1
STARS NKL REVIEW SERVICES AND CONSULTANCY
F0CUS-DETERMINATION-ATTITUDE-FAITH
MEDICAL-SURGICAL NURSING 2 (ENDOCRINE, GASTROINTESTINAL, GENITOURINARY)
John Paul Richard Mindanao
1. Because of steroid excess, the patient who has
undergone a bilateral adrenalectomy is at an increased
risk for
a. malnutrition. b. emboli.
c. delayed wound healing. d. postoperative confusion.
2. Bone resorption is a possible complication of
Cushing’s disease. Which of the following interventions
should the nurse recommend to help the patient prevent
this complication?
a. Limit dietary vitamin D intake.
b. Maintain a regular program of weight-bearing
exercise.
c. Increase the amount of potassium in the diet.
d. Perform isometric exercises.
3. Cushing’s disease is manifested by the excessive
secretion of corticosteroids. The hormones involved are
a. glucocorticoids, aldosterone, and androgens.
b. adrenocorticotropic hormone.
c. glucocorticoids and aldosterone.
d. catecholamines.
4. A 42-year-old female patient reports that she has
gained weight and that her face and body are “rounder, ”
while her legs and arms have become thinner. A
tentative diagnosis of Cushing’s disease is made. When
examining this patient, the nurse would expect to find
a. decreased body hair.
b. bruised areas on the skin.
c. muscle hypertrophy in the extremities.
d. postural hypotension.
5. Which of the following signs and symptoms would
probably indicate that the patient with Addison ’s disease
is receiving much glucocorticoids replacement?
a. Rapid weight gain. b. Poor skin turgor.
c. Anorexia. d. Dizziness.
6. Which of the following findings would be typical of
Addison’s disease?
a. Decreased BUN level. b. Hypokalemia.
c. Hypoglycemia. d. Hypernatremia.
7. The nurse would expect the patient with Addison ’s
disease to exhibit which of the following signs and
symptoms?
a. Lethargy. b. Hunger.
c. Weight gain d. Muscle spasms.
8. When teaching a patiently newly diagnosed with
primary Addison’s disease, the nurse should explain that
the disease results from
a. oversecretion of the adrenal medulla.
b. idiopathic atrophy of the adrenal gland.
c. dysfunction of the hypothalamic pituitary.
d. insufficient secretion of growth hormone (GH).
9. Which of the following activities would be a major
focus of monitoring when planning nursing care for a
patient who has undergone transsphenoidal
hypophysectomy?
a. Cardiac arrest. b. Cushing ’s syndrome.
c. Fluctuating blood glucose levels. d. CSF leak.
10. A patient presents to the emergency room with
diabetic ketoacidosis. The nurse would identify which of
the following nursing diagnoses as a priority problem?
a. Deficient fluid volume.
b. Imbalanced nutrition: less than body requirements.
c. Impaired health maintenance.
d. Disturbed sleep pattern.
11. The best indicator that allows the nurse to judge that
the patient has learned how to give an insulin self-
injection correctly is when the patient can do which of
the following?
a. Explain all steps of the procedure correctly.
b. Perform the procedure safely and correctly.
c. Critique the nurse’s performance of the procedure.
d. Correctly answer a post-test about the procedure.
12. A patient with type 1 DM who jogs daily is given the
following education regarding the preferred sites for
insulin absorption.
a. The preferred sites are the arms.
b. Jogging does not cause altered insulin absorption so
concern about preferred sites is not important.
c. The legs are the preferred sites of injection since the
patient is a jogger.
d. The abdomen would provide a consistent and
effective absorption sire.
13. Which of the following indicates a potential
complication of DM?
a. Stooped appearance. b. Hemoglobin of 9 g/dL.
c. Inflamed, painful joints. d. BP of 160/100 mm Hg.
14. The patient with DM says, “If I could just avoid what
you call carbohydrates in my diet, I guess I would be
okay.” The nurse should base the response to this
comment on the knowledge that diabetes affects
metabolism of which of the following?
a. Fats and carbohydrates only.
b. Protein and carbohydrates only.
c. Carbohydrates only.
d. Proteins, fats, and carbohydrates.
