LYCEUM NORTHERN UNIVERSITY

POST TEST – GUT-GIT – MARCH 7, 2024

1. The nurse has been assigned to provide care for four clients at the
beginning of the day shift. Which one should be prioritized?
A. The client was awaiting hiatal hernia repair at 11 am.
B. A client with suspected gastric cancer who is on nothing-by-mouth (NPO)
status for tests.
C A client with peptic ulcer disease experiencing sudden onset of acute
stomach pain.
D. A client who is requesting pain medication 2 days after surgery to
repair a fractured jaw.

2. After endorsement, the nurse receives the four patients. Which of the following must be
prioritized?
A. A client with Achalasia experiencing mild nausea.
B. A 75-year-old client experiencing constipation 48H ago.
C. A 5-year-old child with coarctation of aorta crying after BP taking.
D. A 34-year-old client with pancreatitis experienced Grey-Turner’s sign this morning.

3. The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis
who is scheduled for surgery in 2 hours. The client begins to complain of increased
abdominal pain and begins to vomit. On assessment, the nurse notes that the abdomen is
distended and bowel sounds are diminished. Which is the most appropriate nursing
intervention?

A. Notify the health care provider (HCP).

B. Administer the prescribed pain medication.
C. Call and ask the operating room team to perform surgery as soon as possible.
D. Reposition the client and apply a heating pad on the warm setting to the client's
abdomen.

4. A client has just had a hemorrhoidectomy. Which nursing intervention is not appropriate
for this client?

A. Administer stool softeners as prescribed.

B. Instruct the client to limit fluid intake to avoid urinary retention.
C. Encourage a high-fiber diet to promote bowel movements without straining.
D. Apply cold packs to the anal-rectal area over the dressing until the packing is removed.

5. The nurse is planning to teach a client with gastroesophageal reflux disease (GERD) about
substances to avoid. Which one is allowed?

A. Coffee
B. Chocolate
C. Peppermint
D. Nonfat milk
E. Fried chicken

6. A client has undergone esophagogastroduodenoscopy. The nurse should place highest

priority on which item as part of the client's care plan?
A. Monitoring the temperature
B. Monitoring complaints of heartburn
C. Giving warm gargles for a sore throat
D. Assessing for the return of the gag reflex

7. The nurse is providing dietary teaching for a client with a diagnosis of chronic gastritis.
The nurse instructs the client to include which foods rich in vitamin B12 in the diet?

A. Nuts
B. Lentils
C. Liver
D. All these.

8. The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment
finding would most likely indicate perforation of the ulcer?

A. Bradycardia
B. Numbness in the legs
C. Nausea and vomiting
D. A rigid, board like abdomen
9. The nurse is caring for a client following a gastrojejunostomy (Bill Roth II procedure).
Which postoperative prescription should the nurse question and verify?

A. Leg exercises
B. Early ambulation
C. Irrigating the nasogastric tube.
D. Coughing and deep-breathing exercises

10. The nurse is providing discharge instructions to a client following gastrectomy and should
instruct the client to take which measure to assist in preventing dumping syndrome?

A. Ambulate following a meal.

B. Eat high-carbohydrate foods.
C. Limit the fluids taken with meals.
D. Sit in a high Fowler's position during meals.

11. The nurse is providing discharge teaching for a client with newly diagnosed Crohn's
disease about dietary measures to implement during exacerbation episodes. Which
statement made by the client indicates a need for further instruction?

A. "I should increase the fiber in my diet."

B. "I will need to avoid caffeinated beverages."
C. "I'm going to learn some stress reduction techniques."
D. "I can have exacerbations and remissions with Crohn's disease."

12. The nurse is doing an admission assessment on a client with a history of duodenal ulcer.
To determine whether the problem is currently active, the nurse should assess the client
for which sign(s)/symptom(s) of duodenal ulcer?

