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1. Which of the following is not an education tool required prior to an endoscopic procedure?

A.the purpose of the procedure B.what to expect during the procedure C.how long the procedure will take D.preparation required prior to the surgery 2. All are complications of endoscopic procedures EXCEPT?

3. Which patient is most susceptible for acquiring secondary stomatitis?


A.an AIDs patient suffering from pneumonia B.an 65 y/o obese female C.a 45 y/o male suffering from colon cancer D.a 50 y/o male with CHF 4. When assessing a client during a routine checkup, the nurse reviews the history and notes that the client had aphthous stomatitis at the time of the last visit. Aphthous stomatitis is best described as: A.a canker sore of the oral soft tissues B.an acute stomach infection C.acid indigestion D.an early sign of peptic ulcer disease 5. Which item is unneccessary when examing the oral cavity of a patient with candidiasis? A.gloves B.penlight C.gown D.tongue blade 6. Which of the following is an inappropriate nursing diagnosis for a client with malignant tumors of the oral cavity? A.Impaired oral mucous membranes B.Defieceint fluid volume C.Acute pain D.Risk for ineffective airway clearance 7. The graduate nurse and her preceptor are establishing priorities for their morning assessments. Which client should they assess first? A.The newly admitted client with acute abdominal pain B.The client who needs an abdominal dressing changed (POD 3) C.The client receiving continuous tube feedings who needs the tube-feeding residual checked D.The sleeping client who received pain medication 1 hour ago 8. Gastroesophageal reflux disease is the abnormal _____ of the lower esophageal sphincter.

9. Which foods should a patient with GERD stay away from (multiple answers)?
A.Burger King double cheeseburger B.lettuce C.candy canes D.chocolate espresso E.white bread 10. To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instruction? A.Lie down after meals to promote digestion B.Avoid coffee and alcoholic beverages C.Take antacids with meals D.Limit fluid intake with meals 11. Which of the following is not a common symptom of GERD? A.dyspepsia B.regurgitation C.dysphagia D.hyposalivation 12. Which drug class isn't used to treat GERD? A.antacids B.histamine receptor antagonists C.beta blockers D.proton pump inhibitors 13. Which of the following has the least important role in terms of peptic ulcer formation?

A.acid B.NSAID use C.prescence of H. pylori D.hypertension 14. A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurse expects this client's stools to be: A.coffee-ground-like B.clay-colored C.black and tarry D.bright red 15. Which diagnostic test would be used first to evaluate a client with upper GI bleeding? A.Endoscopy B.Upper GI series C.Hemoglobin (Hb) levels and hematocrit (HCT D.Arteriography 16. Which of the following isn't a complication of peptic ulcer disease? A.perforation B.GI bleeding C.pyloric obstruction D.pain 17. Which of the following are goals of drug therapy in the treatment of PUD (multiple answers)? A.provide pain relief B.prevent recurrence C.heal ulcerations D.eradicate H. pylori infection 18. An elderly client with Alzheimer's disease begins supplemental tube feedings through a gastrostomy tube to provide adequate calorie intake. The nurse should be concerned most with the potential for: A.hyperglycemia B.fluid volume excess C.aspiration D.constipation 19. A client who underwent abdominal surgery who has a nasogastric (NG) tube in place begins to complain of abdominal pain that he describes as "feeling full and uncomfortable." Which assessment should the nurse perform first? A.Measure abdominal girth B.Auscultate bowel sounds C.Assess patency of the NG tube D.Assess vital signs 20. To verify the placement of a gastric feeding tube, the nurse should perform at least two tests. One test requires instilling air into the tube with a syringe and listening with a stethoscope for air passing into the stomach. Which is another test method? A.Aspiration of gastric contents and testing for a pH less than 6 B.Instillation of 30 ml of water while listening with a stethoscope C.Cessation of reflex gagging D.Ensuring proper measurement of the tube before insertion 21. The nurse is performing an assessment on a client who has developed a paralytic ileus. The client's bowel sounds will be:

22. Which of the following would you NOT teach a patient recently diagnosed with irritable bowel syndrome?
A.identifying food intolerances and needed dietary modifications B.decreasing fiber intake C.avoiding coffee and and limiting alcohol intake D.stress management 23. Which of the following are appropriate nursing diagnoses for patients with colorectal cancer (multiple answers)? A.Altered level of consciousness B.Disturbed body image C.Deficient fluid volume D.Acute/ chronic pain

24. Which of the following is not a complication of colorectal cancer? 25. Which foods should patients with colorectal cancer avoid (multiple answers)?
A.fish and chips B.boiled carrots and broccoli C.beef and cabbage D.concentrated sweets E.whole-grain products 26. A client has undergone a colon resection. While turning him, wound dehiscence with evisceration occurs. The nurse's first response is to: A.call the physician B.place saline-soaked sterile dressings on the wound C.take a blood pressure and pulse D.take a blood pressure and pulse 27. For a client who must undergo colon surgery, the physician orders preoperative cleansing enemas and neomycin sulfate (Mycifradin). The rationale for neomycin use in this client is to:

28. Which is the least likely to cause constipation?


A.high fiber intake B.being over 75 C.overuse of laxatives D.immobilization 29. A 72-year-old client seeks help for chronic constipation. This is a common problem for elderly clients due to several factors related to aging. Which is one such factor? A.Increased intestinal motility B.Decreased abdominal strength C.Increased gastric aid production D.hyperactive bowel sounds 30. Which medication should the nurse expect to administer to a client with constipation?

31. Which outcome indicates effective client teaching to prevent constipation?


A.The client verbalizes consumption of low-fiber foods B.The client maintains a sedentary lifestyle C.The client limits water intake to three glasses per day D.The client reports engaging in a regular exercise regimen 32. In regards to appendicitis, the location of pain in the lower, right abdominal quadrant is called: A.Kernig's sign B.Mc Burney's point C.Brudzinski's point D.Schrute's point 33. When preparing a client, age 50, 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.The appendectomy surgery is very invasive and it puts the client at a risk for infection B.Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix. C.Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage D.The appendix may develop gangrene and rupture, especially in a middle-aged client 34. Which of the following assessment findings suggests early appendicitis? A.nausea and vomiting B.periumbilical pain C.tense positioning D.abdominal rigdity 35. Which of the following is not an appropriate nursing diagnosis related to appendicitis? A.Disturbed body image B.Acute pain C.Risk for infection r/t rupture D.Deficient knowledge 36. While preparing a client for cholecystectomy, the nurse explains that incentive spirometry will be used after surgery primarily to: A.increase respiratory effectiveness.

B.eliminate the need for nasogastric intubation. C.improve nutritional status during recovery. D.decrease the amount of postoperative analgesia needed. 37. Which task can the nurse delegate to a nursing assistant? A.Irrigating a nasogastric (NG) tube B.Assisting a client who had surgery three days ago walk down the hallway C.Helping a client who just returned from surgery to the bathroom D.Administering an antacid to a client complaining of heartburn 38. How are ulcerative colitis and Chron's disease definitively diagnosed? A.EGD B.CBC C.stool sample D.colonoscopy 39. What is toxic megacolon (mulitple answers)? A.a complication of ulcerative colitis B.dilation and paralysis of the colon C.a fistula D.a risk factor for pancreatitis 40. A 28-year-old client is admitted with inflammatory bowel syndrome (Crohn's disease). Which therapies should the nurse expect to be part of the care plan? Check all that apply A.Lactulose therapy B.High-fiber diet C.High-protein milkshakes D.Corticosteroid therapy E.Antidiarrheal medications 41. A client is diagnosed with Crohn's disease after undergoing two weeks of testing. The client's boss calls the medical-surgical floor requesting to speak with the nurse manager. He expresses concern over the client and explains that he must know the client's diagnosis for insurance purposes. Which response by the nurse is best? A."Sure, I understand how demanding insurance companies can be." B."I appreciate your concern, but I can't give out any information." C."Why don't you come in, and we can further discuss this issue." D."He has been diagnosed with Crohn's Disease." 42. A client with a recent history of rectal bleeding is being prepared for a colonoscopy. How should the nurse position the client for this test initially? A.Lying on the right side with legs straight B.Lying on the left side with knees bent C.Prone with the torso elevated D.Bent over with hands touching the floor 43. A client has a newly created colostomy. After participating in counseling with the nurse and receiving support from the spouse, the client decides to change the colostomy pouch unaided. Which behavior suggests that the client is beginning to accept the change in body image? A.The client asks his wife to leave the room B.The client closes the eyes when the abdomen is exposed C.The client avoids talking about the recent surgery D.The client touches the altered body part

1. 2. 3. 4. 5. 6. 7.

C A A C B

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