15. When teaching the diabetic patient about foot care,
the nurse should instruct the patient to do which of the
following?
a. Avoid going barefoot.
b. Use heating pads for sore feet.
c. Buy shoes a half size larger.
d. Cut toenails at angles.
16. Which of the following symptoms might indicate that
a patient was developing tetany after a subtotal
thyroidectomy?
a. Bleeding on the back of the dressing.
b. Tingling in the fingers.
c. Pains in the joints of the hands and feet.
d. Tension on the suture line.
17. A patient who has undergone a subtotal
thyroidectomy is subject to complications in the first 48
hours after surgery. The nurse should obtain and keep at
the bedside equipment to
a. perform a tracheostomy.
b. begin total parenteral nutrition.
c. start a cutdown infusion.
d. administer tube feedings.
18. The nurse should teach the patient to prevent
corneal irritation from mild exophthalmos by
a. wearing dark-colored glasses.
b. covering both eyes with moistened gauze pads.
c. massaging the eyes at regular intervals.
d. instilling an ophthalmic anesthetic as ordered.
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STARS NKL REVIEW SERVICES AND CONSULTANCY
F0CUS-DETERMINATION-ATTITUDE-FAITH
MEDICAL-SURGICAL NURSING 2 (ENDOCRINE, GASTROINTESTINAL, GENITOURINARY)
19. Propylthiouracil (PTU) is prescribed for a patient with
Grave’s disease to decrease circulating thyroid
hormone. The nurse should teach the patient to
immediately report which of the following signs and
symptoms?
a. Painful, excessive menstruation. b. Constipation.
c. Increased urine output. d. Sore throat.
20. A female patient with thyrotoxicosis would probably
report which changes related to the menstrual cycle
during initial assessment?
a. Dysmenorreah. b. Metrorrhagia.
c. Oligomenorrhea. d. Menorrhagia.
21. Nurse Bagets should expect a client with
hypothyroidism to report which health concerns?
a. Increased appetite and weight loss
b. Puffiness of the face and hands
c. Nervousness and tremors
d. Thyroid gland swelling
22. A 62-year-old male client has been complaining of
sleeping more, increased urination, anorexia, weakness,
irritability, depression, and bone pain that interferes with
her going outdoors. Based on these assessment
findings, nurse Richard would suspect which of the
following disorders?
a.    Diabetes mellitus b.    Diabetes insipidus
c.    Hypoparathyroidism d.    Hyperparathyroidism
23. Jemma, who weighs 210 lb (95 kg) and has been
diagnosed with hyperglycemia tells the nurse that her
husband sleeps in another room because her snoring
keeps him awake. The nurse notices that she has large
hands and a hoarse voice. Which of the following would
the nurse suspect as a possible cause of the client ’s
hyperglycemia?
a.    Acromegaly b.    Type 1 diabetes mellitus
c.    Hypothyroidism d.    Deficient growth hormone
24. Which outcome indicates that treatment of a male
client with diabetes insipidus has been effective?
a.    Fluid intake is less than 2,500 ml/day.
b.    Urine output measures more than 200 ml/hour.
c.    Blood pressure is 90/50 mm Hg.
d.    The heart rate is 126 beats/minute.
25. A male client is admitted for treatment of the
syndrome of inappropriate antidiuretic hormone
(SIADH). Which nursing intervention is appropriate?
a.    Infusing I.V. fluids rapidly as ordered
b.    Encouraging increased oral intake
c.    Restricting fluids
d.    Administering glucose-containing I.V. fluids as
ordered
26. Early this morning, a female client had a subtotal
thyroidectomy. During evening rounds, nurse Tina
assesses the client, who now has nausea, a temperature
of 105° F (40.5° C), tachycardia, and extreme
restlessness. What is the most likely cause of these
signs?
a.    Diabetic ketoacidosis b.    Thyroid crisis
c.    Hypoglycemia d.    Tetany
27. Nurse Louie is developing a teaching plan for a male
client diagnosed with diabetes insipidus. The nurse
should include information about which hormone lacking
in clients with diabetes insipidus?
a.    antidiuretic hormone (ADH).
b.    thyroid-stimulating hormone (TSH).
c.    follicle-stimulating hormone (FSH).
d.    luteinizing hormone (LH).
