1. The nurse is teaching the client how to care for an ileostomy.

The client ask the

nurse how long to wear the punch before changing it. The nurse should tell the
client which of the following?

A. "The pouch is changed only when it leaks"

B. "You can wear the ouch for about 4 to 7 days."

C. "You should change the pouch every evening before bedtime."

D. "it depends on your activity level and your diet."

2. Immediately after having surgery to create an ileostomy, which goal has the
highest priority?

A. Provide relief from constipation

B. Assisting the client with self-care activities

C. Maintaining fluid & electrolyte balance

D. Minimizing odor formation

3. On the second day flowing an abdominal perineal resection, the nurse notes that
the wound edges are not approximated & one-half the incision has torn apart.
The nurse should take what action first?

A. Flush the wound with sterile water

B. Apply an abdominal binder

C. Cover the wound with sterile dressing moistened with normal saline

D. Apply strips of tape

4. The client who is scheduled for an ileostomy is to receive oral neomycin

(Mycifradin) before surgery. The intended outcome of administrating oral
neomycin before surgery is to:

A. Prevent postoperative bladder infection

 B. Reduce the number of intestinal bacteria

C. Decrease the potential for post operative hypostatic pneumonia

D. Increase the body's immunologic response to the stressors of surgery

5. A client has a nasogastric tube inserted at the time of abdominal perineal resection with
permanent colostomy for colon cancer. This tube will most likely be removed when the
client demonstrates:

A. Absence of cause & vomiting

B. Passage of mucus from the rectum

C. Passage of flatus & feces from the colostomy

D. Absence of stomach drainage for 24 hours

6. The nurse assesses the client's stoma during the initial postoperative period. Which of
the following observations would be reported immediately to the physician?

A. The stoma is slightly edematous

B. The stoma is dark red to purple

C. The stoma oozes a small amount of blood

D. The stoma does not expel stool

7. The nurse is assessing a client who has been admitted with a diagnosis of an
obstruction in the small intestine. The nurse should assess the client for which of
the following?

A. Projectile vomiting
B. Significant signs of dehydration
C. Increased bowel sounds
D. Diarrhea

8. The client with intestinal obstruction continues to have acute pain even though
the nasogastric tube is patent & draining. Which action by the nurse would be
most appropriate?

A. Reassure the client that the nasogastric tube is functioning

 B. Assess the client for a rigid abdomen

C. Administer an opioid as prescribed

D. Reposition the client on the left side

9. Before abdominal surgery for an intestinal obstruction, the nurse monitors the client's
urine output & finds that the total output for the past 2 hours was 35ml. The nurse then
assesses the client’s total intake & output over the last 24 hours & notes 2,000ml of IV
fluid for intake, 500ml of drainage from the NG tube, & 700ml of urine for total output of
1,200ml. These findings indication which of the following?

A. Decreased renal function

B. Inadequate pain relief

C. Extension of the obstruction

D. Inadequate fluid replacement

10. The physician has prescribed ciprofloxacin for a client who take warfarin. The nurse
should instruct the client to do which of the following while taking this drug?

A. Split the tablets and stir them in food

B. Avoid exposure to sunlight

C. Eliminate caffeine form the diet

D. Report unusual bleeding

11. What is the nurse's initial action when preparing to change a

patient's colostomy pouching system?

A. Applying clean gloves

B. Draping the patient appropriately
C. Emptying the colostomy
D. Assessing the surrounding skin for signs of irritation.

12. When pouching a patient's colostomy, which action reduces

the patient's risk for injury?
 A. Measuring output when emptying the contents of the
pouch
B. Maintaining the patient's bowel elimination function
C. Promoting the patient's autonomy with bowel elimination
care
D. Protecting the skin from irritation caused by fecal
drainage

13. When changing the pouching system, which routine step

best minimizes irritation of the skin surrounding the stoma?

A. Using adhesive remover

B. Emptying the ostomy bag only when full
C. Avoiding unnecessary changes of the pouching
system
D. Wearing clean gloves

14. Which initial nursing action would best help the patient learn self-
care of a colostomy pouching system?

A. Giving the patient handouts on self-care of a colostomy

B. Allowing the patient to examine an ostomy device
C. Identifying a family member who can participate in the ostomy
appliance process
D. Giving the patient a mirror to watch the nurse provide care

15. Which instruction might the nurse give to nursing assistive personnel
(NAP) regarding the care of a patient with a newly established
colostomy?

A. "Be sure to pat-dry the skin surrounding the stoma before applying
the new pouch."
B. "Alert me immediately if you see any blood in the fecal matter in
the pouch."
C. "Using the stoma guide, cut the pouch opening about one-eighth of
an inch bigger than the stoma."
 D. "Remember to change your gloves after cleaning the stoma and the
surrounding skin."

16. Nurse Lee Bing Moh identifies a patient’s hemoglobin level is decreasing and is concerned
about tissue hypoxia. An increase in what diagnostic test result indicates an acceleration in
oxygen dissociation from hemoglobin?
A. pH
B. Po2
C. PCo2
D. HCO3

17. Three days after admission to the hospital for a brain attack, patient Jolina Ferry Dust has a
nasogastric tube inserted and is receiving continuous tube feedings. What should Nurse BJ
Wong do to BEST evaluate whether the feeding is being absorbed?
A. Aspirate for a residual volume
B. Evaluate the intake in relation to the output.
C. Instill air into the patient’s stomach while auscultating.
D. Compare the patient’s body weight with the baseline data.

18. Mrs. Gina Cole is scheduled for a pyloroplasty and vagotomy because of strictures caused by
ulcers unresponsive to medical therapy. What information about the purpose of a vagotomy
should the nurse include when reviewing the health care provider’s discussion with the
patient?
A. Increase the heart rate
B. Hastens gastric emptying
C. Eliminates pain sensations
D. Decreases secretions in the stomach

19. Six weeks after discharge, Mrs. Tina Moran with a jejunoileal bypass for morbid obesity
returns to the OPD clinic reporting palpitation, abdominal cramps, diarrhea, and dizziness 30
minutes after meals. What complication should Nurse Even consider that the patient is MOST
likely experiencing?
A. Gastric reflux
B. Reflux gastritis
C. Dumping syndrome
D. Abdominal peritonitis

20. Princess Jolina Ferry Dust of Sussex, is diagnosed with Crohn’s Disease, and parenteral
vitamins are prescribed. The patient asks why the vitamins must be given IV rather than per
Orem. What rationales for this route should Nurse Crissy May include in a response to the
questions? SELECT ALL THAT APPLY.
A. More rapid action results
B. They are ineffective orally
C. They decreased colon irritability
D. Intestinal absorption may be inadequate
E. Allergic responses are less likely to occur.