A. Weight loss
B. Nausea and vomiting
C. Pain relieved by food intake.
D. Pain radiating down the right arm

13. A client with hiatal hernia chronically experiences heartburn following meals. The nurse
should plan to teach the client to avoid which action because it is contraindicated with a
hiatal hernia?

A. Lying recumbent following meals.

B. Consuming small, frequent, bland meals
C. Taking H2-receptor antagonist medication
D. Raising the head of the bed on 6-inch (15 cm) blocks

14. The nurse is providing care for a client with a recent transverse colostomy. Which
observation requires immediate notification of the health care provider?

A. Stoma is beefy red and shiny

B. Purple discoloration of the stoma.
C. Skin excoriation around the stoma
D. Semi-formed stool noted in the ostomy pouch

15. A client had a new colostomy created 2 days earlier and is beginning to pass malodorous
flatus from the stoma. What is the correct interpretation by the nurse?

A. This is a normal, expected event.

B. The client is experiencing early signs of ischemic bowel
C. The client should not have the nasogastric tube removed
D. This indicates inadequate preoperative bowel preparation

16. A client has just had surgery to have an ileostomy. The nurse assesses the client in the
immediate postoperative period for which most frequent complication of this type of
surgery?

A. Folate deficiency
B. Malabsorption of fat
C. Intestinal obstruction
D. Fluid and electrolyte imbalance.

17. The nurse is monitoring a client for the early signs and symptoms of dumping syndrome.
Which findings indicate this occurrence?

A. Sweating and pallor.

B. Bradycardia and indigestion
C. Double vision and chest pain
D. Abdominal cramping and pain
18. The nurse is caring for a client admitted to the hospital with a suspected diagnosis of
acute appendicitis. Which laboratory result should the nurse expect to note if the client
does have appendicitis?

A. Leukopenia
B. Leukocytosis
C. Anemia
D. Thrombocytopenia.

19. After undergoing Billroth I gastric surgery, the client experiences fatigue and complains of
numbness and tingling in the feet and difficulties with balance. Based on these
symptoms, the nurse suspects which postoperative complication?

A. Stroke
B. Pernicious anemia
C. Bacterial meningitis
D. Peripheral arterial disease.

20. The nurse obtains an admission history for a client with suspected peptic ulcer disease
(PUD). Which client factor documented by the nurse would increase the risk for PUD?

A. Recently retired from a job

B. Significant other has a gastric ulcer
C. Occasionally drinks 1 cup of coffee in the morning
D. Takes nonsteroidal anti-inflammatory drugs (NSAIDs) for osteoarthritis.

21. A client who has a renal mass asks the nurse why an ultrasound has been scheduled, as
opposed to other diagnostic tests that may be ordered. The nurse formulates a response
based on the understanding that:
a) all other tests are more invasive than an ultrasound
b) all other tests require more elaborate postprocedure care
c) an ultrasound can differentiate a solid mass from a fluid-filled cyst
d) an ultrasound is much more cost effective than other diagnostic tests.

22. A client has been admitted to the hospital with a diagnosis of acute glomerulonephritis.
During history-taking the nurse first asks the client about a recent history of:

a) bleeding ulcer
b) deep vein thrombosis
c) myocardial infarction
d) streptococcal infection.

23. A nurse is assigned to care for a client with nephrotic syndrome. The nurse assesses
which important parameter daily?

a) weight
b) albumin levels
c) activity tolerance
d) blood urea nitrogen (BUN) level.

24. A client is being admitted to the hospital with a diagnosis of urolithiasis and ureteral colic.
The nurse assesses the client for pain that is:

a) dull and aching in the costovetebal area

b) aching and camplike thoughout the abdomen
c) sharp and radiating posteriorly to the spinal column
d) excruciating, wavelike, and radiating toward the genitalia.