28. Nurse Toy-toy is aware that the most appropriate for
a client with Addison’s disease?
a.    Risk for infection b.    Excessive fluid volume
c.    Urinary retention d.    Hypothermia
29. Which of these signs suggests that a male client with
the syndrome of inappropriate antidiuretic hormone
(SIADH) secretion is experiencing complications?
a.    Tetanic contractions b.    Neck vein distention
c.    Weight loss d.    Polyuria
30. After undergoing a subtotal thyroidectomy, a female
client develops hypothyroidism. Dr. Archie Alviz
prescribes levothyroxine (Levothroid), 25 mcg P.O. daily.
For which condition is levothyroxine the preferred agent?
a.    Primary hypothyroidism b.    Graves’ disease
c.    Thyrotoxicosis d.    Euthyroidism
31. When instructing Brittany diagnosed with
hyperparathyroidism about diet, nurse Mercedes should
stress the importance of which of the following?
a.    Restricting fluids b.    Restricting sodium
c.    Forcing fluids d.    Restricting potassium
32. Capillary glucose monitoring is being performed
every 4 hours for Maria, a female client diagnosed with
diabetic ketoacidosis. Insulin is administered using a
scale of regular insulin according to glucose results. At 2
p.m., the client has a capillary glucose level of 250 mg/dl
for which he receives 8 U of regular insulin. Nurse Percy
should expect the dose’s:
a.    Onset to be at 2 p.m. and its peak to be at 3 p.m.
b.    Onset to be at 2:15 p.m. and its peak to be at 3 p.m.
c.    Onset to be at 2:30 p.m. and its peak to be at 4 p.m.
d.    Onset to be at 4 p.m. and its peak to be at 6 p.m.
33. Nigel has just been diagnosed with type 1 diabetes
mellitus. When teaching the client and family how diet
and exercise affect insulin requirements, Nurse Ebonni
should include which guideline?
a.    “You’ll need more insulin when you exercise or
increase your food intake.”
b.    “You’ll need less insulin when you exercise or
reduce your food intake.”
c.    “You’ll need less insulin when you increase your
food intake.”
d.    “You’ll need more insulin when you exercise or
decrease your food intake.”
34. Tyra, a 29-year-old female client who is being
successfully treated for Cushing’s syndrome, nurse
Lyzette would expect a decline in:
a.    Serum glucose level. b.    Hair loss.
c.    Bone mineralization. d.    Menstrual flow.
35. Captain America with primary diabetes insipidus is
ready for discharge on desmopressin (DDAVP). Which
instruction should nurse Shey provide?
a.    “Administer desmopressin while the suspension is
cold.”
b.    “Your condition isn’t chronic, so you won’t need to
wear a medical identification bracelet.”
c.    “You may not be able to use desmopressin nasally if
you have nasal discharge or blockage.”
d.    “You won’t need to monitor your fluid intake and
output after you start taking desmopressin.”
36. Nurse Katy Perry is caring for a female client with
type 1 diabetes mellitus who exhibits confusion, light-
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STARS NKL REVIEW SERVICES AND CONSULTANCY
F0CUS-DETERMINATION-ATTITUDE-FAITH
MEDICAL-SURGICAL NURSING 2 (ENDOCRINE, GASTROINTESTINAL, GENITOURINARY)
headedness, and aberrant behavior. The client is still
conscious. The nurse should first administer:
a.    I.M. or subcutaneous glucagon.
b.    I.V. bolus of dextrose 50%.
c.    A fast-acting carbohydrate such as orange juice.
d.    10 U of fast-acting insulin.
