food intake and tolerance gradually. Explanation: Remediation: Question 25 See full question The nurse irrigates a client’s colostomy. If the client has abdominal cramping after receiving about 150 mL of solution during the colostomy irrigation, the nurse should: You Selected: • have the client sit up in bed. Correct response: • stop the flow of solution. Explanation: Remediation: Question 26 See full question The nurse is irrigating a client’s colostomy. The client has abdominal cramping after receiving about 100 mL of the irrigating solution. The nurse should first: You Selected: • remove the irrigation tube. Correct response: • stop the flow of solution. Explanation: Remediation: Question 27 See full question The nurse is evaluating the lifestyle modifications a client has made to prevent gastroesophageal reflux. Which statement indicates that the client understands how to prevent reflux? You Selected: • “I lie down and rest for 45 minutes after each meal.” Correct response: • “I try to eat smaller amounts of food more often throughout the day.” Explanation: Remediation: Question 28 See full question Following a subtotal gastrectomy, a client has a nasogastric (NG) tube connected to low suction. The nurse should: You Selected: • monitor the client for nausea, vomiting, and abdominal distention. Correct response: • monitor the client for nausea, vomiting, and abdominal distention. Explanation: Remediation: Question 29 See full questionAfter a subtotal gastrectomy, the nurse is developing a plan with the client to assist the client to gain weight. To help the client meet nutritional goals at home, the nurse should: You Selected: • inform the client that bland foods are typically less nutritional and should be used minimally. Correct response: • encourage the client to eat smaller amounts more frequently. Explanation: Remediation: Question 30 See full question A client who has had ulcerative colitis for the past 5 years is admitted to the hospital with an exacerbation of the disease. Which factor is of greatest significance in causing an exacerbation of ulcerative colitis? You Selected: • a demanding and stressful job Correct response: • a demanding and stressful job Explanation: Remediation: Question 31 See full question Immediately after surgery to create an ileostomy, which goal has the highest priority? You Selected: • minimizing odor formation Correct response: • maintaining fluid and electrolyte balance Explanation: Remediation: Question 32 See full question On the second day following an abdominal perineal resection, the nurse notes that the wound edges aren't approximated and one half of the incision has torn apart. What should the nurse do first? You Selected:• Apply strips of tape. Correct response: • Cover the wound with a sterile dressing moistened with normal saline. Explanation: Remediation: Question 33 See full question College freshmen are participating in a study abroad program. When teaching them about hepatitis B, the nurse should instruct the students on the need for: You Selected: • single dormitory rooms. Correct response: • safe sexual practices. Explanation: Remediation: Question 34 See full question A client has had an exacerbation of ulcerative colitis with cramping and diarrhea persisting longer than 1 week. The nurse should assess the client for which complication? You Selected: • hypocalcemia Correct response: • hypokalemia Explanation: Remediation: Question 35 See full question A client who is recovering from gastric surgery is receiving IV fluids to be infused at 100 mL/hour. The IV tubing delivers 15 gtt/mL. The nurse should infuse the solution at a flow rate of how many drops per minute to ensure that the client receives 100 mL/hour? Record your answer using a whole number. Your Response: • 15 Correct response:• 25 Explanation: Remediation: Question 36 See full question The nurse on a surgical unit is caring for a client recovering from recent surgery with the placement of a nasogastric tube to low continuous suction Which acid–base imbalance is most likely to occur? You Selected: • Metabolic alkalosis Correct response: • Metabolic alkalosis Explanation: Remediation: Question 37 See full question A client is scheduled to have surgery to relieve an intestinal obstruction. Prior to surgery, the nurse should verify that the client has: You Selected: • discontinued use of blood thinners. Correct response: • discontinued use of blood thinners. Explanation: Remediation: Question 38 See full question A nurse is talking to a neighbor who asks about reoccurring symptoms of gnawing epigastric pain following meals and heartburn. Recognizing these symptoms, what suggestions could the nurse make? You Selected: • Sip green tea throughout the day Correct response: • Avoid alcohol and non-steroidal anti-inflammatory medications