1. Borderline Personality Disorder - Self- others and a lack of remorse.

Rationalization
Mutilation is a common defense mechanism where the
individual justifies their actions to avoid
 Question: A client with borderline personality feelings of guilt or responsibility.
disorder (BPD) frequently engages in self-  Rationales:
mutilation. The primary goal of nursing
interventions should focus on: o a. Regression is reverting to an earlier
o a. Eliminating the behavior stage of development and is not a
completely. primary defense mechanism in
o b. Teaching alternative coping antisocial personality disorder.
mechanisms. (Correct Answer) o b. Projection involves attributing
o c. Ignoring the behavior to avoid one's own unacceptable thoughts or
reinforcement. feelings to others. While it can occur,
o d. Restricting the client's access to rationalization is more characteristic.
sharp objects. o c. (Correct) Rationalization is used to
 Explanation: Borderline personality disorder excuse behaviors like lying, cheating,
is characterized by emotional instability, or stealing, by providing seemingly
impulsivity, and self-harming behaviors. The logical reasons.
primary goal of nursing care is to help the o d. Sublimation is channeling
client develop healthier coping strategies to unacceptable impulses into socially
replace self-mutilation. Simply restricting acceptable behaviors, which is a
sharp objects does not address the healthy defense mechanism, not
underlying emotional distress. typical of antisocial personality
 Rationales: disorder.

o a. Eliminating the behavior 3. Dependent Personality Disorder -

completely is unrealistic in the short Characteristics
term because BPD behaviors are
deeply ingrained and require a  Question: A client with dependent
gradual therapeutic approach. personality disorder is likely to exhibit:
o b. (Correct) Teaching alternative
coping mechanisms helps clients o a. Excessive need for control.
manage distress in healthier ways, o b. Difficulty making independent
reducing the need for self-harm. decisions. (Correct Answer)
o c. Ignoring the behavior can make the o c. Grandiose sense of self-importance.
patient feel neglected, possibly o d. Suspiciousness and mistrust.
worsening self-harm. Patients with
BPD often engage in self-mutilation to  Explanation: Dependent personality disorder
seek attention or cope with involves a pervasive need to be taken care of,
overwhelming emotions. leading to submissive and clinging behavior.
o d. While restricting sharp objects is a Individuals with this disorder have great
safety measure, it does not help the difficulty making everyday decisions without
client develop healthier ways to excessive advice and reassurance from others.
manage emotional pain.  Rationales:

2. Antisocial Personality Disorder - Defense o a. An excessive need for control is

Mechanisms more aligned with obsessive-
compulsive personality disorder.
 Question: Which of the following is a o b. (Correct) Difficulty making
common defense mechanism used by clients independent decisions is a core
with antisocial personality disorder? feature of dependent personality
disorder.
o a. Regression o c. A grandiose sense of self-
o b. Projection - paranoid importance is characteristic of
o c. Rationalization (Correct Answer) narcissistic personality disorder.
o d. Sublimation o d. Suspiciousness and mistrust are
associated with paranoid personality
 Explanation: Antisocial personality disorder is disorder.
characterized by a disregard for the rights of
4. Narcissistic Personality Disorder - Interactions preoccupation can interfere with flexibility,
openness, and efficiency.
 Question: When interacting with a client who  Rationales:
has narcissistic personality disorder, it is
important to: o a. Fears of abandonment are more
associated with borderline or
o a. Challenge their grandiose dependent personality disorder.
statements. o b. (Correct) A need for perfection and
o b. Provide constant praise and control is a central characteristic of
admiration. obsessive-compulsive personality
o c. Set firm limits on manipulative disorder.
behavior. (Correct Answer) o c. Dramatic emotional displays are
o d. Ignore their need for attention. more typical of histrionic personality
disorder.
 Explanation: Narcissistic personality disorder o d. Impulsive and reckless behavior is
is characterized by a sense of grandiosity, a more characteristic of antisocial or
need for admiration, and a lack of empathy. borderline personality disorder.
These individuals may engage in manipulative
behavior to get their needs met. Setting firm 6. Histrionic Personality Disorder - Nursing
limits helps to manage this behavior and Interventions
maintain a therapeutic relationship.
 Rationales:  Question: Which of the following
interventions is most important when caring
o a. Challenging their grandiose for a client with histrionic personality
statements can lead to defensiveness disorder?
and damage the therapeutic
relationship. o a. Encouraging emotional restraint.
o b. Providing constant praise and o b. Maintaining professional
admiration reinforces their narcissistic boundaries. (Correct Answer)
traits. o c. Promoting social isolation.
o c. (Correct) Setting firm limits on o d. Reinforcing dramatic behavior.
manipulative behavior is essential to
protect others and promote healthier  Explanation: Histrionic personality disorder
interactions. (HPD) is marked by excessive emotionality
o d. Ignoring their need for attention is and attention-seeking behavior. Patients
not therapeutic and may escalate often exaggerate their emotions and may act
their behavior. inappropriately to gain attention. The best
nursing intervention is to maintain
professional boundaries to prevent excessive
emotional dependence.
 Rationales:

5. Obsessive-Compulsive Personality Disorder - o a. Encouraging emotional restraint,

Preoccupations while seemingly logical, can be
difficult for these patients and isn't
 Question: A client with obsessive-compulsive the core issue.
personality disorder is likely to be o b. (Correct) Maintaining professional
preoccupied with: boundaries is essential because these
patients may try to form
o a. Fears of abandonment. inappropriate relationships with
o b. Need for perfection and control. healthcare providers.
(Correct Answer) o c. Promoting social isolation is
o c. Dramatic emotional displays. counterproductive; these patients
o d. Impulsive and reckless behavior. need to learn appropriate social skills.
o d. Reinforcing dramatic behavior only
 Explanation: Obsessive-compulsive worsens the condition.
personality disorder is characterized by a
preoccupation with orderliness, 7. Avoidant Personality Disorder - Characteristics
perfectionism, and control. This
  Question: A client with avoidant personality o b. Cognitive restructuring is a
disorder is likely to experience: component of cognitive-behavioral
therapy (CBT), but DBT places a
o a. Intense anger outbursts. greater emphasis on emotional
o b. Social inhibition and feelings of regulation and acceptance.
inadequacy. (Correct Answer) o c. (Correct) Mindfulness and emotion
o c. Delusions and hallucinations. regulation are essential skills taught in
o d. Rapid mood swings. DBT to help patients manage intense
emotions and impulsive behaviors.
 Explanation: Avoidant personality disorder is o d. Aversion therapy is a behavioral
characterized by extreme social inhibition, therapy technique that pairs an
feelings of inadequacy, and hypersensitivity undesirable behavior with an
to negative evaluation. Individuals with this unpleasant stimulus and is not used in
disorder fear criticism and rejection, leading DBT.
to significant social limitations.
 Rationales: 9. Paranoid Personality Disorder - Characteristics