37. Which instruction about insulin administration should
nurse Sophie give to a client?
a.    “Always follow the same order when drawing the
different insulins into the syringe.”
b.    “Shake the vials before withdrawing the insulin.”
c.    “Store unopened vials of insulin in the freezer at
temperatures well below freezing.”
d.    “Discard the intermediate-acting insulin if it appears
cloudy.”
38. Bugoy with a tentative diagnosis of hyperosmolar
hyperglycemic nonketotic syndrome (HHNS) has a
history of type 2 diabetes that is being controlled with an
oral diabetic agent, tolazamide (Tolinase). Which of the
following is the most important laboratory test for
confirming this disorder?
a.    Serum potassium level
b.    Serum sodium level
c.    Arterial blood gas (ABG) values
d.    Serum osmolarity
39. An agitated, confused female client arrives in the
emergency department. Her history includes type 1
diabetes mellitus, hypertension, and angina pectoris.
Assessment reveals pallor, diaphoresis, headache, and
intense hunger. A stat blood glucose sample measures
42 mg/dl, and the client is treated for an acute
hypoglycemic reaction. After recovery, nurse Lily
teaches the client to treat hypoglycemia by ingesting:
a. fruit juice b. cake c. rice cereal d. dextrose 50%
40. A patient is admitted with pheochromocytoma. The
nurse assesses the patient’s blood pressure frequently.
This is based on the knowledge that pheochromocytoma
of the adrenal medulla releases excessive amounts of
a. catecholamines. b. rennin.
c. aldosterone. d. glucocorticoids.
41.A 60-year-old man seeks medical attention
because he has been vomiting blood and passing bloody
stools. The tentative diagnosis is cirrhosis of the liver.
Which information in the client's health history most likely
relates to the development of cirrhosis?
A) He drinks a fifth of whiskey daily.
B) He is a Vietnam veteran.
C) He has a history of pancreatitis.
D) He has been taking antihypertensive
medications for the past 15 years.
42.If the client's cirrhosis is advanced, what will the
nurse most likely find during the initial health
assessment?
A) Laboratory results that reveal an elevated serum
cholesterol level.
B) There are spider-like blood vessels on the skin.
C) The scrotum is unusually large and edematous.
D) The client's blood sugar is abnormally high.
43.Which assessment finding indicates that the client
with cirrhosis is bleeding from somewhere in his upper
gastrointestinal tract?
A) He has mid epigastric pain.
C) His stools are black and sticky.
B) He states that he feels nauseated.
D) His abdomen is distended and shiny.
44.The care plan indicates that the nurse should
monitor the client with cirrhosis each day for signs and
symptoms of ascites. To carry out this nursing order,
which nursing action is most appropriate?
A) The apical and radial pulse rates are counted.
B) The lying and sitting blood pressure are taken.
C) The specific gravity of the urine is checked.
D) The circumference of the abdomen is measured.
45.The physician considers performing a liver biopsy
on the client with cirrhosis. If a liver biopsy is performed,
immediately afterward it is most important for the nurse
to assess the client for signs of
A) hemorrhage B) infection
C blood clots D.collapsed lung.
46.After a liver biopsy, which nursing order is most
appropriate to add to the plan of care?
A) Ambulate the client twice each shift.
B) Keep the client in high Fowler's position.
C) Position the client on his right side.
D) Elevate the client's legs on two pillows.
47. Instead of a liver biopsy, a magnetic resonance
imaging (MRI) test is ordered. Before the MRI is
performed, which nursing action is essential?
A) The nurse administers a pretest sedative.
B) The nurse removes the client's dental bridge.
C) The nurse records the client's body weight.
D) The nurse inserts a Foley retention catheter.
48.The MRI confirms the diagnosis of hepatic
cirrhosis and reveals a large amount of fluid in the
peritoneal cavity. A paracentesis is planned. Which
nursing action is most appropriate prior to assisting with
the paracentesis?
A) The nurse asks the client to void.
B) The nurse withholds food and water.
CThe nurse cleanses the client's abdomen with
Betadine.
D)The nurse obtains a suction machine from the
storage room.
49.After the paracentesis has been performed, which
nursing responsibility is essential?