25. A client with renal failure is receiving epoetin alfa (Epogen) to support erythropoiesis. The
nurse questions the client about compliance with taking which of the following
medications that supports red blood cell (RBC) production?

a) iron supplement.
b) zinc supplement
c) calcium supplement
d) magnesium supplement
26. A client has an arteriovenous (AV) fistula in place in the right upper extremity for
hemodialysis treatments. When planning care for this client, which of the following
measures should the nurse implement to promote client safely?

a) take blood pressures only on the right arm to ensure accuracy

b) use the fistula for all venipunctures and intravenous infusions
c) ensure that small clamps are attached to the AV fistula dressing
d) assess the fistula for the presence of a bruit and thrill every 4 hours

27. A nurse is assessing a client who is diagnosed with cystitis. Which assessment finding is
inconsistent with the typical clinical manifestations noted in this disorder?

a) hematuria
b) low back pain
c) urinary retention
d) burning on urination.

28. The home care nurse is making follow-up visits to a client following renal transplant. The
nurse assesses the client for which signs of acute graft rejection?

a) hypotension, graft tenderness, and anemia

b) hypertension, oliguria, thirst, and hypothermia
c) fever, hypertension, graft tenderness, and malaise
d) fever, vomiting, hypotension, and copious amounts of dilute urine.

29. A client is scheduled for computed tomography (CT) of the kidneys with contrast to rule
out renal disease. As an essential preprocedural component of the nursing assessment,
the nurse plans to ask the client about a history of:

a) familial renal disease

b) frequent antibiotic use
c) long-term diuretic therapy
d) allergy to shellfish or iodine.

30. The client arrives at the emergency department with complaints of low abdominal pain and
hematuria. The client is afebrile. The nurse next assesses the client to determine a history
of:

a) pyelonephritis
b) glomerulonephritis
c) trauma to the bladder or abdomen
d) renal cancer in the client's family.

31. The client who has a history of gout also is diagnosed with urolithiasis and the stones are
determined to be of uric acid type. The nurse gives the client instructions in which foods
to limit, including:

a) milk
b) liver
c) apples
d) carrots.

32. The client with acute renal failure has a serum potassium of 6.0 mEq/L. The nurse would
plan which of the following as a priority action?

a) check the sodium level

b) place the client on a cardiac monitor.
c) encourage increased vegetables in the diet
d) allow an extra 500 ml of fluid intake to dilute the electrolyte concentration.

33. The client with chronic renal failure who is scheduled for hemodialysis this morning is due
to receive a daily dose of enalapril (Vasotec). The nurse should plan to administer this
medication:

a) during dialysis
b) just before dialysis
c) the day after dialysis
d) on return form dialysis.
34. The client with chronic renal failure has an indwelling abdominal catheter for peritoneal
dialysis. The client spills water on the catheter dressing while bathing. The nurse should
immediately:

a) change the dressing.

b) reinforce the dressing
c) flush the peritoneal dialysis catheter
d) scrub the catheter with povidine-iodine.

35. The client hemodialyzed suddenly becomes short of breath and complains of chest pain.
The client is tachycardic, pale and anxious. The nurse suspects air embolism. The priority
action for the nurse is to:

a) discontinue dialysis and notify the physician.

b) monitor vital signs every 15 minutes for the next hour
c) continue dialysis at a slower rate after checking the lines for air
d) bolus the client with 500 ml of normal saline to break up the air embolus.

36. The nurse has completed client teaching with the hemodialysis client about self-
monitoring between hemodialysis treatments. The nurse determines that the best
understands the information if the client states to record daily the:

a) amount of activity
b) pulse and respiratory rate
c) intake and output and weight
d) blood urea nitrogen and creatinine levels.