Explanation: Remediation: Question 39 See full question A client who had abdominal surgery 4 days ago reports that "something gave way" when he sneezed. The nurse observes a wound evisceration. What should the nurse do next? You Selected: • Notify the health care provider. Correct response: • Apply a sterile, moist dressing. Explanation: Remediation: Question 40 See full question A nurse is assessing a client who has a history of a bleeding peptic ulcer. Which of the following assessments should the nurse report immediately? You Selected: • Abdominal distension; cool, clammy skin; weak, thready pulse Correct response: • Abdominal distension; cool, clammy skin; weak, thready pulse Explanation: Remediation: Question 41 See full question A client with cirrhosis of the liver is in the hospital. The nurse involves the client in developing a plan of care. What would be important aspects to include in this plan? You Selected: • Informing the client of the extent of damage to the liver and drawing up a contract to start the rehabilitative process Correct response: • Discussing collaborative goals and involving the client in identifying and prioritizing important interventions Explanation: Remediation:Question 42 See full question The client is to have a gastrectomy. The surgeon will use a transverse incision. Prior to surgery, the nurse is checking to be sure the correct site has been marked. Identify the site that should have marked. You Selected: Your selection and the correct area, market by the green box. Explanation: Question 43 See full question Which statement indicates that a client with esophageal reflux disorder understands the dietary teaching? You Selected: • “I won’t drink any carbonated drinks.” Correct response: • “I won’t drink any carbonated drinks.” Explanation: Remediation: Question 44 See full question A client one day post-operative cholecystectomy, reports severe pain radiating to the shoulder. What should be the first nursing action? You Selected: • Assess the patency of the T-tube Correct response:• Assess the patency of the T-tube Explanation: Remediation: Question 45 See full question A client has been admitted to the emergency department with severe mid-epigastric, upper quadrant abdominal pain. Based on the signs and symptoms and laboratory data documented in the chart below, the nurse would anticipate preparing for which diagnosis? You Selected: • Crohn’s disease. Correct response: • Pancreatitis. Explanation: Remediation: Question 46 See full question Within 6 hours following a subtotal gastrectomy, the drainage from the client’s NG tube is bright red. The nurse should first: You Selected: • clamp the NG tube. Correct response: • chart the finding in the client’s medical record. Explanation: Question 47 See full question The nurse is caring for a client with esophageal varices. The nurse should discuss which laboratory report finding with the health care provider (HCP)? You Selected: • decreased ammonia Correct response: • elevated PT/INR Explanation: Question 48 See full questionA health care provider and nurse are discussing treatment options with a client diagnosed with severe ulcerative colitis. When providing client teaching during early treatment, the symptoms of which diagnosis would be discussed? You Selected: • Bowel perforation Correct response: • Bowel perforation Explanation: Question 49 See full question A client has been taking prescribed aspirin in large doses and reports having stomach irritation, sometimes with vomiting. Which food or beverage noted from the client’s diet history should the nurse suggest the client avoid? You Selected: • glass of wine Correct response: • glass of wine Explanation: Remediation: Question 50 See full question A client with cholecystitis continues to have severe right upper quadrant pain. The nurse obtains the following vital signs: temperature 101.1° F (38.4° C); pulse 114 bpm; respirations 22/min; blood pressure 142/90 mm Hg. Using the SBAR (Situation-Background-Assessment-Recommendation) technique for communication, the nurse recommends to the health care provider for the client to receive: You Selected: • meperidine IM. Correct response: • hydromorphone IV. Question 1 See full question The nurse is checking the client's chart for possible contraindications, before administering meperidine, 50 mg I.M., to a client with pain after an appendectomy. The nurse should hold the meperidine when she sees an order for what type of drug? You Selected:• A monoamine oxidase (MAO) inhibitor Correct response: • A monoamine oxidase (MAO) inhibitor Explanation: Remediation: Question 2 See full question A client with cholecystitis is taking propantheline bromide. The expected outcome of this drug is: You Selected: • decreased biliary spasm. Correct response: • decreased biliary spasm. Explanation: Remediation: Question 3 See full question The nurse administers a tap water enema to a client. While the solution is being infused, the client has abdominal cramping. What should the nurse do first? You Selected: • Temporarily stop the infusion, and have the client take deep breaths. Correct response: • Temporarily stop the infusion, and have the client take deep breaths. Explanation: Remediation: Question 4 See full question A client who has been vomiting for 2 days has a nasogastric tube inserted. The nurse notes that over the past 10 hours the tube has drained 2 L of fluid. The nurse should further assess the client for: You Selected: • hypokalemia. Correct response: • hypokalemia. Explanation: Remediation: Question 5 See full question The nurse is obtaining a nursing history of a client suspected of having hepatitis C. The nurse should ask the client if he has: You Selected: • had a tattoo. Correct response: • had a tattoo. Explanation: Remediation: Question 6 See full question The client is receiving propantheline bromide to treat cholecystitis. The nurse should evaluate the client's response to the medication by observing for which adverse effect? You Selected: • diarrhea Correct response: • urine retention Explanation: Question 7 See full question The nurse notes that a client with acute pancreatitis occasionally experiences muscle twitching and jerking. How should the nurse interpret the significance of these symptoms? You Selected: • The client may be developing hypocalcemia. Correct response: • The client may be developing hypocalcemia. Explanation: Remediation: Question 8 See full questionWhich position would be best for the client in the early postoperative period after a hemorrhoidectomy? You Selected: • supine Correct response: • side-lying Explanation: Remediation: Question 9 See full question Which instruction should the nurse include in the teaching plan for a client who is experiencing gastroesophageal reflux disease (GERD)? You Selected: • Do not lie down for 2 hours after eating. Correct response: • Do not lie down for 2 hours after eating. Explanation: Remediation: Question 10 See full question The nurse determines that a client’s abdominal wound has eviscerated. What should the nurse do first? You Selected: • Cover the wound with sterile saline-moistened dressings. Correct response: • Cover the wound with sterile saline-moistened dressings. Explanation: Remediation: Question 11 See full question A client is scheduled for oral cholecystography. Prior to the test, the nurse should: You Selected: • ask the client about possible allergies to iodine or shellfish.Correct response: • ask the client about possible allergies to iodine or shellfish. Explanation: Remediation: Question 12 See full question A client develops chronic pancreatitis. What would be the appropriate home diet for a client with chronic pancreatitis? You Selected: • A low-fat, bland diet distributed over five to six small meals daily Correct response: • A low-fat, bland diet distributed over five to six small meals daily Explanation: Remediation: Question 13 See full question When caring for a client with ulcerative colitis the nurse should: You Selected: • encourage the use of stool softeners. Correct response: • suggest sitz baths as needed. Explanation: Remediation: Question 14 See full question A client has been diagnosed with cirrhosis. When obtaining a health history, the nurse should specifically determine if the client takes? You Selected: • Acetaminophen. Correct response: • Acetaminophen. Explanation: Remediation: Question 15 See full question The nurse monitors IV replacement therapy for a client with a nasogastric (NG) tube attached to low suction in order to: You Selected: • maintain fluid and electrolyte balance. Correct response: • maintain fluid and electrolyte balance. Explanation: Remediation: Question 16 See full question Which statement indicates to the nurse that the client with Crohn’s disease understands the needed nutritional modifications? You Selected: • ”A diet high in vitamins and protein is important.” Correct response: • ”A diet high in vitamins and protein is important.” Explanation: Remediation: Question 17 See full question The nurse is assessing a client’s abdominal incision 48 hours after surgery. Which finding indicates that the wound is inflamed? You Selected: • Localized warmth over the incisional area. Correct response: • Localized warmth over the incisional area. Explanation: Remediation: Question 18 See full questionWhich is an appropriate nursing goal for the client who has ulcerative colitis? The client: You Selected: • verbalizes the importance of small, frequent feedings. Correct response: • verbalizes the importance of small, frequent feedings. Explanation: Remediation: Question 19 See full question A nurse is assessing a cl