A) Increasing the client's oral fluid intake
C) Administering a prescribed analgesic
B) Recording the volume of withdrawn fluid
D) Encouraging the client to deep-breathe
50.When administering an intramuscular injection to
the client with cirrhosis of the liver, which nursing action
is essential to perform?
A) Cleanse the site with Betadine.
B) Inject no more than 1 mL at any given site.
C) Obtain a vial of vitamin K and place at the
bedside.
D) Apply prolonged pressure to the injection site.
51.Which laboratory result, if elevated, is most
indicative that the client may develop hepatic
encephalopathy?
A) Serum creatinine B) Serum bilirubin
C) Blood ammonia D) Blood urea nitrogen
52.Which assessment finding best indicates that the
cirrhotic client's condition is worsening?
A) He is difficult to arouse
C) He develops pancreatitis.
B) His urine output is 100 mL/h.
D) His blood pressure is 122/60 mm Hg.
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STARS NKL REVIEW SERVICES AND CONSULTANCY
F0CUS-DETERMINATION-ATTITUDE-FAITH
MEDICAL-SURGICAL NURSING 2 (ENDOCRINE, GASTROINTESTINAL, GENITOURINARY)
53.The seriousness of the client's condition is
explained to his wife. She is prepared for the possibility
of her husband's death. The client's wife cries as she
recalls various significant events she and her husband
shared together.
Which nursing action is most therapeutic at this time?
A) Offer to call a close family member.
B) Listen to her express her thoughts.
C) Suggest that she call the clergy at her church.
D) Ask about her future plans in life.
54.A 48-year-old man comes to the emergency
department because of severe upper abdominal pain.
He reports that the pain came on suddenly a few hours
ago and nothing so far has relieved it. The nurse
observes that the client is curled in a fetal position and is
rocking back and forth. Which action would best assist
the nurse in further assessing the client's pain?
A) Determine if the client can stop moving.
B) Ask the client to rate his pain from 0 to 10.
C) Observe if the client is breathing heavily.
D) Give the client a prescribed pain-relieving drug.
55.Which laboratory test, if elevated, provides the
best indication that the client's pain is caused by
pancreatitis?
A) Serum bilirubin B) Serum amylase
C) Lactose tolerance D) Glucose tolerance
56.The physician orders the insertion of a nasogastric
sump tube. To determine the length for inserting the
tube, the nurse most correctly places the tip of the tube
at the client's nose and measures the distance from
there to the
A) jaw and then midway to the sternum.
C) midsternum and then to the umbilicus.
B) mouth and then between the nipples.
D) ear and then to the xiphoid process.
57.If the client turns blue and coughs as the
nasogastric tube is inserted, which additional sign
indicates that the tube has entered the respiratory tract?
A) The client cannot speak.
C) The client begins to sneeze.
B) The client cannot swallow.
D) The client begins to vomit.
58.After being NPO (nothing by mouth) for several days,
the nasogastric tube is removed and the client is placed
on a bland, low-fat diet. Which food, if found on the
client's breakfast tray, should be removed?
A) Stewed prunes B) Skim milk
C) Scrambled eggs D) Whole wheat toast
59.Before discharging the client with pancreatitis,
which information is essential for him to receive?
A) He must never donate blood again.
C) He must not drink alcohol in any form.
B) He must avoid lifting heavy objects.
D) He must forgo taking strong laxatives.
60. Nurse Bundat is caring for a client who is at risk for
developing gastritis. Which finding from the client’s
history leads the nurse to this conclusion?
a. The client is lactose-intolerant and cannot drink milk.
b. The client recently traveled to Mexico and South
America.
c. The client works at least 60 hours per week in a
stressful job.
d. The client takes naproxen sodium (Naprosyn) 500 mg
daily for arthritis pain
61. The nurse is caring for a client with a gastric ulcer
who suddenly develops sharp mid-epigastric pain. The
nurse
notes that the client’s abdomen is hard and very tender
to light palpation. Which is the priority action of the
nurse?
a. Placing the client in a knee-chest position
c. Inserting a nasogastric tube to low intermittent suction
b. Preparing the client for emergency surgery
d. Administering morphine 2 mg IV as ordered by the
physician
62. The nurse is caring for a client with peptic ulcer
disease. The client vomits a large amount of undigested
food after breakfast. Which intervention will the nurse
prepare to do for the client?
a. Administer a soap suds cleansing enema.
nasogastric (NG) tube to low intermittent suction.
b. Change the client’s diet to clear liquids only.