37. Which of the following should be considered in the diet of the client with end-stage-renal-
disease (ESRD)?

a) limit fluid intake during anuric phase

b) limit phosphorus and vitamin D-rich food
c) limit calcium-rich food
d) limit carbohydrates

38. The client with chronic renal failure is on chronic hemodialysis. Which of the following
indicate improvement of the client's condition due to hemodialysis?

a) the client's BP is 150/90

b) the client's serum potassium is 4.8 mEq/L
c) the client's hemoglobin level is 10 g/dL
d) the client's serum calcium is 7.7 mg/dL
e) the client's serum sodium is 150 mEg/L

39. The client has end-stage renal disease. He had undergone a kidney transplant 5 days ago.
Which of the following is the most important intervention for the client to prevent
infection?

a) observe asepsis
b) increase fluid intake
c) avoid clients with flu
d) avoid crowded places.

40. Which of the following anti-hypertensive medications is contraindicated for clients with
renal insufficiency?

a) beta-adrenergic blockers
b) calcium-channel blockers
c) direct-acting vasodilators
d) angiotensin-converting enzyme inhibitors

41. The client newly diagnosed with chronic kidney disease recently has begun
Hemodialysis. The client asked the nurse about the purpose of dialysis
and different kidney functions. Your response will be based on the
following physiology of the renal system.
 1. Acid-Base Balance
2. Blood Pressure Regulation
3. Calcium and Phosphorus Ratio balance
4. Drug end products, metabolic and waste products removal
5. Synthesis of clotting factors
6. Production of bile and conversion of ammonia to urea.
A. 12345
B. 1234
C. 123456
D. 123

42. Which of the following risk factors is nonmodifiable?

A. Alcohol intake
B. Behavior and lifestyle
C. Cigarette smoking
D. Diet
E. Race

43 The following are the factors affecting urinary elimination. Which one is
not?
A. Fluid intake.
B. Loss of body fluid
C. Body position.
D. Neurologic injuries
E. None of these.

44 Hematuria indicates blood in the urine. It can be gross or occult. Pathological

causes of hematuria include, EXCEPT:
A. Bladder Cancer
B. UTI
C. Renal Stone
D. Stress Incontinence

45 A client is admitted in the hospital because of changes in the urinary pattern. The
client said, “I usually wet myself each time I cough or laugh.” This condition is
related to:
A. Overflow incontinence.
B. Urge incontinence.
C. Functional incontinence
D. Stress incontinence

46 A client is scheduled for an IVP. Nursing management PRIOR to an IVP would include
which protocol?
A. Having a client eat a fat-free meal.
B. Placing a retention urinary catheter.
C. Using laxatives or medicines to clear the intestines.
D. Drinking an acid-ash beverage.

47 A client is admitted with a suspicion of urinary tract infection. Which of the following
organism is the most common causative agent?
A. SARS CoV-2
B. Staphylococcus aureus
C. E. coli
D. Escherichia coli

48 A male client has a tentative diagnosis of urethritis. A nurse assesses the client for which
of the following manifestations of the disorder:
A. Fever, dysuria, and penile discharge
B. Proteinuria and pyuria
C. Dysuria and ketonuria
D. Glucosuria and penile discharge

49 A client is scheduled for urinalysis because of suspected infection. Which of the following
is the urine description of UTI?
A. Foamy urine
B. Crystalluria
 C. Ketonuria
D. Cloudy urine

50 Which instruction should be included in the teaching plan of a client taking SULFAMETHOXAZOLE
(BACTRIM)?
A. Restrict fluids to 1500 cc per day.
B. Explain to client that the stool may turn to clay color pale, acholic.
C. The medication should be continued even after symptoms subside.
D. Gold standard for pregnant clients with UTI.

51 Which of the following comments, if made by a patient who has received Phenazopyridine
hydrochloride (Pyridium), would indicate to a nurse that the medication be effective?
A. “There is no swelling in my ankles.”
B. “It does not hurt me to urinate.”
C. “I do not have diarrhea anymore.”
D. “My head is not spinning.”