o a. Intense anger outbursts are more  Question: A client with paranoid personality
associated with borderline personality disorder is likely to exhibit:
disorder or intermittent explosive
disorder. o a. Excessive emotional expression.
o b. (Correct) Social inhibition and o b. Pervasive distrust and suspicion.
feelings of inadequacy are core (Correct Answer)
features of avoidant personality o c. Need for constant reassurance.
disorder. o d. Impulsive decision-making.
o c. Delusions and hallucinations are
symptoms of psychotic disorders, not  Explanation: Paranoid personality disorder is
personality disorders. characterized by a pervasive pattern of
o d. Rapid mood swings are more distrust and suspiciousness of others.
characteristic of borderline Individuals with this disorder interpret the
personality disorder or bipolar motives of others as malevolent, even in the
disorder. absence of evidence.
 Rationales:
8. Borderline Personality Disorder - Dialectical
Behavior Therapy (DBT) o a. Excessive emotional expression is
more typical of histrionic personality
 Question: Which of the following is a key disorder.
component of dialectical behavior therapy o b. (Correct) Pervasive distrust and
(DBT) used for BPD? suspicion are the hallmark traits of
paranoid personality disorder.
o a. Psychoanalysis. o c. A need for constant reassurance is
o b. Cognitive restructuring. more characteristic of dependent
o c. Mindfulness and emotion personality disorder.
regulation. (Correct Answer) o d. Impulsive decision-making is more
o d. Aversion therapy. associated with antisocial or
borderline personality disorder.
 Explanation: Dialectical behavior therapy
(DBT) is a specific type of psychotherapy 10. Antisocial Personality Disorder - Manipulation
developed to treat borderline personality
disorder. It emphasizes teaching patients  Question: When a client with antisocial
skills to cope with stress, regulate emotions, personality disorder attempts to manipulate
and improve relationships. Mindfulness and staff, the most appropriate response is to:
emotion regulation are core components of
DBT. o a. Agree to their demands to avoid
 Rationales: conflict.
o b. Confront them aggressively.
o a. Psychoanalysis is a different form of o c. Consistently enforce established
therapy that is less structured and limits. (Correct Answer)
focused on past experiences. o d. Ignore the behavior.
  Explanation: Clients with antisocial o c. Grandiose sense of self.
personality disorder often engage in o d. Excessive need for attention.
manipulation to get what they want. The
most effective approach is for staff to  Explanation: Schizotypal personality disorder
consistently enforce rules and limits to is characterized by odd or eccentric behavior,
prevent the client from exploiting others. peculiar thought patterns, and social anxiety.
 Rationales: Individuals with this disorder often have odd
beliefs and prefer social isolation.
o a. Agreeing to their demands  Rationales:
reinforces the manipulative behavior.
o b. Confronting them aggressively can o a. (Correct) Social isolation and odd
escalate the situation and is beliefs are key features of schizotypal
unprofessional. personality disorder.
o c. (Correct) Consistently enforcing o b. Intense fear of abandonment is
established limits provides clear more typical of borderline personality
expectations and reduces the disorder.
effectiveness of manipulation. o c. A grandiose sense of self is
o d. Ignoring the behavior can be characteristic of narcissistic
interpreted as permission and does personality disorder.
not address the underlying issue. o d. An excessive need for attention is
seen in histrionic personality disorder.
11. Borderline Personality Disorder - Medication
13. Self-Injurious Behavior - Nursing
 Question: Which medication class is Interventions
commonly used to manage mood instability
in BPD?  Question: Which of the following is a primary
o a. Antipsychotics nursing intervention for a client with self-
o b. Antidepressants injurious behavior?
o c. Mood stabilizers (Correct Answer)
o d. Anxiolytics o a. Administering physical restraints
 Explanation: Mood stabilizers are frequently immediately.
used to help manage the intense mood o b. Exploring the client's past trauma in
swings that are characteristic of borderline detail.
personality disorder. These medications help o c. Establishing a safety contract with
to reduce the frequency and severity of the client. (Correct Answer)
emotional fluctuations. o d. Ignoring the behavior to avoid
 Rationales: reinforcement.

o a. Antipsychotics are used for  Explanation: When a client is engaging in self-

psychotic symptoms, which are not a injurious behavior, the priority is to ensure
core feature of BPD. safety and develop a plan to help them avoid
o b. Antidepressants can treat co- harm. A safety contract is a collaborative
occurring depression but don't agreement where the client commits to
directly target mood instability. seeking help instead of self-harming.
o c. (Correct) Mood stabilizers are the  Rationales:
primary medication class to address
mood lability in BPD. o a. Physical restraints should only be
o d. Anxiolytics treat anxiety symptoms used as a last resort when there is an
but not the underlying mood swings. immediate risk of harm to self or
others.
12. Schizotypal Personality Disorder - o b. Exploring past trauma is important
Characteristics but not the immediate priority; safety
is the first concern.
 Question: A client with schizotypal o c. (Correct) A safety contract
personality disorder may exhibit: promotes client involvement in their
care and provides a structured plan.
o a. Social isolation and odd beliefs. o d. Ignoring self-injurious behavior is
(Correct Answer) never appropriate and can be
o b. Intense fear of abandonment. dangerous.
14. Antisocial Personality Disorder - Risk Factors o b. Minimizing the significance of their
actions is denial or rationalization.
 Question: A client with antisocial personality o c. Projecting their own feelings onto
disorder is at increased risk for: others is projection.
o d. Replacing unacceptable impulses
o a. Developing strong interpersonal with socially acceptable ones is
relationships. sublimation.
o b. Engaging in criminal behavior.
(Correct Answer) 16. Personality Disorders - General Principles
o c. Experiencing intense guilt and
remorse.  Question: When working with a client with a
o d. Seeking help for emotional distress. personality disorder, it is important to
remember that:
 Explanation: Antisocial personality disorder is
characterized by a disregard for the rights of o a. Their behaviors are always
others and a lack of conformity to social intentional and manipulative.
norms. This often leads to involvement in o b. Their behaviors are often a result of
illegal activities. ingrained patterns. (Correct Answer)
 Rationales: o c. They can easily change their
behaviors with simple encouragement.
o a. Antisocial personality disorder is o d. They are not capable of forming
associated with difficulty forming meaningful relationships.
genuine relationships.
o b. (Correct) Engaging in criminal  Explanation: Personality disorders are
behavior is a significant risk due to the characterized by inflexible and enduring
lack of regard for rules and laws. patterns of behavior that are deeply
o c. A lack of guilt and remorse is a ingrained and difficult to change. It's
hallmark of antisocial personality important to recognize that these behaviors
disorder. are often not consciously chosen but rather
o d. Individuals with this disorder rarely represent long-standing maladaptive
seek help voluntarily. patterns.
 Rationales:
15. Borderline Personality Disorder - Splitting
o a. While manipulation can occur, it's
 Question: Which of the following is a not always intentional; many
characteristic of splitting, a defense behaviors are automatic.
mechanism often used by clients with BPD? o b. (Correct) Ingrained patterns are a
hallmark of personality disorders.
o a. Viewing others as all good or all bad. o c. Change is difficult and requires
(Correct Answer) intensive therapy, not just
o b. Minimizing the significance of their encouragement.
actions. o d. They are capable of relationships,
o c. Projecting their own feelings onto but these are often impaired.
others.
o d. Replacing unacceptable impulses 17. Cushing's Syndrome - Signs and Symptoms
with socially acceptable ones.
 Question: A client with Cushing's syndrome is
 Explanation: Splitting is a defense mechanism likely to exhibit which of the following signs
where individuals perceive themselves and and symptoms?
others as either entirely good or entirely bad,
without the ability to integrate positive and o a. Hypotension and weight loss.
negative qualities. This leads to unstable o b. Moon face and buffalo hump.
relationships and rapid shifts in perception. (Correct Answer)
 Rationales: o c. Cold intolerance and bradycardia.
o d. Polyuria and polydipsia.
o a. (Correct) Viewing others as all good
or all bad is the core feature of  Explanation: Cushing's syndrome is caused by
splitting. prolonged exposure to high levels of the
hormone cortisol. Characteristic signs include
 "moon face" (round face) and a "buffalo o b. Hypokalemia and hypernatremia.
hump" (fat pad on the upper back). o c. Hypercalcemia and
 Rationales: hypophosphatemia.
o d. Hypocalcemia and
o a. Hypotension and weight loss are hyperphosphatemia.
more typical of Addison's disease
(adrenal insufficiency).  Explanation: Addison's disease
o b. (Correct) Moon face and buffalo (adrenocortical insufficiency) results in
hump are classic signs of Cushing's decreased production of aldosterone, which
syndrome. leads to sodium and water loss and
o c. Cold intolerance and bradycardia potassium retention. This causes
are signs of hypothyroidism. hyponatremia (low sodium) and
o d. Polyuria and polydipsia are signs of hyperkalemia (high potassium).
diabetes insipidus or diabetes mellitus.  Rationales:

18. Thyroid Storm - Nursing Interventions o a. (Correct) Hyperkalemia and

hyponatremia are the classic
 Question: Which of the following is a priority electrolyte imbalances in Addison's
nursing intervention for a client experiencing disease.
a thyroid storm? o b. Hypokalemia and hypernatremia
are seen in conditions with excess
o a. Administering oral hypoglycemic aldosterone.
agents. o c. Hypercalcemia and
o b. Providing a warm environment. hypophosphatemia are not typically
o c. Administering beta-blockers to associated with Addison's disease.
decrease heart rate. (Correct Answer) o d. Hypocalcemia and
o d. Encouraging increased fluid intake. hyperphosphatemia are also not
characteristic of Addison's disease.
 Explanation: Thyroid storm is a severe and
life-threatening condition caused by a sudden 20. Diabetes Insipidus - Laboratory Values
increase in thyroid hormone levels. A priority
intervention is to decrease the heart rate and  Question: Which of the following laboratory
reduce cardiac workload, which is achieved values is most important to monitor in a
by administering beta-blockers. client with diabetes insipidus?
 Rationales:
o a. Serum glucose.
o a. Oral hypoglycemic agents are used o b. Serum sodium. (Correct Answer)
to treat hyperglycemia, not thyroid o c. Thyroid-stimulating hormone (TSH).
storm. o d. Hemoglobin A1c.
o b. A warm environment is
contraindicated as it can worsen  Explanation: Diabetes insipidus is caused by a
hyperthermia associated with thyroid deficiency of antidiuretic hormone (ADH),
storm. leading to the excretion of large amounts of
o c. (Correct) Beta-blockers are crucial dilute urine. This results in hypernatremia
to control the rapid heart rate and (high sodium) due to the loss of free water.
reduce the risk of cardiac Monitoring serum sodium levels is crucial.
complications.  Rationales:
o d. While fluid intake is important, it is
not the priority over addressing the o a. Serum glucose is monitored in
cardiovascular effects. diabetes mellitus, not diabetes
insipidus.
19. Addison's Disease - Electrolyte Imbalances o b. (Correct) Serum sodium is the most
important lab value to monitor due to
 Question: A client with Addison's disease is at the risk of hypernatremia.
risk for which of the following electrolyte o c. Thyroid-stimulating hormone (TSH)
imbalances? is monitored in thyroid disorders.
o d. Hemoglobin A1c is a measure of
o a. Hyperkalemia and hyponatremia. long-term glucose control in diabetes
(Correct Answer) mellitus.
21. Hypothyroidism - Signs and Symptoms o d. Vitamin D is needed for calcium
absorption; restricting it is not the
 Question: A client with hypothyroidism is primary intervention.
likely to exhibit which of the following signs
and symptoms? 23. Diabetic Ketoacidosis (DKA) - Signs and
Symptoms
o a. Tachycardia and heat intolerance.
o b. Weight gain and fatigue. (Correct  Question: A client with diabetic ketoacidosis
Answer) (DKA) is likely to exhibit which of the
o c. Exophthalmos and tremors. following signs and symptoms?
o d. Polyuria and polydipsia.
o a. Bradycardia and hypotension.
 Explanation: Hypothyroidism is a condition o b. Kussmaul respirations and fruity
where the thyroid gland does not produce breath. (Correct Answer)
enough thyroid hormone. This leads to a o c. Cold extremities and diaphoresis.
slowing of metabolic processes, resulting in o d. Constipation and abdominal
symptoms like weight gain and fatigue. distention.
 Rationales:
 Explanation: Diabetic ketoacidosis (DKA) is a
o a. Tachycardia and heat intolerance serious complication of diabetes caused by a
are signs of hyperthyroidism. severe lack of insulin. It leads to
o b. (Correct) Weight gain and fatigue hyperglycemia, ketosis, and metabolic
are common symptoms of acidosis. Kussmaul respirations (deep, rapid
hypothyroidism. breathing) and fruity breath (due to acetone)
o c. Exophthalmos and tremors are are characteristic signs.
associated with hyperthyroidism  Rationales:
(Graves' disease).
o d. Polyuria and polydipsia are signs of o a. Bradycardia is not typical;
diabetes insipidus or diabetes mellitus. tachycardia is more common.
Hypotension occurs later in DKA.
22. Hyperparathyroidism - Nursing Interventions o b. (Correct) Kussmaul respirations and
fruity breath are classic signs of DKA.
 Question: Which of the following is a key o c. Cold extremities and diaphoresis
nursing intervention for a client with are signs of hypoglycemia.
hyperparathyroidism? o d. Abdominal symptoms can occur but
are not the most distinctive signs.
o a. Encouraging a low-calcium diet.
o b. Monitoring for signs of tetany. 24. Hypothyroidism - Medications
o c. Promoting increased fluid intake.
(Correct Answer)  Question: Which of the following medications
o d. Restricting vitamin D intake. is used to treat hypothyroidism?

 Explanation: Hyperparathyroidism involves o a. Methimazole.

excessive secretion of parathyroid hormone, o b. Propylthiouracil (PTU).
leading to hypercalcemia (high calcium o c. Levothyroxine. (Correct Answer)
levels). Increased fluid intake helps to dilute o d. Radioactive iodine.
the calcium in the blood and prevent kidney
stones.  Explanation: Hypothyroidism is treated with
 Rationales: thyroid hormone replacement. Levothyroxine
is a synthetic form of thyroxine (T4), which is
o a. A low-calcium diet may be used, the primary hormone produced by the
but promoting fluid intake is more thyroid gland.
crucial for immediate management.  Rationales:
o b. Tetany (muscle spasms) is a sign of
hypocalcemia, not hypercalcemia. o a. Methimazole is an antithyroid drug
o c. (Correct) Increased fluid intake is a used to treat hyperthyroidism.
key intervention to manage o b. Propylthiouracil (PTU) is also an
hypercalcemia. antithyroid drug.
 o c. (Correct) Levothyroxine is the o b. Early ambulation is important
standard treatment for postoperatively but is not the priority
hypothyroidism. over airway and calcium monitoring.
o d. Radioactive iodine is used to o c. Radioactive iodine is used to treat
destroy thyroid tissue in hyperthyroidism, not after
hyperthyroidism. thyroidectomy.
o d. A high-fiber diet is generally
25. Pheochromocytoma - Risk Factors beneficial but not the priority in the
immediate postoperative period.
 Question: A client with pheochromocytoma is
at risk for: 27. Syndrome of Inappropriate Antidiuretic
Hormone (SIADH) - Signs and Symptoms
o a. Severe hypotension.
o b. Hyperglycemia and hypertension.  Question: A client with syndrome of
(Correct Answer) inappropriate antidiuretic hormone (SIADH)
o c. Hypoglycemia and bradycardia. is likely to exhibit:
o d. Hypokalemia and polyuria.
o a. Hypernatremia and polyuria.
 Explanation: Pheochromocytoma is a tumor o b. Hyponatremia and fluid overload.
of the adrenal gland that causes the release (Correct Answer)
of excessive amounts of catecholamines o c. Hyperglycemia and polydipsia.
(epinephrine and norepinephrine). This leads o d. Hypokalemia and dehydration.
to severe hypertension and can also cause
hyperglycemia.  Explanation: SIADH involves excessive release
 Rationales: of antidiuretic hormone (ADH), leading to
water retention and dilutional hyponatremia
o a. Pheochromocytoma causes (low sodium). This results in fluid overload
hypertension, not hypotension. and decreased urine output.
o b. (Correct) Hyperglycemia and  Rationales:
hypertension are the primary risks
due to catecholamine release. o a. Hypernatremia and polyuria are
o c. Hypoglycemia and bradycardia are seen in diabetes insipidus.
not typical of pheochromocytoma. o b. (Correct) Hyponatremia and fluid
o d. Hypokalemia and polyuria are not overload are characteristic of SIADH.
characteristic of this condition. o c. Hyperglycemia and polydipsia are
signs of diabetes mellitus.
26. Thyroidectomy - Postoperative Care o d. Hypokalemia and dehydration are
not typical of SIADH.
 Question: Which of the following is a priority
nursing intervention for a client after a 28. Insulin Administration - Preventing
thyroidectomy? Lipodystrophy

o a. Monitoring for signs of  Question: When administering insulin, which

hypocalcemia. (Correct Answer) of the following actions is essential for
o b. Encouraging early ambulation. preventing lipodystrophy?
o c. Administering radioactive iodine. o a. Injecting insulin at room
o d. Promoting a high-fiber diet. temperature.
o b. Rotating injection sites. (Correct
 Explanation: After a thyroidectomy, there is a Answer)
risk of damage to the parathyroid glands, o c. Aspirating before injection.
which can lead to hypocalcemia. Monitoring o d. Massaging the injection site after
for signs of hypocalcemia (e.g., tetany, administration.
Chvostek's sign, Trousseau's sign) is a priority.  Explanation: Lipodystrophy, which includes
 Rationales: both lipohypertrophy (lumps under the skin)
and lipoatrophy (loss of fat tissue), is a
o a. (Correct) Monitoring for common complication of repeated insulin
hypocalcemia is crucial due to the risk injections at the same site. Rotating injection
of parathyroid gland injury. sites prevents this.
 Rationales:
 o a. Injecting insulin at room  Explanation: Long-term use of glucocorticoids
temperature can make the injection (like prednisone) can lead to various side
more comfortable but does not effects, including osteoporosis, due to
prevent lipodystrophy. decreased calcium absorption and increased
o b. (Correct) Rotating injection sites is bone breakdown.
the most effective way to prevent  Rationales:
lipodystrophy.
o c. Aspirating before insulin injection is o a. Glucocorticoids can cause
no longer routinely recommended as hyperglycemia, not hypoglycemia.
it doesn't significantly reduce the risk o b. (Correct) Osteoporosis is a well-
of intramuscular injection. known complication of long-term
o d. Massaging the injection site is not glucocorticoid use.
recommended as it can affect the rate o c. Glucocorticoids can cause sodium
of insulin absorption. retention and potassium loss
(hypokalemia), not hyperkalemia.
o d. Glucocorticoids often lead to
weight gain, not weight loss.
29. Acromegaly - Signs and Symptoms
31. Pituitary Tumor - Visual Disturbances
 Question: A client with acromegaly is likely to
exhibit:  Question: A client with a pituitary tumor is at
risk for which of the following visual
o a. Decreased bone density. disturbances?
o b. Enlarged hands and feet. (Correct
Answer) o a. Macular degeneration.
o c. Weight loss and fatigue. o b. Tunnel vision.
o d. Exophthalmos and tachycardia. o c. Diplopia.
o d. Bitemporal hemianopsia. (Correct
 Explanation: Acromegaly is a hormonal Answer)
disorder caused by prolonged hypersecretion
of growth hormone. This leads to the  Explanation: Pituitary tumors can compress
enlargement of bones in the hands, feet, and the optic chiasm, leading to bitemporal
face. hemianopsia, which is the loss of the outer
 Rationales: half of the visual field in both eyes.
 Rationales:
o a. Decreased bone density is more
characteristic of osteoporosis or o a. Macular degeneration affects
Cushing's syndrome. central vision.
o b. (Correct) Enlarged hands and feet o b. Tunnel vision is a constricted field
are a hallmark sign of acromegaly. of vision.
o c. Weight loss and fatigue are more o c. Diplopia is double vision.
common in hyperthyroidism or o d. (Correct) Bitemporal hemianopsia
Addison's disease. is the classic visual field defect
o d. Exophthalmos and tachycardia are associated with pituitary tumors.
signs of hyperthyroidism (Graves'
disease). 32. Ataxia - Risk Factors

30. Long-Term Glucocorticoid Therapy -  Question: A client with ataxia is at increased

Complications risk for:

 Question: Which of the following is a o a. Hypertension.

common complication of long-term o b. Falls. (Correct Answer)
glucocorticoid therapy? o c. Seizures.
o d. Bradycardia.
o a. Hypoglycemia.
o b. Osteoporosis. (Correct Answer)  Explanation: Ataxia is a lack of muscle
o c. Hyperkalemia. coordination, which can affect balance and
o d. Weight loss. gait. This significantly increases the risk of
falls.
  Rationales: o a. Vertigo does not typically increase
appetite.
o a. Ataxia is not directly related to o b. (Correct) A sensation of spinning is
hypertension. the defining symptom of vertigo.
o b. (Correct) Falls are a major risk due o c. Vertigo does not cause loss of
to impaired coordination. bowel control.
o c. Ataxia does not directly increase o d. Vertigo often impairs mental clarity.
the risk of seizures.
o d. Ataxia does not cause bradycardia. 35. Sensory Perception Deficits - Assessment

33. Unilateral Neglect - Nursing Interventions  Question: When assessing a client with
suspected sensory perception deficits, which
 Question: Which of the following is a key of the following is most important?
nursing intervention for a client with
unilateral neglect? o a. Obtaining a detailed medical
history. (Correct Answer)
o a. Encouraging the client to focus o b. Checking the client's blood
solely on the affected side. pressure.
o b. Approaching the client exclusively o c. Measuring the client's height and
from the unaffected side. weight.
o c. Placing personal items within the o d. Assessing the client's level of
client's neglected visual field. (Correct consciousness.
Answer)
o d. Ignoring the client's neglect to  Explanation: A detailed medical history is
avoid reinforcing the behavior. crucial to identify the onset, duration, and
nature of sensory deficits, as well as any
 Explanation: Unilateral neglect is a condition underlying conditions.
where a client is unaware of one side of their  Rationales:
body or the environment. Placing items in the
neglected field encourages the client to o a. (Correct) A detailed medical history
attend to that side. is essential for a thorough assessment.
 Rationales: o b. Blood pressure is important but not
the priority for sensory deficits.
o a. While encouraging attention to the o c. Height and weight are not directly
affected side is important, forcing relevant to sensory perception.
exclusive focus is not therapeutic. o d. Level of consciousness is important
o b. Approaching only from the but the history is more focused on the
unaffected side reinforces the neglect. sensory issue.
o c. (Correct) Placing items in the
neglected field helps the client 36. Parkinson's Disease - Tremors
become aware of and use that side.
o d. Ignoring the neglect is not helpful  Question: A client with Parkinson's disease
and can be unsafe. often experiences tremors. Which of the
following interventions can help minimize
34. Vertigo - Symptoms these tremors?

 Question: A client with vertigo is likely to o a. Encouraging strenuous exercise.

experience: o b. Providing a calm and quiet
environment. (Correct Answer)
o a. Increased appetite. o c. Restricting fluid intake.
o b. A sensation of spinning. (Correct o d. Administering stimulants.
Answer)
o c. Loss of bowel control.  Explanation: Stress and anxiety can worsen
o d. Increased mental clarity. Parkinsonian tremors. A calm environment
can help reduce these triggers.
 Explanation: Vertigo is a sensation of  Rationales:
spinning or whirling, often caused by inner
ear problems. o a. Strenuous exercise can exacerbate
 Rationales: tremors.
 o b. (Correct) A calm and quiet o c. A high-protein diet is not
environment can help minimize specifically indicated for Meniere's
tremors. disease.
o c. Fluid intake is not directly related to o d. A low-potassium diet is used for
tremor management. kidney disease, not Meniere's disease.
o d. Stimulants can worsen tremors.
39. Impaired Proprioception - Nursing
37. Dementia - Perceptual Disturbances Interventions

 Question: Which of the following is a  Question: Which of the following is a priority

common perceptual disturbance in clients nursing intervention for a client with
with dementia? impaired proprioception?

o a. Hypervigilance. o a. Encouraging the client to walk

o b. Agnosia. (Correct Answer) barefoot.
o c. Euphoria. o b. Providing assistive devices for
o d. Increased pain tolerance. ambulation. (Correct Answer)
o c. Restricting the client's movement.
 Explanation: Agnosia is the inability to o d. Encouraging the client to move
recognize familiar objects, people, or sounds, quickly.
which is a common perceptual disturbance in
dementia.  Explanation: Proprioception is the sense of
 Rationales: body position and movement. Impairment
increases the risk of falls, so assistive devices
o a. Hypervigilance is a state of are essential for safe ambulation.
increased alertness.  Rationales:
o b. (Correct) Agnosia is a key
perceptual disturbance in dementia. o a. Walking barefoot can be dangerous
o c. Euphoria is a state of intense with impaired proprioception.
happiness. o b. (Correct) Assistive devices provide
o d. Dementia can impair pain stability and prevent falls.
perception, but increased tolerance is o c. Restricting movement is not
not the primary issue. therapeutic unless there's an acute
safety risk.
38. Meniere's Disease - Dietary Restrictions o d. Quick movements increase the risk
of injury.
 Question: A client with Meniere's disease
should be educated on which of the following 40. Visual Perceptual Deficits - Environmental
dietary restrictions? Modifications

o a. High-fiber diet.  Question: A client experiencing visual

o b. Low-sodium diet. (Correct Answer) perceptual deficits may benefit from:
o c. High-protein diet.
o d. Low-potassium diet. o a. Dimly lit environments.
o b. Cluttered surroundings.
 Explanation: Meniere's disease is an inner ear o c. High-contrast colors. (Correct
disorder that can cause vertigo. A low- Answer)
sodium diet helps to reduce fluid retention, o d. Frequent changes in room layout.
which can alleviate symptoms.
 Rationales:  Explanation: High-contrast colors help
individuals with visual deficits to better
o a. A high-fiber diet is important for distinguish objects and navigate their
bowel health but not Meniere's environment.
disease.  Rationales:
o b. (Correct) A low-sodium diet is
recommended to manage fluid o a. Dimly lit environments worsen
balance. visual deficits.
o b. Cluttered surroundings increase
confusion and falls.
 o c. (Correct) High-contrast colors  Question: Which of the following is a
improve visibility. common cause of peripheral neuropathy,
o d. Frequent changes in layout leading to sensory and coordination
increase disorientation. problems?

41. Coordination Assessment - Tests o a. Hypertension.

o b. Diabetes mellitus. (Correct Answer)
 Question: When assessing a client's o c. Hypothyroidism.
coordination, which of the following tests is o d. Hyperlipidemia.
commonly used?
 Explanation: Diabetes mellitus is a major
o a. Romberg test. (Correct Answer) cause of peripheral neuropathy, which
o b. Babinski reflex. damages nerves and leads to sensory loss
o c. Deep tendon reflexes. and impaired coordination.
o d. Pupillary response.  Rationales:

 Explanation: The Romberg test assesses o a. Hypertension mainly affects the

balance and coordination by observing if a cardiovascular system.
person can stand with their eyes closed o b. (Correct) Diabetes mellitus is a
without swaying. leading cause of peripheral
 Rationales: neuropathy.
o c. Hypothyroidism can cause some
o a. (Correct) The Romberg test neurological symptoms but is not a
specifically assesses coordination and primary cause of peripheral
balance. neuropathy.
o b. The Babinski reflex tests for o d. Hyperlipidemia contributes to
neurological damage. cardiovascular disease.
o c. Deep tendon reflexes assess the
nervous system but not coordination. 44. Apraxia - Difficulties
o d. Pupillary response assesses
neurological function related to the  Question: A client with apraxia may have
eyes. difficulty:

42. Seizures - Perceptual Changes o a. Understanding spoken language.

o b. Performing purposeful movements.
 Question: A client with a history of seizures (Correct Answer)
should be assessed for which of the following o c. Recognizing familiar faces.
perceptual changes? o d. Experiencing emotional lability.

o a. Aura. (Correct Answer)  Explanation: Apraxia is a motor disorder that

o b. Increased appetite. impairs the ability to perform learned,
o c. Decreased heart rate. purposeful movements, despite having the
o d. Improved memory. physical ability and willingness to do so.
 Rationales:
 Explanation: An aura is a perceptual
disturbance (e.g., visual, auditory, olfactory) o a. Understanding spoken language is
that can precede a seizure. affected by aphasia, not apraxia.
 Rationales: o b. (Correct) Apraxia impairs the ability
to carry out motor commands.
o a. (Correct) An aura is a warning sign o c. Recognizing familiar faces is
that a seizure may occur. affected by agnosia.
o b. Increased appetite is not typically o d. Emotional lability is characterized
related to seizures. by rapid mood swings.
o c. Heart rate may increase during a
seizure, but a decrease is not a typical 45. Sensory Overload - Interventions
perceptual change.
o d. Seizures can impair memory.  Question: When caring for a client with
sensory overload, which of the following
43. Peripheral Neuropathy - Causes interventions is appropriate?
 o a. Increasing environmental stimuli. 47. Dysphagia - Risks
o b. Providing frequent, detailed
explanations.  Question: A client with dysphagia is at
o c. Reducing noise and lighting. increased risk for:
(Correct Answer)
o d. Encouraging frequent visitors. o a. Hyperglycemia.
o b. Aspiration pneumonia. (Correct
 Explanation: Sensory overload occurs when Answer)
the brain is overwhelmed by excessive o c. Hypokalemia.
sensory input. Reducing stimuli helps to o d. Renal failure.
create a calming environment.
 Rationales:  Explanation: Dysphagia is difficulty
swallowing, which increases the risk of food
o a. Increasing stimuli worsens sensory or liquid entering the lungs, leading to
overload. aspiration pneumonia.
o b. Detailed explanations can add to  Rationales:
the overload.
o c. (Correct) Reducing noise and o a. Dysphagia is not directly related to
lighting helps to minimize sensory hyperglycemia.
input. o b. (Correct) Aspiration pneumonia is a
o d. Frequent visitors can contribute to major risk with dysphagia.
sensory overload. o c. Dysphagia does not directly cause
hypokalemia.
46. Stroke with Hemiplegia - Safety Precautions o d. Dysphagia does not directly lead to
renal failure.
 Question: A client who has had a stroke, and
now has right-sided hemiplegia, should have 48. Anorexia Nervosa - Nursing Interventions
what kind of safety precautions implemented?
 Question: Which of the following is a key
o a. Raise the head of the bed to a high nursing intervention for a client with
Fowler's position. anorexia nervosa?
o b. Place all needed items on the o a. Encouraging rapid weight gain.
client's left side. (Correct Answer) o b. Monitoring electrolyte levels.
o c. Encourage the client to walk (Correct Answer)
without assistance to promote o c. Promoting strenuous exercise.
independence. o d. Allowing unrestricted access to
o d. Place the call light out of reach, so food.
the client does not accidentally call  Explanation: Anorexia nervosa is an eating
the nurse. disorder characterized by an abnormally low
body weight, an intense fear of gaining
 Explanation: Hemiplegia is paralysis on one weight, and a distorted perception of weight.
side of the body. Placing items on the Monitoring electrolyte levels is crucial
unaffected (left) side encourages the client to because imbalances can lead to cardiac
turn and attend to that side, promoting arrhythmias and other life-threatening
safety and awareness. complications.
 Rationales:  Rationales:

o a. While head elevation is important, o a. Rapid weight gain can overwhelm

it's not the primary safety precaution the system and lead to refeeding
for hemiplegia. syndrome.
o b. (Correct) Placing items on the o b. (Correct) Monitoring electrolyte
unaffected side compensates for the levels is essential due to the risk of
neglect of the affected side. imbalances.
o c. Walking without assistance is o c. Promoting strenuous exercise is
unsafe due to weakness and balance contraindicated as it exacerbates
issues. weight loss.
o d. The call light must be within reach o d. Unrestricted access to food does
for the client to call for assistance. not address the psychological
component of the disorder.
49. Gastric Bypass Surgery - Risks  Question: When administering enteral
feedings, which of the following is a priority
 Question: A client with a history of gastric nursing intervention?
bypass surgery is at risk for:
o a. Positioning the client supine.
o a. Hypernatremia. o b. Checking tube placement before
o b. Dumping syndrome. (Correct each feeding. (Correct Answer)
Answer) o c. Administering cold formula.
o c. Hyperlipidemia. o d. Infusing feedings rapidly.
o d. Increased bone density.
 Explanation: Enteral feedings are delivered
 Explanation: Dumping syndrome is a directly into the gastrointestinal tract.
common complication of gastric bypass Checking tube placement is essential to
surgery, where food moves too quickly from prevent aspiration.
the stomach to the small intestine, causing  Rationales:
symptoms like nausea, vomiting, diarrhea,
and dizziness. o a. The client should be positioned
 Rationales: semi-Fowler's or higher to reduce
aspiration risk.
o a. Hypernatremia (high sodium) is not o b. (Correct) Checking tube placement
a typical complication of gastric is the priority to ensure the feeding
bypass. goes into the stomach or intestine.
o b. (Correct) Dumping syndrome is a o c. Cold formula can cause discomfort;
frequent complication. it should be at room temperature.
o c. Gastric bypass can sometimes o d. Feedings should be infused slowly
improve hyperlipidemia. to prevent complications like diarrhea.
o d. Gastric bypass can lead to
decreased nutrient absorption and 52. Celiac Disease - Dietary Restrictions
potentially decreased bone density.
 Question: A client with celiac disease should
50. Malnutrition - Signs avoid foods containing:

 Question: Which of the following is a sign of o a. Lactose.

malnutrition? o b. Gluten. (Correct Answer)
o c. Potassium.
o a. Increased muscle mass. o d. Sodium.
o b. Dry, brittle hair. (Correct Answer)
o c. Elevated blood pressure.  Explanation: Celiac disease is an autoimmune
o d. Increased energy levels. disorder triggered by gluten, a protein found
in wheat, barley, and rye. Consuming gluten
 Explanation: Malnutrition is a condition damages the small intestine.
caused by a deficiency in nutrients. Signs can  Rationales:
include dry, brittle hair, as well as other
symptoms like weight loss, muscle weakness, o a. Lactose intolerance is a separate
and fatigue. condition.
 Rationales: o b. (Correct) Gluten must be avoided in
celiac disease.
o a. Increased muscle mass is a sign of o c. Potassium is an electrolyte and not
good nutrition or muscle building. related to celiac disease.
o b. (Correct) Dry, brittle hair is a o d. Sodium should be limited in some
common sign of malnutrition. diets but not specifically in celiac
o c. Malnutrition can sometimes lead to disease.
low blood pressure.
o d. Malnutrition is associated with 53. Total Parenteral Nutrition (TPN) -
decreased energy levels. Complications

 Question: Which of the following is a

common complication of total parenteral
51. Enteral Feedings - Nursing Interventions nutrition (TPN)?
 o a. Hypoglycemia. heart tries to compensate for decreased
o b. Infection. (Correct Answer) blood volume.
o c. Hyperkalemia.  Rationales:
o d. Constipation.
o a. Dehydration leads to decreased
 Explanation: TPN is intravenous nutrition, urine output.
and infection is a significant risk due to the o b. (Correct) Tachycardia is a sign of
central venous catheter used for dehydration.
administration. o c. Bradycardia (slow heart rate) is not
 Rationales: typical of dehydration.
o d. Dry mucous membranes are a sign
o a. TPN can cause hyperglycemia, not of dehydration.
hypoglycemia.
o b. (Correct) Infection is a major 56. Chronic Kidney Disease - Dietary Restrictions
complication.
o c. TPN can cause electrolyte  Question: A client with chronic kidney
imbalances, but hyperkalemia is less disease should limit their intake of:
common than other imbalances.
o d. TPN bypasses the GI tract, so it o a. Iron.
doesn't directly cause constipation. o b. Protein. (Correct Answer)
o c. Vitamin D.
54. Iron-Deficiency Anemia - Dietary o d. Folic acid.
Recommendations
 Explanation: In chronic kidney disease, the
 Question: A client with iron-deficiency kidneys have difficulty filtering waste
anemia should be encouraged to consume products, including protein. Limiting protein
foods high in: intake can help reduce the workload on the
kidneys.
o a. Calcium.  Rationales:
o b. Vitamin C. (Correct Answer)
o c. Potassium. o a. Iron may be supplemented in
o d. Magnesium. kidney disease.
o b. (Correct) Protein restriction is often
 Explanation: Vitamin C enhances the necessary.
absorption of iron from plant-based foods. o c. Vitamin D may be supplemented.
 Rationales: o d. Folic acid may be supplemented.

o a. Calcium is important for bone 57. Diabetic Diet - Key Components

health.
o b. (Correct) Vitamin C improves iron  Question: Which of the following is a key
absorption. component of a diabetic diet?
o c. Potassium is an electrolyte.
o d. Magnesium is important for various o a. High intake of simple carbohydrates.
bodily functions. o b. Consistent carbohydrate intake.
(Correct Answer)
55. Dehydration - Symptoms o c. Frequent consumption of sugary
drinks.
 Question: Which of the following is a o d. Unrestricted fat intake.
symptom of dehydration?
 Explanation: A diabetic diet focuses on
o a. Increased urine output. consistent carbohydrate intake to help
o b. Tachycardia. (Correct Answer) manage blood glucose levels.
o c. Bradycardia.  Rationales:
o d. Moist mucous membranes.
o a. Simple carbohydrates cause rapid
 Explanation: Dehydration occurs when the blood sugar spikes.
body loses too much fluid. Tachycardia (rapid o b. (Correct) Consistent carbohydrate
heart rate) is a common symptom as the intake is essential for blood sugar
control.
 o c. Sugary drinks cause rapid blood  Question: When a client is receiving TPN,
sugar spikes. what is a priority nursing intervention?
o d. Fat intake should be controlled, not
unrestricted. o a. Checking blood glucose levels.
(Correct Answer)
58. Ulcerative Colitis - Foods to Avoid o b. Increasing the infusion rate if the
client is hungry.
 Question: A client with ulcerative colitis o c. Allowing the TPN bag to hang for 48
should avoid foods that are: hours.
o d. Only checking vital signs once per
o a. High in fiber. (Correct Answer) shift.
o b. High in protein.
o c. Low in fat.  Explanation: TPN solutions are high in
o d. High in Vitamin C. glucose, so monitoring blood glucose levels is
crucial to prevent hyperglycemia or
 Explanation: During flares of ulcerative colitis, hypoglycemia.
high-fiber foods can irritate the inflamed  Rationales:
colon and worsen symptoms.
 Rationales: o a. (Correct) Blood glucose monitoring
is essential.
o a. (Correct) High-fiber foods can o b. The infusion rate should not be
exacerbate symptoms during flares. increased without an order; it can
o b. Protein is generally well-tolerated. cause complications.
o c. A balanced fat intake is usually o c. TPN bags should be changed every
recommended. 24 hours to reduce infection risk.
o d. Vitamin C is important; it's not o d. Vital signs should be checked more
typically restricted. frequently than once per shift.

59. Difficulty Swallowing Post-Stroke - Diet 61. Alcoholism - Vitamin Deficiency

 Question: A client who has had a stroke, and  Question: What vitamin deficiency is often
now has difficulty swallowing, should have associated with alcoholism?
what kind of diet ordered?
o a. Vitamin C
o a. A regular diet. o b. Thiamine (Vitamin B1) (Correct
o b. A pureed diet. (Correct Answer) Answer)
o c. A high fiber diet. o c. Vitamin K
o d. A high sodium diet. o d. Vitamin D.

 Explanation: Difficulty swallowing (dysphagia)  Explanation: Alcohol interferes with thiamine

after a stroke requires a diet that reduces the absorption and metabolism, leading to
risk of aspiration. Pureed diets have a smooth deficiency. This can cause neurological
consistency that is easier to swallow. problems like Wernicke-Korsakoff syndrome.
 Rationales:  Rationales:

o a. A regular diet is too difficult and o a. Vitamin C deficiency can occur but
dangerous for someone with is less specific to alcoholism.
dysphagia. o b. (Correct) Thiamine deficiency is
o b. (Correct) A pureed diet is the safest very common in alcoholism.
option. o c. Vitamin K deficiency is related to
o c. High fiber can be difficult to liver function, which can be affected
swallow. by alcoholism.
o d. Sodium is not the primary concern o d. Vitamin D deficiency can occur but
with swallowing difficulties. is less specific.

62. Gastroesophageal Reflux Disease (GERD) -

Foods to Avoid
60. Total Parenteral Nutrition (TPN) - Priority
Intervention
  Question: A client with gastroesophageal  Explanation: Diverticulitis is the inflammation
reflux disease (GERD) should be instructed to or infection of small pouches (diverticula) in
avoid: the colon. During acute flares, a low-fiber
diet helps the bowel rest. During remission, a
o a. High-fiber foods. high-fiber diet prevents future problems.
o b. Fatty and spicy foods. (Correct  Rationales:
Answer)
o c. Cold beverages. o a. (Correct) Low-fiber during flares is
o d. Bland foods. important.
o b. High-fiber during remission is
 Explanation: GERD is a condition where important.
stomach acid frequently flows back into the o c. Laxatives should be used cautiously.
esophagus. Fatty and spicy foods can trigger o d. Adequate fluids are always
symptoms. important.
 Rationales:
65. Acute Pancreatitis - Priority Intervention
o a. High-fiber foods are generally good
but not specifically problematic for  Question: Which of the following is a priority
GERD. nursing intervention for a client with acute
o b. (Correct) Fatty and spicy foods are pancreatitis?
common triggers.
o c. Cold beverages are not a typical o a. Encouraging early ambulation.
trigger. o b. Administering pain medication.
o d. Bland foods are often (Correct Answer)
recommended. o c. Providing a high-protein diet.
o d. Promoting frequent oral intake.
63. Peptic Ulcer - Symptoms
 Explanation: Acute pancreatitis is
 Question: Which of the following is a inflammation of the pancreas, which causes
common symptom of a peptic ulcer? severe abdominal pain. Pain management is
a priority.
o a. Constipation.  Rationales:
o b. Epigastric pain. (Correct Answer)
o c. Diarrhea. o a. Ambulation may be limited initially
o d. Jaundice. due to pain.
o b. (Correct) Pain management is
 Explanation: A peptic ulcer is a sore in the crucial.
lining of the stomach or duodenum. o c. Oral intake is often restricted
Epigastric pain (pain in the upper central initially.
abdomen) is a classic symptom. o d. Oral intake is often restricted
 Rationales: initially.

o a. Constipation is not typical. 66. Ulcerative Colitis - Risks

o b. (Correct) Epigastric pain is the
hallmark symptom.  Question: A client with ulcerative colitis is at
o c. Diarrhea is not typical. risk for:
o d. Jaundice indicates liver problems.
o a. Constipation.
64. Diverticulitis - Dietary Recommendations o b. Dehydration. (Correct Answer)
o c. Increased appetite.
 Question: A client with a history of o d. Hypertension.
diverticulitis should be educated on the
importance of:  Explanation: Ulcerative colitis causes
inflammation and ulceration of the colon,
o a. A low-fiber diet during acute leading to frequent diarrhea and increased
exacerbations. (Correct Answer) risk of dehydration.
o b. A high-fiber diet during remission.  Rationales:
o c. Frequent use of laxatives.
o d. Avoiding fluids.
 o a. Diarrhea is more common than o a. Hyperkalemia.
constipation. o b. Metabolic alkalosis. (Correct
o b. (Correct) Dehydration is a Answer)
significant risk. o c. Metabolic acidosis.
o c. Appetite may be decreased. o d. Hypoglycemia.
o d. Hypertension is not a direct risk.
 Explanation: Prolonged vomiting leads to the
67. Cholecystitis - Symptoms loss of stomach acid, causing metabolic
alkalosis.
 Question: Which of the following is a  Rationales:
common symptom of cholecystitis?
o a. Vomiting can cause hypokalemia.
o a. Left lower quadrant pain. o b. (Correct) Metabolic alkalosis is
o b. Right upper quadrant pain. (Correct typical.
Answer) o c. Metabolic acidosis is not typical.
o c. Periumbilical pain. o d. Vomiting can cause dehydration,
o d. Diffuse abdominal pain. but not directly hypoglycemia.

 Explanation: Cholecystitis is inflammation of 70. Cirrhosis - Risks

the gallbladder. Pain is typically located in the
right upper quadrant.  Question: A client with cirrhosis is at risk for:
 Rationales: o a. Hypoalbuminemia. (Correct Answer)
o b. Hyperglycemia.
o a. Left lower quadrant pain is o c. Hyperkalemia.
associated with other conditions. o d. Increased platelet count.
o b. (Correct) Right upper quadrant pain  Explanation: Cirrhosis is severe scarring of
is characteristic. the liver. The liver produces albumin, so liver
o c. Periumbilical pain is around the damage leads to decreased albumin levels in
navel. the blood (hypoalbuminemia).
o d. Diffuse pain is spread out.  Rationales:

68. New Colostomy - Instructions o a. (Correct) Hypoalbuminemia is a

common complication.
 Question: A client with a new colostomy o b. Cirrhosis can cause both hypo- and
should be instructed to: hyperglycemia.
o c. Cirrhosis can lead to electrolyte
o a. Change the appliance daily. imbalances, but hypokalemia is more
o b. Empty the pouch when it is one- typical.
third to one-half full. (Correct Answer) o d. Cirrhosis typically causes a
o c. Avoid drinking fluids. decreased platelet count.
o d. Restrict physical activity.
71. Small Bowel Obstruction - Priority
 Explanation: Colostomy pouches should be Intervention
emptied regularly to prevent leaks and
maintain comfort.  Question: Which of the following is a priority
 Rationales: nursing intervention for a client with a small
bowel obstruction?
o a. Appliances are changed less
frequently. o a. Encouraging a high-fiber diet.
o b. (Correct) Emptying regularly is o b. Administering laxatives.
important. o c. Maintaining nasogastric (NG) tube
o c. Adequate fluids are essential. patency. (Correct Answer)
o d. Physical activity is encouraged. o d. Promoting early ambulation.

69. Prolonged Vomiting - Complications  Explanation: A small bowel obstruction

blocks the passage of intestinal contents.
 Question: Which of the following is a Maintaining NG tube patency is crucial to
common complication of prolonged vomiting? decompress the bowel and relieve pressure.
 Rationales:
 o a. A high-fiber diet would worsen the  Question: A client with Crohn's disease may
obstruction. experience:
o b. Laxatives are contraindicated; they
can increase pressure. o a. Infrequent bowel movements.
o c. (Correct) NG tube patency is o b. Skip lesions in the gastrointestinal
essential. tract. (Correct Answer)
o d. Ambulation is important later but o c. Weight gain.
not the immediate priority. o d. Decreased abdominal pain.

72. Hepatitis - Patient Education  Explanation: Crohn's disease is an

inflammatory bowel disease that can affect
 Question: A client with hepatitis should be any part of the GI tract. "Skip lesions" (areas
educated on the importance of: of inflammation separated by healthy tissue)
are characteristic.
o a. Restricting fluid intake.  Rationales:
o b. Avoiding alcohol and hepatotoxic
medications. (Correct Answer) o a. Diarrhea is more common.
o c. Increasing physical activity. o b. (Correct) Skip lesions are a hallmark.
o d. Consuming a high-fat diet. o c. Weight loss is common.
o d. Abdominal pain is common.
 Explanation: Hepatitis is inflammation of the
liver. Alcohol and hepatotoxic medications 75. Post-Abdominal Surgery - Diet
can further damage the liver and should be
avoided.  Question: A client who has had recent
 Rationales: abdominal surgery, and has absent bowel
sounds, should have what kind of diet
o a. Adequate fluid intake is important. ordered?
o b. (Correct) Avoiding liver toxins is
crucial. o a. A regular diet.
o c. Rest is important; excessive activity o b. A clear liquid diet.
can be harmful. o c. A full liquid diet.
o d. A balanced diet is better; high-fat o d. NPO status. (Correct Answer)
can be hard on the liver.
 Explanation: After abdominal surgery, absent
73. Peritonitis - Signs bowel sounds indicate that the intestines are
not yet functioning properly. NPO (nothing by
 Question: Which of the following is a sign of mouth) status is necessary to prevent
peritonitis? complications.
 Rationales:
o a. Hyperactive bowel sounds.
o b. Rigid, board-like abdomen. (Correct o a. A regular diet is too heavy.
Answer) o b. Clear liquids are a step, but NPO is
o c. Increased appetite. first.
o d. Loose stools. o c. Full liquids are also too heavy
initially.
 Explanation: Peritonitis is inflammation of o d. (Correct) NPO is the initial order.
the peritoneum (lining of the abdominal
cavity). A rigid, board-like abdomen is a 76. Esophageal Varices - Risks
classic sign of irritation.
 Rationales:  Question: A client with esophageal varices is
at risk for:
o a. Bowel sounds are decreased or
absent. o a. Constipation.
o b. (Correct) A rigid abdomen is a key o b. Hemorrhage. (Correct Answer)
sign. o c. Diarrhea.
o c. Appetite is decreased. o d. Increased appetite.
o d. Constipation is more typical.
 Explanation: Esophageal varices are enlarged
74. Crohn's Disease - Characteristics veins in the esophagus, often caused by liver
 disease. They are at high risk of rupturing and
causing severe bleeding (hemorrhage).
 Rationales:

o a. Not a direct risk.

o b. (Correct) Hemorrhage is the major
risk.
o c. Not a direct risk.
o d. Appetite is often decreased.