Administer prochlorperazine (Compazine) 10 mg IM.
63. The nurse learns that a client who is being treated
for peptic ulcer disease is still "having problems". Which
of the following should the nurse instruct this client?
a. Smoking cessation techniques.
breakfast.
b. Have the largest meal of the day at lunchtime.
d. Make sure the client is eating a bland diet.
64. 8. The nurse monitors a client for early signs of
dumping syndrome. Which is not included?
a. Bradycardia b. Vertigo c. Sweating d. Diarrhea
65. The nurse is caring for a client with colon cancer and
a new colostomy. The client wishes to talk with someone
with a similar experience. Which is the nurse’s best
response?
a. "I will make a referral to the Philippine Cancer
Society."
b. "You can get all the information you need from the
enterostomal therapist."
c. "I do not think that we have any other clients with
colostomies on the unit right now."
d. "Most people who have had a colostomy are reluctant
to talk about it."
66. The nurse is caring for a client who just had colon
resection surgery with a new colostomy. Which teaching
objective will the nurse include in the client’s plan of
care?
a. The client will understand colostomy care and lifestyle
implications.
b. The client will learn how to change the appliance.
c. The client will demonstrate correct changing of the
appliance before discharge.
d. The client will not be afraid to handle the ostomy
appliance tomorrow.
67. A 23-year-old woman is being evaluated in the
emergency department for acute lower abdominal pain
and vomiting. During the nursing history, the most
helpful question by the nurse to obtain information
regarding the patient’s condition is?
a. "What type of foods do you usually eat?"
your usual elimination pattern?"
b. "Can you tell me about your pain?"
that you are pregnant?"
68. A client experiences regurgitation and dyspepsia.
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STARS NKL REVIEW SERVICES AND CONSULTANCY
F0CUS-DETERMINATION-ATTITUDE-FAITH
MEDICAL-SURGICAL NURSING 2 (ENDOCRINE, GASTROINTESTINAL, GENITOURINARY)
The nurse assists the client to assume an upright
position. Which of the following statements by the nurse
would best describe the purpose of this measure?
a. "It prevents the flow of gastric contents into the
esophagus."
b. "It decreases the inflammatory changes in the
esophagus."
c. "It enhances and strengthens esophageal peristalsis."
d. "It increases the lower esophageal pressure.
69. Because a client has Crohn’s disease, plans for
nursing intervention should include?
a. Weight reduction measures and low-calorie.
b. Frequent application of lubricant location and
discouraging scratching.
c. Teaching the importance of following-up liver function
test after discharge.
d. Perianal care and restoration of fluids and
electrolytes.
70. During an acute exacerbation of Crohn’s disease,
which of the following nursing diagnoses should have
priority?
a. Imbalanced nutrition: less than body requirements
related to anorexia and diarrhea.
b. Anxiety related to altered self-concept and health
status.
c. Fatigue related to decreased nutrient intake and
anemia.
d. Knowledge deficiency related to lack of information
about disease process.
71. The client is diagnosed with an acute episode of
ureteral calculi. Which client problem is priority when
caring for this client?
a. Fluid volume loss. b. Knowledge deficit.
c. Impaired urinary elimination. d. Pain.
72. Which statement indicates that the client diagnosed
with calcium phosphate renal calculi understands the
discharge teaching for ways to prevent future calculi
formation?
a. “I should increase my fluid intake, especially in warm
weather.”
b. “I should eat foods that contain cocoa and chocolate. ”
c. “I will walk about a mile every week and not exercise
often.”
d. “I should take one vitamin a day that has extra
calcium.”
