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  1. 1. 1. Nurse Berlinda is assigned to a 41-year-old client who has a diagnosis of chronicpancreatitis. The nurse reviews the laboratory result, anticipating a laboratory report thatindicates a serum amylase level of:a. 45 units/Lb. 100 units/Lc. 300 units/Ld. 500 units/L2. A male client who is recovering from surgery has been advanced from a clear liquid dietto a full liquid diet. The client is looking forward to the diet change because he has been“bored” with the clear liquid diet. The nurse would offer which full liquid item to the client?a. Teab. Gelatinc. Custardd. Popsicle3. Nurse Juvy is caring for a client with cirrhosis of the liver. To minimize the effects of thedisorder, the nurse teaches the client about foods that are high in thiamine. The nursedetermines that the client has the best understanding of the dietary measures to follow ifthe client states an intension to increase the intake of:a. Porkb. Milkc. Chickend. Broccoli4. Nurse Oliver checks for residual before administering a bolus tube feeding to a client witha nasogastric tube and obtains a residual amount of 150 mL. What is appropriate action forthe nurse to take?a. Hold the feedingb. Reinstill the amount and continue with administering the feedingc. Elevate the client’s head at least 45 degrees and administer the feedingd. Discard the residual amount and proceed with administering the feeding5. A nurse is inserting a nasogastrictube in an adult male client. During the procedure, the client begins to cough and hasdifficulty breathing. Which of the following is the appropriate nursing action?a. Quickly insert the tubeb. Notify the physician immediatelyc. Remove the tube and reinsert when the respiratory distress subsidesd. Pull back on the tube and wait until the respiratory distress subsides
  2. 2. 6. Nurse Ryan is assessing for correct placement of a nosogartric tube. The nurse aspiratesthe stomach contents and check the contents for pH. The nurse verifies correct tubeplacement if which pH value is noted?a. 3.5b. 7.0c. 7.35d. 7.57. A nurse is preparing to remove a nasogartric tube from a female client. The nurse shouldinstruct the client to do which of the following just before the nurse removes the tube?a. Exhaleb. Inhale and exhale quicklyc. Take and hold a deep breathd. Perform a Valsalva maneuver8. Nurse Joy is preparing to administer medication through a nasogastric tube that isconnected to suction. To administer the medication, the nurse would:a. Position the client supine to assist in medication absorptionb. Aspirate the nasogastric tube after medication administration to maintain patencyc. Clamp the nasogastric tube for 30 minutes following administration of the medicationd. Change the suction setting to low intermittent suction for 30 minutes after medicationadministration9. A nurse is preparing to care for a female client with esophageal varices who has just hasa Sengstaken-Blakemore tube inserted. The nurse gathers supplies, knowing that which ofthe following items must be kept at the bedside at all times?a. An obturatorb. Kelly clampc. An irrigation setd. A pair of scissors10. Dr. Smith has determined that the client with hepatitis has contracted the infection formcontaminated food. The nurse understands that this client is most likely experiencing whattype of hepatitis?a. Hepatitis Ab. Hepatitis Bc. Hepatitis Cd. Hepatitis D11. A client is suspected of having hepatitis. Which diagnostic test result will assist inconfirming this diagnosis?
  3. 3. a. Elevated hemoglobin levelb. Elevated serum bilirubin levelc. Elevated blood urea nitrogen leveld. Decreased erythrocycle sedimentation rate12. The nurse is reviewing the physician’s orders written for a male client admitted to thehospital with acute pancreatitis. Which physician order should the nurse question if noted onthe client’s chart?a. NPO statusb. Nasogastric tube insertedc. Morphine sulfate for paind. An anticholinergic medication13. A female client being seen in a physician’s office has just been scheduled for a bariumswallow the next day. The nurse writes down which instruction for the client to follow beforethe test?a. Fast for 8 hours before the testb. Eat a regular supper and breakfastc. Continue to take all oral medications as scheduledd. Monitor own bowel movement pattern for constipation14. The nurse is performing an abdominal assessment and inspects the skin of theabdomen. The nurse performs which assessment technique next?a. Palpates the abdomen for sizeb. Palpates the liver at the right rib marginc. Listens to bowel sounds in all for quadrantsd. Percusses the right lower abdominal quadrant15. Polyethylene glycol-electrlyte solution (GoLYTELY) is prescribed for the female clientscheduled for a colonoscopy. The client begins to experience diarrhea followingadministration of the solution. What action by the nurse is appropriate?a. Start an IV infusionb. Administer an enemac. Cancel the diagnostic testd. Explain that diarrhea is expected16. The nurse is caring for a male client with a diagnosis of chronic gastritis. The nursemonitors the client knowing that this client is at risk for which vitamin deficiency?a. Vitamin Ab. Vitamin B12c. Vitamin Cd. Vitamin E
  4. 4. 17. The nurse is reviewing the medication record of a female client with acute gastritis.Which medication, if noted on the client’s record, would the nurse question?a. Digoxin (Lanoxin)b. Furosemide (Lasix)c. Indomethacin (Indocin)d. Propranolol hydrochloride (Inderal)18. The nurse is assessing a male client 24 hours following a cholecystectomy. The nursenoted that the T tube has drained 750 mL of green-brown drainage since the surgery. Whichnursing intervention is appropriate?a. Clamp the T tubeb. Irrigate the T tubec. Notify the physiciand. Document the findings19. The nurse is monitoring a female client with a diagnosis of peptic ulcer. Whichassessment findings would most likely indicate perforation of the ulcer?a. Bradycardiab. Numbness in the legsc. Nausea and vomitingd. A rigid, board-like abdomen20. A male client with a peptic ulcer is scheduled for a vagotomy and the client asks thenurse about the purpose of this procedure. Which response by the nurse best describes thepurpose of a vagotomy?a. Halts stress reactionsb. Heals the gastric mucosac. Reduces the stimulus to acid secretionsd. Decreases food absorption in the stomach21. The nurse is caring for a female client following a Billroth II procedure. Whichpostoperative order should the nurse question and verify?a. Leg exercisesb. Early ambulationc. Irrigating the nasogastric tubed. Coughing and deep-breathing exercises22. The nurse is providing discharge instructions to a male client following gastrectomy andinstructs the client to take which measure to assist in preventing dumping syndrome?
  5. 5. a. Ambulate following a mealb. Eat high carbohydrate foodsc. Limit the fluid taken with meald. Sit in a high-Fowler’s position during meals23. The nurse is monitoring a female client for the early signs and symptoms of dumpingsyndrome. Which of the following indicate this occurrence?a. Sweating and pallorb. Bradycardia and indigestionc. Double vision and chest paind. Abdominal cramping and pain24. The nurse is preparing a discharge teaching plan for the male client who had umbilicalhernia repair. What should the nurse include in the plan?a. Irrigating the drainb. Avoiding coughingc. Maintaining bed restd. Restricting pain medication25. The nurse is instructing the male client who has an inguinal hernia repair how to reducepostoperative swelling following the procedure. What should the nurse tell the client?a. Limit oral fluidb. Elevate the scrotumc. Apply heat to the abdomend. Remain in a low-fiber diet26. The nurse is caring for a hospitalized female client with a diagnosis of ulcerative colitis.Which finding, if noted on assessment of the client, would the nurse report to the physician?a. Hypotensionb. Bloody diarrheac. Rebound tendernessd. A hemoglobin level of 12 mg/dL27. The nurse is caring for a male client postoperatively following creation of a colostomy.Which nursing diagnosis should the nurse include in the plan of care?a. Sexual dysfunctionb. Body image, disturbedc. Fear related to poor prognosisd. Nutrition: more than body requirements, imbalanced28. The nurse is reviewing the record of a female client with Crohn’s disease. Which stool
  6. 6. characteristics should the nurse expect to note documented in the client’s record?a. Diarrheab. Chronic constipationc. Constipation alternating with diarrhead. Stools constantly oozing form the rectum29. The nurse is performing a colostomy irrigation on a male client. During the irrigation,the client begins to complain of abdominal cramps. What is the appropriate nursing action?a. Notify the physicianb. Stop the irrigation temporarilyc. Increase the height of the irrigationd. Medicate for pain and resume the irrigation30. The nurse is teaching a female client how to perform a colostomy irrigation. To enhancethe effectiveness of the irrigation and fecal returns, what measure should the nurse instructthe client to do?a. Increase fluid intakeb. Place heat on the abdomenc. Perform the irrigation in the eveningd. Reduce the amount of irrigation solution<< Back to Questions1. Answer C. The normal serum amylase level is 25 to 151 units/L. With chronic cases ofpancreatitis, the rise in serum amylase levels usually does not exceed three times thenormal value. In acute pancreatitis, the value may exceed five times the normal value.Options A and B are within normal limits. Option D is an extremely elevated level seen inacute pancreatitis.2. Answer C. Full liquid food items include items such as plain ice cream, sherbet,breakfast drinks, milk, pudding and custard, soups that are strained, and strained vegetablejuices. A clear liquid diet consists of foods that are relatively transparent. The food items inoptions A, B, and D are clear liquids.3. Answer A. The client with cirrhosis needs to consume foods high in thiamine. Thiamineis present in a variety of foods of plant and animal origin. Pork products are especially richin this vitamin. Other good food sources include nuts, whole grain cereals, and legumes.Milk contains vitamins A, D, and B2. Poultry contains niacin. Broccoli contains vitamins C, E,and K and folic acid4. Answer A. Unless specifically indicated, residual amounts more than 100 mL requireholding the feeding. Therefore options B, C, and D are incorrect. Additionally, the feeding isnot discarded unless its contents are abnormal in color or characteristics.
  7. 7. 5. Answer D. During the insertion of a nasogastric tube, if the client experiencesdifficulty breathing or any respiratory distress, withdraw the tube slightly, stop the tubeadvancement, and wait until the distress subsides. Options B and C are unnecessary.Quickly inserting the tube is not an appropriate action because, in this situation, it may belikely that the tube has entered the bronchus.6. Answer A. If the nasogastric tube is in the stomach, the pH of the contents will beacidic. Gastric aspirates have acidic pH values and should be 3.5 or lower. Option Bindicates a slightly acidic pH. Option C indicates a neutral pH. Option D indicates an alkalinepH.7. Answer C. When the nurse removes a nasogastric tube, the client is instructed to takeand hold a deep breath. This will close the epiglottis. This allows for easy withdrawalthrough the esophagus into the nose. The nurse removes the tube with one smooth,continuous pull.8. Answer C. If a client has a nasogastric tube connected to suction, the nurse shouldwait up to 30 minutes before reconnecting the tube to the suction apparatus to allowadequate time for medication absorption. Aspirating the nasogastric tube will remove themedication just administered. Low intermittent suction also will remove the medication justadministered. The client should not be placed in the supine position because of the risk foraspiration.9. Answer C. When the client has a Sengstaken-Blakemore tube, a pair of scissors mustbe kept at the client’s bedside at all times. The client needs to be observed for suddenrespiratory distress, which occurs if the gastric balloon ruptures and the entire tube movesupward. If this occurs, the nurse immediately cuts all balloon lumens and removes the tube.An obturator and a Kelly clamp are kept at the bedside of a client with a tracheostomy. Anirrigation set may be kept at the bedside, but it is not the priority item.10. Answer A. Hepatitis A is transmitted by the fecal-oral route via contaminated food orinfected food handlers. Hepatitis B, C, and D are transmitted most commonly via infectedblood or body fluids.11. Answer B. Laboratory indicators of hepatitis include elevated liver enzyme levels,elevated serum bilirubin levels, elevated erythrocyte sedimentation rates, and leukopenia.An elevated blood urea nitrogen level may indicate renal dysfunction. A hemoglobin level isunrelated to this diagnosis.12. Answer C. Meperidine (Demerol) rather than morphine sulfate is the medication ofchoice to treat pain because morphine sulfate can cause spasms in the sphincter of Oddi.Options A, B, and D are appropriate interventions for the client with acute pancreatitis.13. Answer A. A barium swallow is an x-ray study that uses a substance called bariumfor contrast to highlight abnormalities in the gastrointestinal tract. The client should fast for
  8. 8. 8 to 12 hours before the test, depending on physician instructions. Most oral medicationsalso are withheld before the test. After the procedure, the nurse must monitor forconstipation, which can occur as a result of the presence of barium in the gastrointestinaltract.14. Answer C. The appropriate sequence for abdominal examination is inspection,auscultation, percussion, and palpation. Auscultation is performed after inspection to ensurethat the motility of the bowel and bowel sounds are not altered by percussion or palpation.Therefore, after inspecting the skin on the abdomen, the nurse should listen for bowelsounds.15. Answer D. The solution GoLYTELY is a bowel evacuant used to prepare a client for acolonoscopy by cleansing the bowel. The solution is expected to cause a mild diarrhea andwill clear the bowel in 4 to 5 hours. Options A, B, and C are inappropriate actions.16. Answer B. Chronic gastritis causes deterioration and atrophy of the lining of thestomach, leading to the loss of the function of the parietal cells. The source of the intrinsicfactor is lost, which results in the inability to absorb vitamin B12. This leads to thedevelopment of pernicious anemia. The client is not at risk for vitamin A, C, or E deficiency.17. Answer C. Indomethacin (Indocin) is a nonsteroidal anti-inflammatory drug and cancause ulceration of the esophagus, stomach, or small intestine. Indomethacin iscontraindicated in a client with gastrointestinal disorders. Furosemide (Lasix) is a loopdiuretic. Digoxin is a cardiac medication. Propranolol (Inderal) is a β-adrenergic blocker.Furosemide, digoxin, and propranolol are not contraindicated in clients with gastricdisorders.18. Answer D. Following cholecystectomy, drainage from the T tube is initially bloodyand then turns to a greenish-brown color. The drainage is measured as output. The amountof expected drainage will range from 500 to 1000 mL/day. The nurse would document theoutput.19. Answer D. Perforation of an ulcer is a surgical emergency and is characterized bysudden, sharp, intolerable severe pain beginning in the midepigastric area and spreadingover the abdomen, which becomes rigid and board-like. Nausea and vomiting may occur.Tachycardia may occur as hypovolemic shock develops. Numbness in the legs is not anassociated finding.20. Answer C. A vagotomy, or cutting of the vagus nerve, is done to eliminateparasympathetic stimulation of gastric secretion. Options A, B, and D are incorrectdescriptions of a vagotomy.21. Answer C. In a Billroth II procedure, the proximal remnant of the stomach isanastomosed to the proximal jejunum. Patency of the nasogastric tube is critical forpreventing the retention of gastric secretions. The nurse should never irrigate or repositionthe gastric tube after gastric surgery, unless specifically ordered by the physician. In this
  9. 9. situation, the nurse should clarify the order. Options A, B, and D are appropriatepostoperative interventions.22. Answer C. Dumping syndrome is a term that refers to a constellation of vasomotorsymptoms that occurs after eating, especially following a Billroth II procedure. Earlymanifestations usually occur within 30 minutes of eating and include vertigo, tachycardia,syncope, sweating, pallor, palpitations, and the desire to lie down. The nurse should instructthe client to decrease the amount of fluid taken at meals and to avoid high-carbohydratefoods, including fluids such as fruit nectars; to assume a low-Fowler’s position during meals;to lie down for 30 minutes after eating to delay gastric emptying; and to takeantispasmodics as prescribed.23. Answer A. Early manifestations of dumping syndrome occur 5 to 30 minutes aftereating. Symptoms include vertigo, tachycardia, syncope, sweating, pallor, palpitations, andthe desire to lie down.24. Answer B. Coughing is avoided following umbilical hernia repair to prevent disruptionof tissue integrity, which can occur because of the location of this surgical procedure. Bedrest is not required following this surgical procedure. The client should take analgesics asneeded and as prescribed to control pain. A drain is not used in this surgical procedure,although the client may be instructed in simple dressing changes.25. Answer B. Following inguinal hernia repair, the client should be instructed to elevatethe scrotum and apply ice packs while in bed to decrease pain and swelling. The nurse alsoshould instruct the client to apply a scrotal support when out of bed. Heat will increaseswelling. Limiting oral fluids and a low-fiber diet can cause constipation.26. Answer C. Rebound tenderness may indicate peritonitis. Bloody diarrhea is expectedto occur in ulcerative colitis. Because of the blood loss, the client may be hypotensive andthe hemoglobin level may be lower than normal. Signs of peritonitis must be reported to thephysician.27. Answer B. Body image, disturbed relates to loss of bowel control, the presence of astoma, the release of fecal material onto the abdomen, the passage of flatus, odor, and theneed for an appliance (external pouch). No data in the question support options A and C.Nutrition: less than body requirements, imbalanced is the more likely nursing diagnosis.28. Answer A. Crohn’s disease is characterized by nonbloody diarrhea of usually notmore than four to five stools daily. Over time, the diarrhea episodes increase in frequency,duration, and severity. Options B, C, and D are not characteristics of Crohn’s disease.29. Answer B. If cramping occurs during a colostomy irrigation, the irrigation flow isstopped temporarily and the client is allowed to rest. Cramping may occur from an infusionthat is too rapid or is causing too much pressure. The physician does not need to benotified. Increasing the height of the irrigation will cause further discomfort. Medicating theclient for pain is not the appropriate action in this situation.
  10. 10. 30. Answer A. To enhance effectiveness of the irrigation and fecal returns, the client isinstructed to increase fluid intake and to take other measures to prevent constipation.Options B, C and D will not enhance the effectiveness of this procedure.Question Excerpt From Med Surg Nursing - GI disorders Which of the following is not an education tool required prior to an endoscopicQ.1) procedure?A.the purpose of the procedureB.what to expect during the procedureC.how long the procedure will takeD.preparation required prior to the surgeryQ.2) All are complications of endoscopic procedures EXCEPT?A.perforationB.aspirationC.hemorrhageD.paracentesisQ.3) Which patient is most susceptible for acquiring secondary stomatitis?A.an AIDs patient suffering from pneumoniaB.an 65 y/o obese femaleC.a 45 y/o male suffering from colon cancerD.a 50 y/o male with CHF When assessing a client during a routine checkup, the nurse reviews the history and notes that theQ.4) client had aphthous stomatitis at the time of the last visit. Aphthous stomatitis is best described as:A.a canker sore of the oral soft tissuesB.an acute stomach infectionC.acid indigestionD.an early sign of peptic ulcer diseaseQ.5) Which item is unneccessary when examing the oral cavity of a patient with candidiasis?A.glovesB.penlightC.gownD.tongue blade Which of the following is an inappropriate nursing diagnosis for a client with malignantQ.6) tumors of the oral cavity?A.Impaired oral mucous membranesB.Defieceint fluid volumeC.Acute painD.Risk for ineffective airway clearance The graduate nurse and her preceptor are establishing priorities for their morning assessments. WhichQ.7) client should they assess first?A.The newly admitted client with acute abdominal painB.The client who needs an abdominal dressing changed (POD 3)
  11. 11. C.The client receiving continuous tube feedings who needs the tube-feeding residual checkedD.The sleeping client who received pain medication 1 hour ago Gastroesophageal reflux disease is the abnormal _____ of the lower esophagealQ.8) sphincter.A.relaxationB.constrictionC.abscenceD.reductionQ.9) Which foods should a patient with GERD stay away from (multiple answers)?A.Burger King double cheeseburgerB.lettuceC.candy canesD.chocolate espressoE.white bread To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide whichQ.10) discharge instruction?A.Lie down after meals to promote digestionB.Avoid coffee and alcoholic beveragesC.Take antacids with mealsD.Limit fluid intake with mealsQ.11) Which of the following is not a common symptom of GERD?A.dyspepsiaB.regurgitationC.dysphagiaD.hyposalivationQ.12) Which drug class isnt used to treat GERD?A.antacidsB.histamine receptor antagonistsC.beta blockersD.proton pump inhibitorsQ.13) Which of the following has the least important role in terms of peptic ulcer formation?A.acidB.NSAID useC.prescence of H. pyloriD.hypertension A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurseQ.14) expects this clients stools to be:A.coffee-ground-likeB.clay-coloredC.black and tarryD.bright redQ.15) Which diagnostic test would be used first to evaluate a client with upper GI bleeding?A.Endoscopy
  12. 12. B.Upper GI seriesC.Hemoglobin (Hb) levels and hematocrit (HCTD.ArteriographyQ.16) Which of the following isnt a complication of peptic ulcer disease?A.perforationB.GI bleedingC.pyloric obstructionD.pain Which of the following are goals of drug therapy in the treatment of PUD (multipleQ.17) answers)?A.provide pain reliefB.prevent recurrenceC.heal ulcerationsD.eradicate H. pylori infection An elderly client with Alzheimers disease begins supplemental tube feedings throughQ.18) agastrostomy tube to provide adequate calorie intake. The nurse should be concerned most with the potential for:A.hyperglycemiaB.fluid volume excessC.aspirationD.constipation A client who underwent abdominal surgery who has a nasogastric (NG) tube in place begins toQ.19) complain of abdominal pain that he describes as "feeling full and uncomfortable." Which assessment should the nurse perform first?A.Measure abdominal girthB.Auscultate bowel soundsC.Assess patency of the NG tubeD.Assess vital signs To verify the placement of a gastric feeding tube, the nurse should perform at least two tests. One testQ.20) requires instilling air into the tube with a syringe and listening with a stethoscope for air passing into the stomach. Which is another test method?A.Aspiration of gastric contents and testing for a pH less than 6B.Instillation of 30 ml of water while listening with a stethoscopeC.Cessation of reflex gaggingD.Ensuring proper measurement of the tube before insertion The nurse is performing an assessment on a client who has developed a paralytic ileus. TheQ.21) clients bowel sounds will be:A.hyperactiveB.hypoactiveC.high-pitchedD.blowing Which of the following would you NOT teach a patient recently diagnosed with irritableQ.22) bowel syndrome?
  13. 13. A.identifying food intolerances and needed dietary modificationsB.decreasing fiber intakeC.avoiding coffee and and limiting alcohol intakeD.stress management Which of the following are appropriate nursing diagnoses for patients with colorectalQ.23) cancer (multiple answers)?A.Altered level of consciousnessB.Disturbed body imageC.Deficient fluid volumeD.Acute/ chronic painQ.24) Which of the following is not a complication of colorectal cancer?A.metastasesB.bleedingC.seizuresD.infectionQ.25) Which foods should patients with colorectal cancer avoid (multiple answers)?A.fish and chipsB.boiled carrots and broccoliC.beef and cabbageD.concentrated sweetsE.whole-grain products A client has undergone a colon resection. While turning him,Q.26) wound dehiscence withevisceration occurs. The nurses first response is to:A.call the physicianB.place saline-soaked sterile dressings on the woundC.take a blood pressure and pulseD.take a blood pressure and pulse For a client who must undergo colon surgery, the physician orders preoperative cleansing enemasQ.27) and neomycin sulfate (Mycifradin). The rationale for neomycin use in this client is to:A.control postoperative nausea and vomitingB.decrease the intestinal bacteria countC.increase the intestinal bacteria countD.prevent the development of megacolonQ.28) Which is the least likely to cause constipation?A.high fiber intakeB.being over 75C.overuse of laxativesD.immobilization A 72-year-old client seeks help for chronic constipation. This is a common problem for elderly clientsQ.29) due to several factors related to aging. Which is one such factor?A.Increased intestinal motilityB.Decreased abdominal strength
  14. 14. C.Increased gastric aid productionD.hyperactive bowel soundsQ.30) Which medication should the nurse expect to administer to a client with constipation?A.lorazepam (Ativan)B.loperamide (Imodium)C.flurbiprofen (Ansaid)D.docusate sodium (Colace)Q.31) Which outcome indicates effective client teaching to prevent constipation?A.The client verbalizes consumption of low-fiber foodsB.The client maintains a sedentary lifestyleC.The client limits water intake to three glasses per dayD.The client reports engaging in a regular exercise regimen In regards to appendicitis, the location of pain in the lower, right abdominal quadrant isQ.32) called:A.Kernigs signB.Mc Burneys pointC.Brudzinskis pointD.Schrutes point When preparing a client, age 50, for surgery to treat appendicitis, the nurse formulates a nursingQ.33) diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis?A.The appendectomy surgery is very invasive and it puts the client at a risk for infection Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of theB. appendix.C.Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainageD.The appendix may develop gangrene and rupture, especially in a middle-aged clientQ.34) Which of the following assessment findings suggests early appendicitis?A.nausea and vomitingB.periumbilical painC.tense positioningD.abdominal rigdityQ.35) Which of the following is not an appropriate nursing diagnosis related to appendicitis?A.Disturbed body imageB.Acute painC.Risk for infection r/t ruptureD.Deficient knowledge While preparing a client for cholecystectomy, the nurse explains that incentive spirometry will be usedQ.36) after surgery primarily to:A.increase respiratory effectiveness.B.eliminate the need for nasogastric intubation.C.improve nutritional status during recovery.D.decrease the amount of postoperative analgesia needed.Q.37) Which task can the nurse delegate to a nursing assistant?
  15. 15. A.Irrigating a nasogastric (NG) tubeB.Assisting a client who had surgery three days ago walk down the hallwayC.Helping a client who just returned from surgery to the bathroomD.Administering an antacid to a client complaining of heartburnQ.38) How are ulcerative colitis and Chrons disease definitively diagnosed?A.EGDB.CBCC.stool sampleD.colonoscopyQ.39) What is toxic megacolon (mulitple answers)?A.a complication of ulcerative colitisB.dilation and paralysis of the colonC.a fistulaD.a risk factor for pancreatitis A 28-year-old client is admitted with inflammatory bowel syndrome (Crohns disease). Which therapiesQ.40) should the nurse expect to be part of the care plan? Check all that applyA.Lactulose therapyB.High-fiber dietC.High-protein milkshakesD.Corticosteroid therapyE.Antidiarrheal medications A client is diagnosed with Crohns disease after undergoing two weeks of testing. The clients boss calls the medical-surgical floor requesting to speak with the nurse manager. He expresses concernQ.41) over the client and explains that he must know the clients diagnosis for insurance purposes. Which response by the nurse is best?A."Sure, I understand how demanding insurance companies can be."B."I appreciate your concern, but I cant give out any information."C."Why dont you come in, and we can further discuss this issue." "He has been diagnosed with Crohns Disease."D. A client with a recent history of rectal bleeding is being prepared for a colonoscopy. How should theQ.42) nurse position the client for this test initially?A.Lying on the right side with legs straightB.Lying on the left side with knees bentC.Prone with the torso elevatedD.Bent over with hands touching the floor A client has a newly created colostomy. After participating in counseling with the nurse and receivingQ.43) support from the spouse, the client decides to change the colostomy pouch unaided. Which behavior suggests that the client is beginning to accept the change in body image?A.The client asks his wife to leave the roomB.The client closes the eyes when the abdomen is exposedC.The client avoids talking about the recent surgery
  16. 16. D.The client touches the altered body part