52 A client with urolithiasis has a history of chronic urinary tract infections (UTIs). A nurse
concludes that this client most likely has which of the following types of urinary stones?
A. Calcium Oxalate
B. Uric acid
C. Struvite
D. Cystine

53 A priority nursing diagnosis in patients with renal colic is:

A. Altered bladder function.
B. Altered bowel function.
C. Risk for infection.
D. Altered comfort.

54 Priority management in renal colic is the alleviation of discomfort. Other management

includes:
A. Strain all urine.
B. TRIPSIES or ESWL
C. Oral fluids of 3L/day
D. NSAIDS OR NARCOTIC
E. All these.

55 A client has severe renal colic due to renal lithiasis. What is the nurse's priority in
managing care for this client?
A. Do not allow the client to ingest fluids.
B. Encourage the client to drink at least 500 mL of water each hour.
C. Request the central supply department to send supplies for straining urine.
D. Administer an opioid analgesic as prescribed.

Situation - Polycystic kidney disease (PKD) is a genetic disorder that causes many fluid-filled
cysts to grow in your kidneys. Unlike the usually harmless simple kidney cysts that can form in
the kidneys later in life, PKD cysts can change the shape of your kidneys, including making them
much larger.
56 A client with polycystic kidney disease is admitted to a nearby hospital. Which of the
following symptoms would the nurse report?
A. Proteinuria and bland urine
B. Pain in the anterior portion of the abdomen
C. Flattening of the abdomen
D. Hypertension and gross hematuria

57 ULTRASOUND is the most reliable, inexpensive, and non-invasive way to diagnose PKD. If
someone at risk for PKD is older than 40 years and has a normal ultrasound of the
kidneys, he or she probably does not have PKD. Occasionally, a CT scan (computed
tomography scan) and MRI (magnetic resonance imaging) may detect smaller cysts that
cannot be found by an ultrasound. Which of the following would the nurse include in the
plan of care?
A. Place the client on radiation precautions for 18 hours.
B. Save all urine in a radiation-safe container for 18 hours.
 C. Limit contact with the client to minutes per hour.
D. No special precautions except to wear gloves if in contact with the client’s urine.

58. A nurse is reviewing a client’s record and notes that the physician has documented that
the client has PKD. Which of the following must be reported to the doctor?
Laboratory Test: Result: Findings:
a. BUN 20 mg/dL
b. Creatinine 2.6 mg/dL
c. Phos4orus 4.0 mg/dL
d. Calcium 9.0 mg/dL
e. Sodium 140 mEq/L
f. Potassium 5.1 mEq/L

59 A client is diagnosed with polycystic kidney disease. Which of the following would the
nurse NOT expect to be a component of the treatment plan:
A. Reduce salt, low fat, moderate calories.
B. Careful control of blood pressure and pain.
C. Prompt treatment with antibiotics for a kidney infection.
D. Reduce smoking and increase fluid to 5L/24H.

60 Clients with PKD are at risk for many complications especially if you have relatives with a
history of PKD. Which of the following complications is life-threatening that requires
regular screening?
A. Hematuria
B. Infection
C. Pain
D. Aneurysms

Situation - Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a

noncancerous increase in the size of the prostate gland.
61 A patient has an enlarged prostate detected by digital rectal examination (DRE) and an
elevated prostate-specific antigen (PSA) level. The nurse will anticipate that the patient will
need teaching about:
A. cystourethroscopy
B. uroflowmetry studies
C. magnetic resonance imaging (MRI).
D. transrectal ultrasonography (TRUS)

62 Following a prostatectomy, the client has a 3-way, indwelling catheter for continuous
bladder irrigation. During the evening shift, 2400 ml of IRRIGANT was instilled. At the end
of the shift, the drainage bag was drained of 2900 ml of fluid. The nurse calculates the
urine output to be
A. 5300 ml B. 200 ml C. 100 ml D. 500 ml

63 A nurse is caring for a client who has had a renal biopsy. Which of the following
interventions would the nurse avoid in the care of the client after this procedure?
A. Forcing fluids to at least 3 liters in the first 24 hours
B. Administering narcotics for pain
C. Testing serial with dipsticks for occult blood
D. Ambulating the client in the room and hall for short distances.

64 The diet of a patient with Acute Glomerulonephritis is:

A. High sodium and seasoning
B. Low sodium, potassium, and low fat
C. High potassium and high phosphorus
D. High calcium and salt substitute

65 The triad of symptoms of Nephrotic syndrome:

a. Hematuria, abdominal mass, flank pain
b. Hypertension, oliguria, hematuria, proteinuria
c. Oliguria, hyperkalemia, hypertension, fatigue
d. Marked proteinuria, hypoalbuminemia, anasarca.
Situation - Acute kidney injury (AKI) is a sudden episode of kidney failure or kidney damage that
happens within a few hours or a few days.
Which client is a likely candidate for developing
66 acute kidney injury?
A. Young female with a recent ileostomy due to ulcerative colitis
B. Middle-aged male with elevated temperature and chronic pancreatitis
C. Teenager in hypovolemic shock following a crushing injury to the chest.
D. Child with a compound fracture of the right femur and massive laceration to left
arm.

67 A client with chronic renal failure has been prescribed calcium carbonate. What is the
rationale for this medication?
A. Diminishes incidence of gastric ulcer formation
B. Alleviates constipation
C. Binds with phosphorus to lower concentration
D. Increase tubular reabsorption of sodium

68 A client with acute renal failure develops sever hyperkalemia. What would the nurse
anticipate being used to treat this imbalance?
A. Furosemide (Lasix)
B. Amphojel (aluminum hydroxide)
C. 50% glucose and regular insulin
D. Epoetin (Procrit)

69 A client with chronic renal failure has an internal venous access site for hemodialysis on
her left forearm. What action will the nurse take to protect this access site?
A. Irrigate with heparin and NS q8 hrs.
B. Apply warm moist packs to the area after hemodialysis
C. Do not use the left arm to take blood pressure readings.
D. Keep the arm elevated above the level of the heart.

70 The nurse is caring for a patient who had kidney transplantation several years ago. Which
assessment finding may indicate that the patient is experiencing adverse effects to the
prescribed corticosteroid?
A. Joint pain
B. Nausea
C. Vomiting
D. Diarrhea
Situation - A client with PUD is asking the nurse about the functions of the digestive system.
The nurse will respond based on her knowledge about GIT and accessory organs’
71 functions which are,

A. Absorption of water, secretion of mucus by the large intestine

B. Bile production and conversion of ammonia to urea by the liver
C. CHON, CHO, and fat synthesis by the liver
D. Digestion and absorption of nutrients by the small intestine
E. All these.

72 Which of the following is the hormonal stimulator in GIT which is responsible to digest fat
and protein:
A. Bile
B. Intrinsic factor
C. Trypsin
D. Cholecystokinin
E. Amylase

73 Hepatitis C is a
A. fecal-oral infection
B. delta hepatitis.
C. common hepatitis among pregnant clients
D. blood-borne disease.

74 A client with dysphagia is refusing breakfast because it is “Yin”.

Which of the following actions is correct? The nurse collaborates
with the licensed:
A. Speech therapist
 B. Nutritionist
C. Dietitian
D. Biomedical Technician

75 Women have 8% to 11% and men have an 11% to 14% lifetime risk of developing peptic
ulcers, but the major risk factor for peptic ulcers are:
1. EBV
2. HPV
3. H. pylori
4. NSAIDS
5. Cox-2 inhibitors
A. 14
B. 34
C. 35
D. 24

76 When obtaining a nursing history of a client with a suspected gastric ulcer, which signs
and symptoms should the nurse NOT expect to assess?
A. Epigastric pain at night.
B. Vomiting.
C. Weight loss.
D. Hematemesis

77. The urea breath test is based on the ability of H. pylori to break down urea, a chemical
made up of nitrogen and carbon, into carbon dioxide which then is absorbed from the
stomach and eliminated in the breath. The urea breath test (UBT) is a
A. test for diagnosing the presence of a bacterium, Helicobacter pylori.
B. test to aspirate tissue for biopsy.
C. test to check the GI and rectal polyps.
D. Test to visualize the lower 3rd of the bowel.

78 A 58-year-old woman has just returned to the nursing unit after an Esophagogastric-
duodenoscopy (EGD). Which action by the nurse assistant (NA) requires that the
registered nurse (RN) intervene?
A. Offering the patient drink of water
B. Positioning the patient on the right side
C. Checking the vital signs every 30 Minutes
D. Swabbing the patient's mouth with H2O

79 A patient is to collect a specimen for a stool guaiac test. Which direction should the
patient be given?
A. Do not eat red meat for at least 3 days before collecting the specimen
B. Strain during defecation
C. Take laxative and enema before the test
D. Take vitamin C before the test
E. Refrigerate the specimen for 72H.

80 A patient has a vagotomy with antrectomy to treat a duodenal ulcer. Postoperatively, the
patient develops dumping syndrome. Which of the following statements, if made by the
patient, should indicate to the nurse that further dietary teaching is needed?
A. I should eat bread with each meal.
B. I should eat smaller meals more frequently.
C. I should lie down after eating.
D. I should avoid drinking fluids with my meals

81 When caring for a patient with a history of a total gastrectomy, the nurse will monitor for
A. constipation.
B. dehydration.
C. elevated total serum cholesterol
D. cobalamin (vitamin B12) deficiency.

82 Which of the following statements shows a positive response to B12 treatment?

A. It does not hurt my stomach.
B. My lips are so red and glossy.
C. I easily get tired every time I climb stairs.
D. I do not feel any tingling in my legs anymore.
83. Which finding by the nurse during abdominal auscultation indicates a need for a focused
abdominal assessment?
a. Loud gurgles
b. High-pitched gurgles
c. Absent bowel sounds
d. Frequent clicking sounds

Situation - Gastroesophageal reflux disease (GERD) occurs when stomach acid frequently flows
back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux)
can irritate the lining of your esophagus.
84 The nurse determines that a patient has experienced the beneficial effects of therapy with
famotidine (Pepcid) when which symptom is relieved?
A. Nausea
B. Belching
C. Epigastric pain
D. Difficulty swallowing

85 A female patient has a sliding hiatal hernia. What nursing interventions will prevent the
symptoms of heartburn and dyspepsia that she is experiencing?
A. Keep the patient NPO.
B. Put the bed in the Modified Trendelenburg position.
C. Have the patient eat 4 to 6 smaller meals each day.
D. Give various antacids to determine which one works for the patient.

86 After the nurse teaches a patient with gastroesophageal reflux disease (GERD) about
recommended dietary modifications, which statement by the patient indicates that the
teaching has been effective?
A. "I can have a glass of low-fat milk at bedtime."
B. "I will have to eliminate all spices.”
C. "I will have to use herbal teas instead of caffeinated and carbonated drinks."
D. "I should keep something in my stomach

87 The exact cause of inflammatory bowel disease is:

A. H. pylori infection
B. Kissing disease infection
C. Hereditary
D. Racial in origin
E. Unknown

88 Which clinical manifestations of inflammatory bowel disease are common to both patients
with ulcerative colitis (UC) and Crohn's disease:
A. Restricted to rectum
B. Small bowel fistulas and
C. Strictures are common
D. Cramping, diarrhea, and blood in the stools
E. Lesions penetrate the large and small intestine.

89 What information would have the highest priority to be included in PREOPERATIVE

teaching for a 68-year-old patient scheduled for a colectomy?
A. How to care for the wound
B. How to deep breath and cough
C. The location and care of drains after surgery
D. The type of anesthesia to be used in surgery.

90 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?
A. The ostomy bag should be adjusted.
B. Blood supply to the stoma has been interrupted.
C. An intestinal obstruction has occurred.
D. It is an expected appearance.

91 After several days of antibiotic therapy, an older hospitalized patient develops watery
diarrhea. Which action should the nurse take first?
A. Notify the health care provider.
B. Obtain a stool specimen for analysis
C. Teach the patient about airborne.
D. Place the patient on contact precaution.

92 Which question from the nurse would help determine if a patient's abdominal pain might
indicate irritable bowel syndrome?
a. "Have you been passing a lot of gas?"
b. "What foods affect your bowel patterns?"
 c. "Do you have any abdominal distention?"
d. "How long have you had abdominal pain?"

93 A 25-year-old male patient calls the clinic complaining of diarrhea for 24 hours. Which
action should the nurse take first?
a. Inform the patient that laboratory testing of blood and stools will be necessary.
b. Ask the patient to describe the character of the stools and any associated
symptoms.
c. Suggest that the patient drink clear liquid fluids with electrolytes, such as
Gatorade or Pedialyte.
d. Advise the patient to use over the counter loperamide (Imodium) to slow
gastrointestinal (GI) motility.

Situation - is when pockets called diverticula form in the walls of your digestive tract. The inner
layer of your intestine pushes through weak spots in the outer lining.
94 A 73-year-old patient with diverticulosis has a large bowel obstruction. The nurse will
monitor for
A. referred pain and vomiting
B. metabolic alkalosis and hypokalemia
C. projectile vomiting and alkalosis
D. abdominal distention and LLQ pain

95 Which of the following laboratory findings would the nurse expect to find in a client
with diverticulitis?
A. Elevated red blood cell count.
B. Decreased platelet count.
C. Elevated white blood cell count.
D. Elevated serum blood urea nitrogen concentration.

96 When preparing a male client, age 51, for surgery to treat appendicitis, the nurse
formulates a nursing diagnosis of Risk for infection related to inflammation, perforation,
and surgery. What is the rationale for choosing this nursing diagnosis?
A. Obstruction of the appendix may Increase venous drainage and cause the
appendix to rupture.
B. Obstruction of the appendix reduces arterial flow, leading to ischemia,
inflammation, and rupture of the appendix.
C. The appendix may develop gangrene and rupture, especially in a middle-aged
client.
D. Infection of the appendix diminishes necrotic arterial blood flow and
increases venous drainage."

97. "The nurse is caring for a patient in the emergency department with complaints of acute
abdominal pain, nausea, and vomiting. When the nurse palpates the patient's left lower
abdominal quadrant, the patient complains of pain in the right lower quadrant. The nurse
will document this as which of the following diagnostic signs of appendicitis?
A. Rovsing’s sign
B. Referred
C. Chvostek's sign
D. Psoas sign

98. Which of the following interventions are included in the care of hemorrhoids?
A. Advice the patient to avoid straining with defecation.
B. Baths (sitz baths with warm water three to four times per day).
C. Care of perianal meticulously; after surgery, keep the wound site clean.
D. Diet (high fiber and fiber supplements) to prevent constipation.
E. All these.

99. A patient with cholelithiasis needs to have the gallbladder removed. Which patient
assessment is a contraindication for a cholecystectomy?
A. Low-grade fever of 100° F and dehydration.
B. Abscess in the right upper quadrant of the abdomen.
C. Activated partial thromboplastin time (APTT) of 54 seconds.
D. Multiple obstructions in the cystic and common bile duct.

100. What client problem has a priority for the client diagnosed with acute pancreatitis?
A. Risk for fluid volume deficient
B. Alteration in comfort
C. Imbalanced nutrition: less than the body requires
D. Knowledge deficient
E. Congratulations RNs.