73. The nurse is caring for an elderly client who has an
indwelling catheter. Which data warrant further
investigation?
a. The client’s temperature is 98.0_F.
b. The client has become confused and irritable.
c. The client’s urine is clear and light yellow.
d. The client has no discomfort or pain.
74. The nurse is observing the unlicensed nursing
assistant (NA) provide direct care to a client with a Foley
catheter. Which data warrant immediate intervention by
the nurse?
a. The NA secures the tubing to the client’s leg with
tape.
b. The NA provides catheter care with the client’s bath.
c. The NA positions the collection bag on the client ’s
bed.
d. The NA cares for the catheter after washing the
hands.
75. The client complains of fever, perineal pain, and
urinary urgency, frequency, and dysuria. To assess
whether the client's problem is related to bacterial
prostatitis, the nurse would look at the results of the
prostate examination, which should reveal that the
prostate gland is:
a. Soft and swollen
b. Reddened, swollen, and boggy
c. Tender and edematous with ecchymosis
d. Tender, indurated, and warm to the touch
76. Phenazopyridine hydrochloride (Pyridium) is
prescribed for a client for symptomatic relief of pain
resulting from a lower urinary tract infection. The nurse
teaches the client:
a. To take the medication at bedtime
b. To take the medication before meals
c. To discontinue the medication if a headache occurs
d. That a reddish orange discoloration of the urine may
occur
77. A 69 – year old male client has been diagnosed to
have benign prostatic hyper trophy. BPH is primarily
associated with which of the following?
a.Chronic bacterial invasion of the urinary tract
b.Endocrine imbalances associated with aging
c. Tumor growth due to excessive smoking
d.Local inflammation of the prostate due to
contamination from rectal organisms
78. The client has been diagnosed to have cancer of the
blader. The characterisctics manifestation of the client
more likely would be:
a.Oliguria B. Burning or urination
b.Painless hematuria D. Incontinence
79. The client was diagnosed with acute renal failure. He
has been prescribed low protein, low potassium and low
sodium diet. A teaching program should include:
a.Encouraging the client to include raw carrots ,
tomatoes and cabbage in the diet
b.Recommending protein of high biologic value such as
eggs, poultry and lean meat
c. Pointing out that raw fruits such as bananas,
cantaloupe and oranges may be included in the diet
d.Allowing the client to have cheese, canned foods, and
processed foods.
80. Patients with urolithiasis need to ne encourage to:
a.Decrease fluid intake C. Strain all urine
b.Supplement diet with calcium D.Void every 6 – 8 hours
81. You’re assessing a 24-year-old woman who
might have a urinary tract infection (UTI). Which
statement by the client suggests that UTI is likely?
A. “I urinate large amounts.”
B. “It burns when I urinate.”
C. “I go for hours without the urge to urinate.”
D. “My urine has sweet smell.”
82. You must send a patient for a magnetic
resonance imaging (MRI) study of his kidneys. Identify
two primary nursing considerations in preparation for the
MRI.
A. Coordinating the MRI with other patient care activities
and informing the patient about the test
B. Giving all scheduled medications and completing the
bath before the test
C. Report metal screening findings to the MRI
department and sedate for claustrophobia before
sending him or her to the MRI department
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STARS NKL REVIEW SERVICES AND CONSULTANCY
F0CUS-DETERMINATION-ATTITUDE-FAITH
MEDICAL-SURGICAL NURSING 2 (ENDOCRINE, GASTROINTESTINAL, GENITOURINARY)

D. Make sure the patient is NPO and hold all A. 10 to 15 minutes B. 30 minutes
medications until the test is completed C. 1 hour 2 to 3 hours

83. The main indication for hemodialysis for a client 92. Health information for a female patient
who has chronic kidney failure is: diagnosed as having cystitis includes all of the following
A. Ascites B. Acidosis except:
C. Hypertension D.Hyperkalemia A. cleanse around the perineum and urethral meatus
(from front to back) after each bowel movement.
84. A client with acute kidney failure is to receive a B. drink liberal amounts of fluid
very low-protein diet. This diet is based on the principles C. shower rather than bathe in a tub.
that: D. void no more frequently than every 6 hours to allow
A. A high-protein intake ensures an adequate daily urine to dilute the bacteria in the bladder.
supply of all amino acids to compensate for loses
B. Essential and nonessential amino acids are 93. A clinical diagnosis of nephrotic syndrome is
necessary in the diet to supply materials for tissue consistent with an exceedingly high level of:
protein synthesis A. albumin B. low-density lipoproteins
C. This supplies only essential amino acids reducing the C. protein in the urine D. serum cholesterol
amount of metabolic waste products, thus decreasing
stress on the kidneys 94. In the oliguric phase of ARF, the nurse should
D. Urea nitrogen cannot be used to synthesize amino anticipate the development of which of the following
acids in the body, so the nitrogen for amino acid complications?
synthesis must come from the dietary protein A. Pulmonary edemA B.Metabolic alkalosis
C. Hypotension D.Hypokalemia
85. To obtain an accurate urine output for a client
with a continuous bladder irrigation (CBI), the nurse 95. If the client’s serum potassium continues to rise
should: in ARF, the nurse should be prepared for which of the
A. Measure the contents of the bedside drainage bag following emergencies?
B. Stop irrigation until the urine output is determined A. Cardiac arrest B. Pulmonary edema
C. Subtract the volume of the irrigant from the total C. Circulatory collapse D. Hemorrhage
drainage
D. Ensure that urine and irrigant drain into two separate 96. The client’s blood urea nitrogen (BUN)
bags concentration is elevated in renal failure. This is likely
due to:
86. Which data would support the client’s diagnosis of A. Fluid retention
acute bacterial prostatitis? B. Hemolysis
a. Terminal dribbling. b. Urinary frequency. C. Below normal metabolic rate
c. Stress incontinence. d. Sudden fever and chills. D. Reduced renal blood flow

87. The client is admitted to a nursing unit from a long-
term care facility with a hematocrit of 56% and a serum
sodium level of 152 mEq/L. Which condition would be a
cause for these findings?
a. Overhydration. b. Anemia.
c. Dehydration. d. Renal failure.
88. A patient with Chronic Renal Failure is being
maintained on Peritoneal Dialysis. Which of the
following is NOT an indication that the patient is
developing possible Peritonitis?
a. Slightly blood tinged drainage after the first exchange
b. Rigid abdomen with abdominal pain
c. Decreased rate of fluid return
d. Nausea and vomiting
89. The client diagnosed with ARF is admitted to the
intensive care department and placed on a therapeutic
diet. Which diet would be most appropriate for the client?
a. A high-potassium and low-calcium diet.
b. A low-fat and low-cholesterol diet.
c. A high-carbohydrate and restricted-protein diet.
d. A regular diet with six (6) small feedings a day.
90.Edward needs to be taught how to detect signs of the
most serious and most common complication of CAPD,
which is:
A. an abdominal hernia B. anorexia
C. edema D. peritonitis
97. The client undergoes a transurethral resection of
the prostrate (TURP) and is brought back to his room
with continuous bladder irrigation (CBI). Which of the
following statements best explains for the CBI?
A. to decrease bladder atony
B. to remove blood clots form the bladder
C. to maintain gateway of the urethral catheter
D. to dilute the concentrated urine
98. The physician examines the prostrate gland of
the client. What will the nurse prepare?
A. a foley catheter B.lubricant and gloves
C. urethral dilators D.a rectal tube
99. The client appears distressed and asks the
nurse how she got the infection. The nurse explains that
in most cases, cystitis is caused by
A. an ascending infection from the urethra
B. an infection elsewhere in the body
C. congenital structure of the urethra
D. urine stasis in the urinary bladder
100. When scheduling the administration of Lasix
(furosemide) it would be in the patient’s best interest to
schedule the medication to be given at:
A. 9:00 am B.12:00 noon
C. 2100 D. 12:00 midnight

91.Edward needs to be aware that toxic wastes are

exchanged during the equilibration or dwell time, which
usually lasts for: