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1. Nurse Berlinda is assigned to a 41-year-old client who   0
has a diagnosis of chronic pancreatitis. The nurse
reviews the laboratory result, anticipating a laboratory
report that indicates a serum amylase level of:
A. 45 units/L
B. 100 units/L
C. 300 units/L
D. 500 units/L
2. A male client who is recovering from surgery has

been advanced from a clear liquid diet to a full liquid
diet. The client is looking forward to the diet change
 because he has been “bored” with the clear liquid diet.
The nurse would offer which full liquid item to the client?

A. Tea

B. Gelatin
C. Custard
D. Popsicle
3. Nurse Juvy is caring for a client with cirrhosis of the
liver. To minimize the effects of the disorder, the nurse
teaches
CARE the client
PLANS about&foods
TOOLS APPSthat are high in thiamine.
BULLETS
The nurse determines that the client has the best
understanding of the dietary measures to follow if the
client states an intension to increase the intake of:
A. Pork
B. Milk
C. Chicken
D. Broccoli
4. Nurse Oliver checks for residual before administering

a bolus tube feeding to a client with a nasogastric tube
and obtains a residual amount of 150 mL. What is
appropriate action for the nurse to take?
A. Hold the feeding

B. Reinstill the amount and continue with
administering the feeding
C. Elevate the client’s head at least 45 degrees and
administer the feeding
D. Discard the residual amount and proceed with
administering the feeding
5. A nurse is inserting a nasogastric tube in an adult

male client. During the procedure, the client begins to
cough and has difficulty breathing. Which of the

following is the appropriate nursing action?

A. Quickly insert the tube
 B. Notify the physician immediately
C. Remove
HOME
the tube and reinsert when
NURSING NOTES 
the respiratory
PRACTICE EXAMS  MNEMONICS ARTICLES
distress subsides
CARE PLANS
D. Pull back onTOOLS & APPS
the tube BULLETS
and wait until the respiratory
distress subsides
6. Nurse
CARE Ryan isTOOLS
PLANS assessing for correct
& APPS placement of a
BULLETS
nosogartric tube. The nurse aspirates the stomach
contents and check the contents for pH. The nurse
verifies correct tube placement if which pH value is
noted?
A. 3.5
B. 7.0
C. 7.35
D. 7.5
7. A nurse is preparing to remove a nasogartric tube

from a female client. The nurse should instruct the client
to do which of the following just before the nurse
removes the tube?
A. Exhale
B. Inhale and exhale quickly
C. Take and hold a deep breath
D. Perform a Valsalva maneuver
8. Nurse Joy is preparing to administer medication

through a nasogastric tube that is connected to suction.
To administer the medication, the nurse would:
A. Position the client supine to assist in medication


absorption
 B. Aspirate the nasogastric tube after medication
administration to maintain patency
 C. Clamp the nasogastric tube for 30 minutes
following administration of the medication
D. Change
HOME
the suction setting to low
NURSING NOTES 
intermittent
suction for 30 minutes after medication
CAREadministration
PLANS TOOLS & APPS BULLETS

9. A nurse is preparing to care for a female client with
esophageal
CARE PLANSvarices
TOOLSwho&has just has
APPS a Sengstaken-
BULLETS
Blakemore tube inserted. The nurse gathers supplies,
knowing that which of the following items must be kept
at the bedside at all times?
A. An obturator
B. Kelly clamp
C. An irrigation set
D. A pair of scissors
10. Dr. Smith has determined that the client with

hepatitis has contracted the infection form
contaminated food. The nurse understands that this
client is most likely experiencing what type of hepatitis?
A. Hepatitis A
B. Hepatitis B
C. Hepatitis C
D. Hepatitis D
11. A client is suspected of having hepatitis. Which

diagnostic test result will assist in confirming this
diagnosis?
A. Elevated hemoglobin level

B. Elevated serum bilirubin level

C. Elevated blood urea nitrogen level
 D. Decreased erythrocycle sedimentation rate
 12. The nurse is reviewing the physician’s orders written

for a male client admitted to the hospital with acute
pancreatitis.
HOME
Which physician orderPRACTICE
NURSING NOTES 
should theEXAMS
nurse  MNEMONICS ARTICLES
question if noted on the client’s chart?
A. NPO status
B. Nasogastric tube inserted
C. Morphine
CARE PLANS sulfate
TOOLS for&pain
APPS BULLETS
D. An anticholinergic medication
13. A female client being seen in a physician’s office has

just been scheduled for a barium swallow the next day.
The nurse writes down which instruction for the client to
follow before the test?
A. Fast for 8 hours before the test

B. Eat a regular supper and breakfast
C. Continue to take all oral medications as scheduled
D. Monitor own bowel movement pattern for
constipation
14. The nurse is performing an abdominal assessment

and inspects the skin of the abdomen. The nurse
performs which assessment technique next?
A. Palpates the abdomen for size

B. Palpates the liver at the right rib margin
C. Listens to bowel sounds in all for quadrants
D. Percusses the right lower abdominal quadrant
15. Polyethylene glycol-electrlyte solution (GoLYTELY) is

prescribed for the female client scheduled for a
colonoscopy. The client begins to experience diarrhea

following administration of the solution. What action by
 the nurse is appropriate?
 A. Start an IV infusion
B. Administer an enema
C. Cancel
HOME
the diagnostic test
NURSING NOTES  PRACTICE EXAMS  MNEMONICS ARTICLES
D. Explain that diarrhea is expected
16. The nurse is caring for a male client with a diagnosis
of chronic gastritis. The nurse monitors the client
knowing
CARE that thisTOOLS
PLANS client is at risk for BULLETS
& APPS which vitamin
deficiency?
A. Vitamin A
B. Vitamin B12
C. Vitamin C
D. Vitamin E
17. The nurse is reviewing the medication record of a

female client with acute gastritis. Which medication, if
noted on the client’s record, would the nurse question?
A. Digoxin (Lanoxin)
B. Furosemide (Lasix)
C. Indomethacin (Indocin)
D. Propranolol hydrochloride (Inderal)
18. The nurse is assessing a male client 24 hours

following a cholecystectomy. The nurse noted that the T
tube has drained 750 mL of green-brown drainage since
the surgery. Which nursing intervention is appropriate?
A. Clamp the T tube

B. Irrigate the T tube
C. Notify the physician
D. Document the findings

 19. The nurse is monitoring a female client with a

diagnosis of peptic ulcer. Which assessment findings
 would most likely indicate perforation of the ulcer?
A. Bradycardia
B. Numbness in the legs
CARE PLANS andTOOLS
C. Nausea & APPS
vomiting BULLETS
D. A rigid, board-like abdomen
20. APLANS
CARE male clientTOOLS
with a peptic
& APPS ulcer BULLETS
is scheduled for a
vagotomy and the client asks the nurse about the
purpose of this procedure. Which response by the nurse
best describes the purpose of a vagotomy?
A. Halts stress reactions

B. Heals the gastric mucosa
C. Reduces the stimulus to acid secretions
D. Decreases food absorption in the stomach
21. The nurse is caring for a female client following a

Billroth II procedure. Which postoperative order should
the nurse question and verify?
A. Leg exercises
B. Early ambulation
C. Irrigating the nasogastric tube
D. Coughing and deep-breathing exercises
22. The nurse is providing discharge instructions to a

male client following gastrectomy and instructs 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 fluid taken with meal
 D. Sit in a high-Fowler’s position during meals
 23. The nurse is monitoring a female client for the early

signs and symptoms of dumping syndrome. Which of
the following
HOME
indicate this occurrence?
CARE PLANS and

A. Sweating TOOLS
pallor& APPS BULLETS
B. Bradycardia and indigestion
C. Double vision and chest pain
D. Abdominal
CARE PLANS cramping
TOOLS & and
APPSpain BULLETS
24. The nurse is preparing a discharge teaching plan for

the male client who had umbilical hernia repair. What
should the nurse include in the plan?
A. Irrigating the drain

B. Avoiding coughing
C. Maintaining bed rest
D. Restricting pain medication
25. The nurse is instructing the male client who has an

inguinal hernia repair how to reduce postoperative
swelling following the procedure. What should the nurse
tell the client?
A. Limit oral fluid

B. Elevate the scrotum
C. Apply heat to the abdomen
D. Remain in a low-fiber diet
26. The nurse is caring for a hospitalized female client

with a diagnosis of ulcerative colitis. Which finding, if
noted on assessment of the client, would the nurse
report to the physician?

A. Hypotension
 B. Bloody diarrhea
C. Rebound tenderness
 D. A hemoglobin level of 12 mg/dL
27. The nurse
HOME
is caring for a male client
NURSING NOTES 
postoperatively
following creation of a colostomy. Which nursing
CARE PLANS
diagnosis shouldTOOLS & APPS
the nurse BULLETS
include in the plan of care?

A. Sexual dysfunction
B. Body
CARE PLANSimage,TOOLS
disturbed
& APPS BULLETS
C. Fear related to poor prognosis
D. Nutrition: more than body requirements,
imbalanced
28. The nurse is reviewing the record of a female client

with Crohn’s disease. Which stool characteristics should
the nurse expect to note documented in the client’s
record?
A. Diarrhea
B. Chronic constipation
C. Constipation alternating with diarrhea
D. Stools constantly oozing form the rectum
29. The nurse is performing a colostomy irrigation on a

male client. During the irrigation, the client begins to
complain of abdominal cramps. What is the appropriate
nursing action?
A. Notify the physician

B. Stop the irrigation temporarily
C. Increase the height of the irrigation
D. Medicate for pain and resume the irrigation
30. The nurse is teaching a female client how to perform


a colostomy irrigation. To enhance the effectiveness of
 the irrigation and fecal returns, what measure should the
nurse instruct the client to do?

A. Increase fluid intake
B. PlaceNURSING
HOME
heat on the abdomen PRACTICE EXAMS 
NOTES  MNEMONICS ARTICLES
C. Perform the irrigation in the evening
CARE PLANS the TOOLS
D. Reduce amount&ofAPPS
irrigationBULLETS
solution

31. A patient with chronic alcohol abuse is admitted
with liver
CARE PLANS failure.TOOLS
You closely monitorBULLETS
& APPS the patient’s blood
pressure because of which change that is associated
with the liver failure?
A. Hypoalbuminemia
B. Increased capillary permeability
C. Abnormal peripheral vasodilation
D. Excess rennin release from the kidneys
32. You’re assessing the stoma of a patient with a

healthy, well-healed colostomy. You expect the stoma to
appear:
A. Pale, pink and moist

B. Red and moist
C. Dark or purple colored
D. Dry and black
33. You’re caring for a patient with a sigmoid

colostomy. The stool from this colostomy is:
A. Formed
B. Semisolid
C. Semiliquid
D. Watery

34. You’re advising a 21 y.o. with a colostomy who
 reports problems with flatus. What food should you
recommend?

A. Peas
B. Cabbage
C. Broccoli
CARE PLANS
D. Yogurt TOOLS & APPS BULLETS

35. You have to teach ostomy self care to a patient
with aPLANS
CARE colostomy. You tell
TOOLS the patient
& APPS to measure and
BULLETS
cut the wafer:
A. To the exact size of the stoma.

B. About 1/16” larger than the stoma.
C. About 1/8” larger than the stoma.
D. About 1/4″ larger than the stoma.
36. You’re performing an abdominal assessment on

Brent who is 52 y.o. In which order do you proceed?
A. Observation, percussion, palpation, auscultation

B. Observation, auscultation, percussion, palpation
C. Percussion, palpation, auscultation, observation
D. Palpation, percussion, observation, auscultation
37. You’re doing preoperative teaching with Gertrude

who has ulcerative colitis who needs surgery to create
an ileoanal reservoir. Which information do you include?
A. A reservoir is created that exits through the

abdominal wall.
B. A second surgery is required 12 months after the
first surgery.
C. A permanent ileostomy is created.
D. The surgery occurs in two stages.

 38. You’re caring for Carin who has just had ileostomy
surgery. During the first 24 hours post-op, how much
 drainage can you expect from the ileostomy?
A. 100 ml
B. 500 ml
CARE PLANS
C. 1500 ml TOOLS & APPS BULLETS
D. 5000 ml
39. You’re
CARE PLANS preparing
TOOLSa teaching
& APPSplanBULLETS
for a 27 y.o. named
Jeff who underwent surgery to close a temporary
ileostomy. Which nutritional guideline do you include in
this plan?
A. There is no need to change eating habits.

B. Eat six small meals a day.
C. Eat the largest meal in the evening.
D. Restrict fluid intake.
40. Arthur has a family history of colon cancer and is

scheduled to have a sigmoidoscopy. He is crying as he
tells you, “I know that I have colon cancer, too.” Which
response is most therapeutic?
A. “I know just how you feel.”

B. “You seem upset.”
C. “Oh, don’t worry about it, everything will be just fine.”
D. “Why do you think you have cancer?”
41. You’re caring for Beth who underwent a Billroth II

procedure (surgical removal of the pylorus and
duodenum) for treatment of a peptic ulcer. Which
findings suggest that the patient is developing dumping
syndrome, a complication associated with this
procedure?

 A. Flushed, dry skin.

B. Headache and bradycardia.
 C. Dizziness and sweating.
D. Dyspnea and chest pain.
42. You’re
HOME
developing the plan of care
NURSING NOTES 
for a patient
experiencing dumping syndrome after a Billroth II
CARE PLANSWhich
procedure. TOOLS
dietary& instructions
APPS BULLETS
do you include?

A. Omit fluids with meals.
B. Increase
CARE PLANS carbohydrate
TOOLS & APPSintake. BULLETS
C. Decrease protein intake.
D. Decrease fat intake.
43. You’re caring for Lewis, a 67 y.o. patient with liver

cirrhosis who develops ascites and requires
paracentesis. Relief of which symptom indicated that
the paracentesis was effective?
A. Pruritus
B. Dyspnea
C. Jaundice
D. Peripheral Neuropathy
44. You’re caring for Jane, a 57 y.o. patient with liver

cirrhosis who develops ascites and requires
paracentesis. Before her paracentesis, you instruct her
to:
A. Empty her bladder.

B. Lie supine in bed.
C. Remain NPO for 4 hours.
D. Clean her bowels with an enema.
45. After abdominal surgery, your patient has a severe

coughing episode that causes wound evisceration. In

addition to calling the doctor, which intervention is most
 appropriate?
 A. Irrigate the wound & organs with Betadine.

B. CoverNURSING
HOME
the wound with a saline PRACTICE
NOTES 
soaked sterile
EXAMS  MNEMONICS ARTICLES
dressing.
CARE PLANS
C. Apply TOOLSdressing
a dry sterile & APPS & binder.
BULLETS
D. Push the organs back & cover with moist sterile
dressings.
46. You’re caring for Betty with liver cirrhosis. Which of
the following assessment findings leads you to suspect
hepatic encephalopathy in her?
A. Asterixis
B. Chvostek’s sign
C. Trousseau’s sign
D. Hepatojugular reflex
47. You are developing a careplan on Sally, a 67 y.o.

patient with hepatic encephalopathy. Which of the
following do you include?
A. Administering a lactulose enema as ordered.

B. Encouraging a protein-rich diet.
C. Administering sedatives, as necessary.
D. Encouraging ambulation at least four times a day.
48. You have a patient with achalasia (incomplete

muscle relaxtion of the GI tract, especially sphincter
muscles). Which medications do you anticipate to
administer?
A. Isosorbide dinitrate (Isordil)

B. Digoxin (Lanoxin)

C. Captopril (Capoten)
 D. Propanolol (Inderal)
 49. The student nurse is preparing a teaching care plan

to help improve nutrition in a patient with achalasia. You
include which
HOME
of the following:
CARE PLANS foods

A. Swallow TOOLS
while& leaning
APPS forward.
BULLETS
B. Omit fluids at mealtimes.
C. Eat meals sitting upright.
D. Avoid
CARE PLANS soft and semisoft
TOOLS foods. BULLETS
& APPS
50. Britney, a 20 y.o. student is admitted with acute

pancreatitis. Which laboratory findings do you expect to
be abnormal for this patient?
A. Serum creatinine and BUN

B. Alanine aminotransferase (ALT) and aspartate
aminotransferase (AST)
C. Serum amylase and lipase
D. Cardiac enzymes
51. A patient with Crohn’s disease is admitted after 4

days of diarrhea. Which of the following urine specific
gravity values do you expect to find in this patient?
A. 1.005
B. 1.011
C. 1.020
D. 1.030
52. Your goal is to minimize David’s risk of

complications after a heriorrhaphy. You instruct the
patient to:
A. Avoid the use of pain medication.


B. Cough and deep breathe Q2H.
 C. Splint the incision if he can’t avoid sneezing or
coughing.
 D. Apply heat to scrotal swelling.
53. Janice
HOME
is waiting for dischargePRACTICE
NURSING NOTES 
instructions after her
herniorrhaphy. Which of the following instructions do
CARE PLANS
you include? TOOLS & APPS BULLETS

A. Eat a low-fiber diet.
B. Resume
CARE PLANS heavy lifting
TOOLS & in 2 weeks.
APPS BULLETS
C. Lose weight, if obese.
D. Resume sexual activity once discomfort is gone.
54. Develop a teaching care plan for Angie who is about

to undergo a liver biopsy. Which of the following points
do you include?
A. “You’ll need to lie on your stomach during the test.”

B. “You’ll need to lie on your right side after the test.”
C. “During the biopsy you’ll be asked to exhale deeply
and hold it.”
D. “The biopsy is performed under general anesthesia.”
55. Stephen is a 62 y.o. patient that has had a liver

biopsy. Which of the following groups of signs alert you
to a possible pneumothorax?
A. Dyspnea and reduced or absent breath sounds over

the right lung
B. Tachycardia, hypotension, and cool, clammy skin
C. Fever, rebound tenderness, and abdominal rigidity
D. Redness, warmth, and drainage at the biopsy site
56. Michael, a 42 y.o. man is admitted to the med-surg

floor with a diagnosis of acute pancreatitis. His BP is

136/76, pulse 96, Resps 22 and temp 101. His past
 history includes hyperlipidemia and alcohol abuse. The
doctor prescribes an NG tube. Before inserting the tube,
 you explain the purpose to patient. Which of the
following is a most accurate explanation?
A. “It empties
HOME
the stomach of fluids
NURSING NOTES 
and gas.”
B. “It prevents spasms at the sphincter of Oddi.”
CARE PLANS
C. “It TOOLS
prevents air from&forming
APPS in the
BULLETS
small intestine
and large intestine.”
D. “It removes bile from the gallbladder.”
57. Jason, a 22 y.o. accident victim, requires an NG tube
for feeding. What should you immediately do after
inserting an NG tube for liquid enteral feedings?
A. Aspirate for gastric secretions with a syringe.

B. Begin feeding slowly to prevent cramping.
C. Get an X-ray of the tip of the tube within 24 hours.
D. Clamp off the tube until the feedings begin.
58. Stephanie, a 28 y.o. accident victim, requires TPN.

The rationale for TPN is to provide:
A. Necessary fluids and electrolytes to the body.

B. Complete nutrition by the I.V. route.
C. Tube feedings for nutritional supplementation.
D. Dietary supplementation with liquid protein given
between meals.
59. Type A chronic gastritis can be distinquished from

type B by its ability to:
A. Cause atrophy of the parietal cells.

B. Affect only the antrum of the stomach.
C. Thin the lining of the stomach walls.
D. Decrease gastric secretions.

 60. Matt is a 49 y.o. with a hiatal hernia that you are

about to counsel. Health care counseling for Matt
 should include which of the following instructions?
A. Restrict
HOME
intake of high-carbohydrate
NURSING NOTES 
foods.
B. Increase fluid intake with meals.
CARE PLANS fatTOOLS
C. Increase intake. & APPS BULLETS
D. Eat three regular meals a day.
61. Jerod
CARE PLANSis experiencing an acute episode
TOOLS & APPS BULLETS of ulcerative
colitis. Which is priority for this patient?
A. Replace lost fluid and sodium.

B. Monitor for increased serum glucose level from
steroid therapy.
C. Restrict the dietary intake of foods high in
potassium.
D. Note any change in the color and consistency of
stools.
62. A 29 y.o. patient has an acute episode of ulcerative

colitis. What diagnostic test confirms this diagnosis?
A. Barium Swallow.
B. Stool examination.
C. Gastric analysis.
D. Sigmoidoscopy.
63. Eleanor, a 62 y.o. woman with diverticulosis is your

patient. Which interventions would you expect to include
in her care?
A. Low-fiber diet and fluid restrictions.

B. Total parenteral nutrition and bed rest.
C. High-fiber diet and administration of psyllium.

D. Administration of analgesics and antacids.

64. Regina is a 46 y.o. woman with ulcerative colitis.
 You expect her stools to look like:
A. Watery
HOME
and frothy.
B. Bloody and mucoid.
CARE PLANS
C. Firm TOOLS & APPS
and well-formed. BULLETS
D. Alternating constipation and diarrhea.
65. Donald
CARE PLANSis a 61 y.o. man
TOOLS with diverticulitis.
& APPS BULLETS
Diverticulitis is characterized by:
A. Periodic rectal hemorrhage.

B. Hypertension and tachycardia.
C. Vomiting and elevated temperature.
D. Crampy and lower left quadrant pain and low-grade
fever.
66. Brenda, a 36 y.o. patient is on your floor with acute

pancreatitis. Treatment for her includes:
A. Continuous peritoneal lavage.

B. Regular diet with increased fat.
C. Nutritional support with TPN.
D. Insertion of a T tube to drain the pancreas.
67. Glenda has cholelithiasis (gallstones). You expect

her to complain of:
A. Pain in the right upper quadrant, radiating to the

shoulder.
B. Pain in the right lower quadrant, with rebound
tenderness.
C. Pain in the left upper quadrant, with shortness of
breath.

D. Pain in the left lower quadrant, with mild cramping.

68. After an abdominal resection for colon cancer,
 Madeline returns to her room with a Jackson-Pratt drain
in place. The purpose of the drain is to:
A. Irrigate
HOME
the incision with a saline
NURSING NOTES 
solution.
B. Prevent bacterial infection of the incision.
CARE PLANS theTOOLS
C. Measure amount & of
APPS BULLETS
fluid lost after surgery.
D. Prevent accumulation of drainage in the wound.
69. Anthony,
CARE PLANS a 60 y.o. patient,
TOOLS & APPS has just undergone a
BULLETS
bowel resection with a colostomy. During the first 24
hours, which of the following observations about the
stoma should you report to the doctor?
A. Pink color.
B. Light edema.
C. Small amount of oozing.
D. Trickles of bright red blood.
70. Your teaching Anthony how to use his new

colostomy. How much skin should remain exposed
between the stoma and the ring of the appliance?
A. 1/16”
B. 1/4″
C. 1/2”
D. 1”
71. Claire, a 33 y.o. is on your floor with a possible

bowel obstruction. Which intervention is priority for her?
A. Obtain daily weights.

B. Measure abdominal girth.
C. Keep strict intake and output.
D. Encourage her to increase fluids.

 72. Your patient has a GI tract that is functioning, but

has the inability to swallow foods. Which is the preferred
 method of feeding for your patient?
A. TPN NURSING NOTES
HOME PRACTICE EXAMS  MNEMONICS ARTICLES

B. PPN
CARE PLANS
C. NG feeding TOOLS & APPS BULLETS
D. Oral liquid supplements
73. You’re
CARE PLANS patient is complaining
TOOLS & APPS ofBULLETS
abdominal pain
during assessment. What is your priority?
A. Auscultate to determine changes in bowel sounds.

B. Observe the contour of the abdomen.
C. Palpate the abdomen for a mass.
D. Percuss the abdomen to determine if fluid is
present.
74. Before bowel surgery, Lee is to administer enemas

until clear. During administration, he complains of
intestinal cramps. What do you do next?
A. Discontinue the procedure.

B. Lower the height of the enema container.
C. Complete the procedure as quickly as possible.
D. Continue administration of the enema as ordered
without making any adjustments.
75. Leigh Ann is receiving pancrelipase (Viokase) for

chronic pancreatitis. Which observation best indicates
the treatment is effective?
A. There is no skin breakdown.

B. Her appetite improves.
C. She loses more than 10 lbs.

D. Stools are less fatty and decreased in frequency.

76. Ralph has a history of alcohol abuse and has acute
 pancreatitis. Which lab value is most likely to be
elevated?
A. Calcium
B. Glucose
CARE PLANS
C. Magnesium TOOLS & APPS BULLETS
D. Potassium
77. Anna
CARE is 45 y.o.
PLANS and has
TOOLS a bleeding
& APPS ulcer. Despite
BULLETS
multiple blood transfusions, her HGB is 7.5g/dl and HCT
is 27%. Her doctor determines that surgical intervention
is necessary and she undergoes partial gastrectomy.
Postoperative nursing care includes:
A. Giving pain medication Q6H.

B. Flushing the NG tube with sterile water.
C. Positioning her in high Fowler’s position.
D. Keeping her NPO until the return of peristalsis.
78. Sitty, a 66 y.o. patient underwent a colostomy for

ruptured diverticulum. She did well during the surgery
and returned to your med-surg floor in stable condition.
You assess her colostomy 2 days after surgery. Which
finding do you report to the doctor?
A. Blanched stoma
B. Edematous stoma
C. Reddish-pink stoma
D. Brownish-black stoma
79. Sharon has cirrhosis of the liver and develops

ascites. What intervention is necessary to decrease the
excessive accumulation of serous fluid in her peritoneal
cavity?

 A. Restrict fluids
B. Encourage ambulation
 C. Increase sodium in the diet
D. Give antacids as prescribed
80. Katrina
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is diagnosed with lactose
NURSING NOTES 
intolerance. To
avoid complications with lack of calcium in the diet,
CARE
whichPLANS
food shouldTOOLS & APPSin theBULLETS
be included diet?

A. Fruit
B. Whole
CARE PLANSgrainsTOOLS & APPS BULLETS
C. Milk and cheese products
D. Dark green, leafy vegetables
81. Nathaniel has severe pruritus due to having

hepatitis B. What is the best intervention for his
comfort?
A. Give tepid baths.

B. Avoid lotions and creams.
C. Use hot water to increase vasodilation.
D. Use cold water to decrease the itching.
82. Rob is a 46 y.o. admitted to the hospital with a

suspected diagnosis of Hepatitis B. He’s jaundiced and
reports weakness. Which intervention will you include in
his care?
A. Regular exercise.
B. A low-protein diet.
C. Allow patient to select his meals.
D. Rest period after small, frequent meals.
83. You’re discharging Nathaniel with hepatitis B. Which

statement suggests understanding by the patient?

A. “Now I can never get hepatitis again.”
 B. “I can safely give blood after 3 months.”
C. “I’ll never have a problem with my liver again, even if
 I drink alcohol.”
D. “My family
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knows that if I get tired
NURSING NOTES 
and start
vomiting, I may be getting sick again.”
84. Gail is scheduled for a cholecystectomy. After
completion of preoperative teaching, Gail states,”If I lie
still and
CARE avoid turning
PLANS TOOLS after the operation,
& APPS BULLETSI’ll avoid pain.
Do you think this is a good idea?” What is the best
response?
A. “You’ll need to turn from side to side every 2 hours.”

B. “It’s always a good idea to rest quietly after surgery.”
C. “The doctor will probably order you to lie flat for 24
hours.”
D. “Why don’t you decide about activity after you return
from the recovery room?”
85. You’re caring for a 28 y.o. woman with hepatitis B.

She’s concerned about the duration of her recovery.
Which response isn’t appropriate?
A. Encourage her to not worry about the future.

B. Encourage her to express her feelings about the
illness.
C. Discuss the effects of hepatitis B on future health
problems.
D. Provide avenues for financial counseling if she
expresses the need.
86. Elmer is scheduled for a proctoscopy and has an I.V.

The doctor wrote an order for 5mg of I.V.
diazepam(Valium). Which order is correct regarding

diazepam?

A. Give diazepam in the I.V. port closest to the vein.
 B. Mix diazepam with 50 ml of dextrose 5% in water
and give over 15 minutes.
C. Give NURSING
HOME
diazepam NOTES
rapidly I.V.
 to prevent the
bloodstream from diluting the drug mixture.
CARE PLANS theTOOLS
D. Question & APPS I.V. BULLETS
order because administration of
diazepam is contraindicated.
87. Annebell
CARE PLANS is being
TOOLS discharged
& APPS with a colostomy, and
BULLETS
you’re teaching her about colostomy care. Which
statement correctly describes a healthy stoma?
A. “At first, the stoma may bleed slightly when

touched.”
B. “The stoma should appear dark and have a bluish
hue.”
C. “A burning sensation under the stoma faceplate is
normal.”
D. “The stoma should remain swollen away from the
abdomen.”
88. A patient who underwent abdominal surgery now

has a gaping incision due to delayed wound healing.
Which method is correct when you irrigate a gaping
abdominal incision with sterile normal saline solution,
using a piston syringe?
A. Rapidly instill a stream of irrigating solution into the

wound.
B. Apply a wet-to-dry dressing to the wound after the
irrigation.
C. Moisten the area around the wound with normal
saline solution after the irrigation.
D. Irrigate continuously until the solution becomes

clear or all of the solution is used.

89. Hepatic encephalopathy develops when the blood
 level of which substance increases?
A. Ammonia
B. Amylase
CARE PLANS
C. Calcium TOOLS & APPS BULLETS
D. Potassium
90. Your
CARE patientTOOLS
PLANS recently& had
APPSabdominal surgery and
BULLETS
tells you that he feels a popping sensation in his incision
during a coughing spell, followed by severe pain. You
anticipate an evisceration. Which supplies should you
take to his room?
A. A suture kit.
B. Sterile water and a suture kit.
C. Sterile water and sterile dressings.
D. Sterile saline solution and sterile dressings.
91. Findings during an endoscopic exam include a

cobblestone appearance of the colon in your patient.
The findings are characteristic of which disorder?
A. Ulcer
B. Crohn’s disease
C. Chronic gastritis
D. Ulcerative colitis
92. What information is correct about stomach cancer?
A. Stomach pain is often a late symptom.

B. Surgery is often a successful treatment.
C. Chemotherapy and radiation are often successful
treatments.

D. The patient can survive for an extended time with
 TPN.
 93. Dark, tarry stools indicate bleeding in which location

of the GI tract?
A. Upper
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colon.
B. Lower colon.
CARE PLANS
C. Upper TOOLS & APPS
GI tract. BULLETS
D. Small intestine.
94. APLANS
CARE patient has an acute
TOOLS upper GIBULLETS
& APPS hemorrhage. Your
interventions include:
A. Treating hypovolemia.
B. Treating hypervolemia.
C. Controlling the bleeding source.
D. Treating shock and diagnosing the bleeding source.
95. You promote hemodynamic stability in a patient

with upper GI bleeding by:
A. Encouraging oral fluid intake.

B. Monitoring central venous pressure.
C. Monitoring laboratory test results and vital signs.
D. Giving blood, electrolyte and fluid replacement.
96. You’re preparing a patient with a malignant tumor

for colorectal surgery and subsequent colostomy. The
patient tells you he’s anxious. What should your initial
step be in working with this patient?
A. Determine what the patient already knows about

colostomies.
B. Show the patient some pictures of colostomies.
C. Arrange for someone who has a colostomy to visit
the patient.

D. Provide the patient with written material about
 colostomy care.
 97. Your patient, Christopher, has a diagnosis of

ulcerative colitis and has severe abdominal pain
aggravated
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by movement, reboundPRACTICE
NURSING NOTES 
tenderness, fever,
nausea, and decreased urine output. This may indicate
CARE
whichPLANS TOOLS & APPS
complication? BULLETS

A. Fistula.
B. Bowel
CARE PLANS perforation.
TOOLS & APPS BULLETS
C. Bowel obstruction.
D. Abscess.
98. A patient has a severe exacerbation of ulcerative

colitis. Long-term medications will probably include:
A. Antacids.
B. Antibiotics.
C. Corticosteroids.
D. Histamine2-receptor blockers.
99. The student nurse is teaching the family of a patient

with liver failure. You instruct them to limit which foods
in the patient’s diet?
A. Meats and beans.

B. Butter and gravies.
C. Potatoes and pastas.
D. Cakes and pastries.
100. An intubated patient is receiving continuous

enteral feedings through a Salem sump tube at a rate of
60ml/hr. Gastric residuals have been 30-40ml when
monitored Q4H. You check the gastric residual and
aspirate 220ml. What is your first response to this

finding?

A. Notify the doctor immediately.
 B. Stop the feeding, and clamp the NG tube.
C. Discard the 220ml, and clamp the NG tube.
D. Give NURSING
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a prescribed GI stimulant PRACTICE
NOTES 
such as EXAMS  MNEMONICS ARTICLES
metoclopramide (Reglan).
Answers and Rationales

1. Answer
CARE PLANS C. The normal
TOOLS serum amylase
& APPS BULLETSlevel is 25 to
151 units/L. With chronic cases of pancreatitis, the
rise in serum amylase levels usually does not
exceed three times the normal value. In acute
pancreatitis, the value may exceed five times the
normal value. Options A and B are within normal
limits. Option D is an extremely elevated level seen
in acute pancreatitis.
2. Answer C. Full liquid food items include items such
as plain ice cream, sherbet, breakfast drinks, milk,
pudding and custard, soups that are strained, and
strained vegetable juices. A clear liquid diet consists
of foods that are relatively transparent. The food
items in options A, B, and D are clear liquids.
3. Answer A. The client with cirrhosis needs to
consume foods high in thiamine. Thiamine is
present in a variety of foods of plant and animal
origin. Pork products are especially rich in this
vitamin. Other good food sources include nuts,
whole grain cereals, and legumes. Milk contains
vitamins A, D, and B2. Poultry contains niacin.
Broccoli contains vitamins C, E, and K and folic acid
4. Answer A. Unless specifically indicated, residual
amounts more than 100 mL require holding the
feeding. Therefore options B, C, and D are incorrect.
Additionally, the feeding is not discarded unless its

contents are abnormal in color or characteristics.
 5. Answer D. During the insertion of a nasogastric
tube, if the client experiences difficulty breathing or
 any respiratory distress, withdraw the tube slightly,
stop the tube advancement, and wait until the
HOME
distress subsides. Options B and
NURSING NOTES 
C are
unnecessary. Quickly inserting the tube is not an
CAREappropriate
PLANS TOOLS & APPS in this
action because, BULLETS
situation, it may
be likely that the tube has entered the bronchus.
6. Answer A. If the nasogastric tube is in the stomach,
CAREthe pH of the
PLANS contents
TOOLS will be acidic.
& APPS BULLETSGastric
aspirates have acidic pH values and should be 3.5
or lower. Option B indicates a slightly acidic pH.
Option C indicates a neutral pH. Option D indicates
an alkaline pH.
7. Answer C. When the nurse removes a nasogastric
tube, the client is instructed to take and hold a deep
breath. This will close the epiglottis. This allows for
easy withdrawal through the esophagus into the
nose. The nurse removes the tube with one smooth,
continuous pull.
8. Answer C. If a client has a nasogastric tube
connected to suction, the nurse should wait up to
30 minutes before reconnecting the tube to the
suction apparatus to allow adequate time for
medication absorption. Aspirating the nasogastric
tube will remove the medication just administered.
Low intermittent suction also will remove the
medication just administered. The client should not
be placed in the supine position because of the risk
for aspiration.
9. Answer D. When the client has a Sengstaken-
Blakemore tube, a pair of scissors must be kept at
the client’s bedside at all times. The client needs to
be observed for sudden respiratory distress, which
occurs if the gastric balloon ruptures and the entire

tube moves upward. If this occurs, the nurse
 immediately cuts all balloon lumens and removes
the tube. An obturator and a Kelly clamp are kept at
 the bedside of a client with a tracheostomy. An
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irrigation set may be kept at the
NURSING NOTES 
bedside, but it is
not the priority item.
CARE PLANS A. Hepatitis
10. Answer TOOLS &AAPPS BULLETS
is transmitted by the fecal-
oral route via contaminated food or infected food
handlers. Hepatitis B, C, and D are transmitted most
CAREcommonly
PLANS via infected
TOOLS blood orBULLETS
& APPS body fluids.
11. Answer B. Laboratory indicators of hepatitis include
elevated liver enzyme levels, elevated serum
bilirubin levels, elevated erythrocyte sedimentation
rates, and leukopenia. An elevated blood urea
nitrogen level may indicate renal dysfunction. A
hemoglobin level is unrelated to this diagnosis.
12. Answer C. Meperidine (Demerol) rather than
morphine sulfate is the medication of choice to
treat pain because morphine sulfate can cause
spasms in the sphincter of Oddi. Options A, B, and D
are appropriate interventions for the client with
acute pancreatitis.
13. Answer A. A barium swallow is an x-ray study that
uses a substance called barium for contrast to
highlight abnormalities in the gastrointestinal tract.
The client should fast for 8 to 12 hours before the
test, depending on physician instructions. Most oral
medications also are withheld before the test. After
the procedure, the nurse must monitor for
constipation, which can occur as a result of the
presence of barium in the gastrointestinal tract.
14. Answer C. The appropriate sequence for abdominal
examination is inspection, auscultation, percussion,
and palpation. Auscultation is performed after
inspection to ensure that the motility of the bowel

and bowel sounds are not altered by percussion or
 palpation. Therefore, after inspecting the skin on the
abdomen, the nurse should listen for bowel sounds.
 15. Answer D. The solution GoLYTELY is a bowel
evacuant used to prepare a client for a colonoscopy
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by cleansing the bowel. The solution
NURSING NOTES 
is expected to
cause a mild diarrhea and will clear the bowel in 4
CAREtoPLANS TOOLS &
5 hours. Options A,APPS BULLETS
B, and C are inappropriate
actions.
16. Answer B. Chronic gastritis causes deterioration
CAREand atrophyTOOLS
PLANS of the lining
& APPSof the stomach,
BULLETS leading to
the loss of the function of the parietal cells. The
source of the intrinsic factor is lost, which results in
the inability to absorb vitamin B12. This leads to the
development of pernicious anemia. The client is not
at risk for vitamin A, C, or E deficiency.
17. Answer C. Indomethacin (Indocin) is a nonsteroidal
anti-inflammatory drug and can cause ulceration of
the esophagus, stomach, or small intestine.
Indomethacin is contraindicated in a client with
gastrointestinal disorders. Furosemide (Lasix) is a
loop diuretic. Digoxin is a cardiac medication.
Propranolol (Inderal) is a β-adrenergic blocker.
Furosemide, digoxin, and propranolol are not
contraindicated in clients with gastric disorders.
18. Answer D. Following cholecystectomy, drainage
from the T tube is initially bloody and then turns to a
greenish-brown color. The drainage is measured as
output. The amount of expected drainage will range
from 500 to 1000 mL/day. The nurse would
document the output.
19. Answer D. Perforation of an ulcer is a surgical
emergency and is characterized by sudden, sharp,
intolerable severe pain beginning in the
midepigastric area and spreading over the
abdomen, which becomes rigid and board-like.

Nausea and vomiting may occur. Tachycardia may
 occur as hypovolemic shock develops. Numbness
in the legs is not an associated finding.
 20. Answer C. A vagotomy, or cutting of the vagus
nerve, is done to eliminate parasympathetic
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stimulation of gastric secretion.
NURSING NOTES 
Options A, B, and D
are incorrect descriptions of a vagotomy.
CARE PLANS C. In
21. Answer TOOLS & APPS
a Billroth BULLETS
II procedure, the proximal
remnant of the stomach is anastomosed to the
proximal jejunum. Patency of the nasogastric tube
CAREis critical forTOOLS
PLANS preventing
& APPSthe retention of gastric
BULLETS
secretions. The nurse should never irrigate or
reposition the gastric tube after gastric surgery,
unless specifically ordered by the physician. In this
situation, the nurse should clarify the order. Options
A, B, and D are appropriate postoperative
interventions.
22. Answer C. Dumping syndrome is a term that refers
to a constellation of vasomotor symptoms that
occurs after eating, especially following a Billroth II
procedure. Early manifestations usually occur
within 30 minutes of eating and include vertigo,
tachycardia, syncope, sweating, pallor, palpitations,
and the desire to lie down. The nurse should
instruct the client to decrease the amount of fluid
taken at meals and to avoid high-carbohydrate
foods, including fluids such as fruit nectars; to
assume a low-Fowler’s position during meals; to lie
down for 30 minutes after eating to delay gastric
emptying; and to take antispasmodics as
prescribed.
23. Answer A. Early manifestations of dumping
syndrome occur 5 to 30 minutes after eating.
Symptoms include vertigo, tachycardia, syncope,
sweating, pallor, palpitations, and the desire to lie
down.

24. Answer B. Coughing is avoided following umbilical
 hernia repair to prevent disruption of tissue integrity,
which can occur because of the location of this
 surgical procedure. Bed rest is not required
following this surgical procedure. The client should
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take analgesics as needed andPRACTICE
NURSING NOTES 
as prescribed to
control pain. A drain is not used in this surgical
CAREprocedure,
PLANS TOOLS &the
although APPS BULLETS
client may be instructed in
simple dressing changes.
25. Answer B. Following inguinal hernia repair, the client
CAREshould
PLANSbe instructed
TOOLS & to elevate BULLETS
APPS the scrotum and
apply ice packs while in bed to decrease pain and
swelling. The nurse also should instruct the client to
apply a scrotal support when out of bed. Heat will
increase swelling. Limiting oral fluids and a low-fiber
diet can cause constipation.
26. Answer C. Rebound tenderness may indicate
peritonitis. Bloody diarrhea is expected to occur in
ulcerative colitis. Because of the blood loss, the
client may be hypotensive and the hemoglobin level
may be lower than normal. Signs of peritonitis must
be reported to the physician.
27. Answer B. Body image, disturbed relates to loss of
bowel control, the presence of a stoma, the release
of fecal material onto the abdomen, the passage of
flatus, odor, and the need for an appliance (external
pouch). No data in the question support options A
and C. Nutrition: less than body requirements,
imbalanced is the more likely nursing diagnosis.
28. Answer A. Crohn’s disease is characterized by
nonbloody diarrhea of usually not more than four to
five stools daily. Over time, the diarrhea episodes
increase in frequency, duration, and severity.
Options B, C, and D are not characteristics of
Crohn’s disease.
29. Answer B. If cramping occurs during a colostomy

irrigation, the irrigation flow is stopped temporarily
 and the client is allowed to rest. Cramping may
occur from an infusion that is too rapid or is
 causing too much pressure. The physician does not
need to be notified. Increasing the height of the
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irrigation will cause further discomfort.
NURSING NOTES 
Medicating
the client for pain is not the appropriate action in
CAREthis
PLANS
situation.TOOLS & APPS BULLETS
30. Answer A. To enhance effectiveness of the
irrigation and fecal returns, the client is instructed to
CAREincrease
PLANS fluid intake&and
TOOLS to takeBULLETS
APPS other measures to
prevent constipation. Options B, C and D will not
enhance the effectiveness of this procedure.
31. Answer A. Blood pressure decreases as the body is
unable to maintain normal oncotic pressure with
liver failure, so patients with liver failure require
close blood pressure monitoring. Increased
capillary permeability, abnormal peripheral
vasodilation, and excess rennin released from the
kidney’s aren’t direct ramifications of liver failure.
32. Answer B. Good circulation causes tissues to be
moist and red, so a healthy, well-healed stoma
appears red and moist.
33. Answer A. A colostomy in the sigmoid colon
produces a solid, formed stool.
34. Answer D. High-fiber foods stimulate peristalsis,
and a result, flatus. Yogurt reduces gas formation.
35. Answer B. A proper fit protects the skin, but doesn’t
impair circulation. A 1/16” should be cut.
36. Answer B. Observation, auscultation, percussion,
palpation
37. Answer D. An ileoanal reservoir is created in two
stages. The two surgeries are about 2 to 3 months
apart. First, diseased intestines are removed and a
temporary loop ileostomy is created. Second, the
loop ileostomy is closed and stool goes to the

reservoir and out through the anus.
 38. Answer C. The large intestine absorbs large
amounts of water so the initial output from the
 ileostomy may be as much as 1500 to 2000 ml/24
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hours. Gradually, the small intestine
NURSING NOTES 
absorbs more
fluid and the output decreases.
CARE PLANS To
39. Answer B. TOOLS
avoid &overloading
APPS BULLETS
the small intestine,
encourage the patient to eat six small, regularly
spaced meals.
40. Answer B.
CARE PLANS MakingTOOLSobservations
& APPS about what you see
BULLETS
or hear is a useful therapeutic technique. This way,
you acknowledge that you are interested in what the
patient is saying and feeling.
41. Answer C. After a Billroth II procedure, a large
amount of hypertonic fluid enters the intestine. This
causes extracellular fluid to move rapidly into the
bowel, reducing circulating blood volume and
producing vasomotor symptoms. Vasomotor
symptoms produced by dumping syndrome include
dizziness and sweating, tachycardia, syncope,
pallor, and palpitations.
42. Answer A. Gastric emptying time can be delayed by
omitting fluids from your patient’s meal. A diet low
in carbs and high in fat & protein is recommended
to treat dumping syndrome.
43. Answer B. Ascites puts pressure on the diaphragm.
Paracentesis is done to remove fluid and reducing
pressure on the diaphragm. The goal is to improve
the patient’s breathing. The others are signs of
cirrhosis that aren’t relieved by paracentesis.
44. Answer A. A full bladder can interfere with
paracentesis and be punctured inadvertently.
45. Answer B. Cover the organs with a sterile,
nonadherent dressing moistened with normal
saline. Do this to prevent infection and to keep the

organs from drying out.
 46. Answer A. Asterixis is an early neurologic sign of
hepatic encephalopathy elicited by asking the
 patient to hold her arms stretched out. Asterixis is
present if the hands rapidly extend and flex.
47. Answer A.
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You may administerPRACTICE
NURSING NOTES 
the laxative
lactulose to reduce ammonia levels in the colon.
CARE PLANS Achalasia
48. Answer A. TOOLS & isAPPS BULLETS
characterized by incomplete
relaxation of the LES, dilation of the lower
esophagus, and a lack of esophageal peristalsis.
CAREBecause
PLANS nitrates
TOOLSrelax the lowerBULLETS
& APPS esophageal
sphincter, expect to give Isordil orally or
sublingually.
49. Answer C. Eating in the upright position aids in
emptying the esophagus. Doing the opposite of the
other three also may be helpful.
50. Answer C. Pancreatitis involves activation of
pancreatic enzymes, such as amylase and lipase.
These levels are elevated in a patient with acute
pancreatitis.
51. Answer D. The normal range of specific gravity of
urine is 1.010 to 1.025; a value of 1.030 may be
seen with dehydration.
52. Answer C. Teach the pt to avoid activities that
increase intra-abdominal pressure such as
coughing, sneezing, or straining with a bowel
movement.
53. Answer C. Because obesity weakens the abdominal
muscles, advise weight loss for the patient who has
had a hernia repair.
54. Answer B. After a liver biopsy, the patient is placed
on the right side to compress the liver and to reduce
the risk of bleeding or bile leakage.
55. Answer A. Signs and Symptoms of pneumothorax
include dyspnea and decreased or absent breath
sounds over the affected lung (right lung).

56. Answer A. An NG tube is inserted into the patients
 stomach to drain fluid and gas.
57. Answer A. Aspirating the stomach contents
 confirms correct placement. If an X-ray is ordered, it
should be done immediately, not in 24 hours.
58. Answer B.
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TPN is given I.V. to provide
NURSING NOTES 
all the
nutrients your patient needs. TPN isn’t a tube
CAREfeeding
PLANS nor TOOLS & APPS
is it a liquid BULLETS
dietary supplement.
59. Answer A. Type A causes changes in parietal cells.
60. Answer B. Increasing fluids helps empty the
CAREstomach.
PLANS A TOOLS
high carb diet isn’t restricted
& APPS BULLETS and fat
intake shouldn’t be increased.
61. Answer A. Diarrhea d/t an acute episode of
ulcerative colitis leads to fluid & electrolyte losses
so fluid replacement takes priority.
62. Answer D. Sigmoidoscopy allows direct observation
of the colon mucosa for changes, and if needed,
biopsy.
63. Answer C. She needs a high-fiber diet and a
psyllium (bulk laxative) to promote normal soft
stools.
64. Answer B. Stools from ulcerative colitis are often
bloody and contain mucus.
65. Answer D. One sign of acute diverticulitis is crampy
lower left quadrant pain. A low-grade fever is
another common sign.
66. Answer C. With acute pancreatitis, you need to rest
the GI tract by TPN as nutritional support.
67. Answer A. The gallbladder is located in the RUQ and
a frequent sign of gallstones is pain radiating to the
shoulder.
68. Answer D. A Jackson-Pratt drain promotes wound
healing by allowing fluid to escape from the wound.
69. Answer D. After creation of a colostomy, expect to
see a stoma that is pink, slightly edematous, with
some oozing. Bright red blood, regardless of

amount, indicates bleeding and should be reported
 to the doctor.
70. Answer A. Only a small amount of skin should be
 exposed and more than 1/16” of skin allows the
excretement to irritate the skin.
71. Answer B.
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Measuring abdominal
NURSING NOTES 
girth provides
quantitative information about increases or
CAREdecreases
PLANS inTOOLS & APPS
the amount BULLETS
of distention.
72. Answer C. Because the GI tract is functioning,
feeding methods involve the enteral route which
CAREbypasses
PLANS the mouth&but
TOOLS allowsBULLETS
APPS for a major portion
of the GI tract to be used.
73. Answer B. The first step in assessing the abdomen
is to observe its shape and contour, then auscultate,
palpate, and then percuss.
74. Answer B. Lowering the height decreases the
amount of flow, allowing him to tolerate more fluid.
75. Answer D. Pancrelipase provides the exocrine
pancreatic enzyme necessary for proper protein, fat,
and carb digestion. With increased fat digestion and
absorption, stools become less frequent and
normal in appearance.
76. Answer B. Glucose level increases and diabetes
mellitus may result d/t the pancreatic damage to
the islets of langerhans.
77. Answer D. After surgery, she remains NPO until
peristaltic activity returns. This decreases the risk
for abdominal distention and obstruction.
78. Answer D. A brownish-black color indicates lack of
blood flow, and maybe necrosis.
79. Answer A. Restricting fluids decrease the amount
of body fluid and the accumulation of fluid in the
peritoneal space.
80. Answer D. Dark green, leafy vegetables are rich in
calcium.
81. Answer A. For pruritus, care should include tepid

sponge baths and use of emollient creams and
 lotions.
82. Answer D. Rest periods and small frequent meals is
 indicated during the acute phase of hepatitis B.
83. Answer D.
HOME
Hepatitis B can recur.
NURSING NOTES 
Patients who have
had hepatitis are permanently barred from donating
CAREblood.
PLANS TOOLS
Alcohol & APPS by
is metabolized BULLETS
the liver and
should be avoided by those who have or had
hepatitis B.
84. Answer A.
CARE PLANS To prevent
TOOLS venous stasis
& APPS and improve
BULLETS
muscle tone, circulation, and respiratory function,
encourage her to move after surgery.
85. Answer A. Telling her not to worry minimizes her
feelings.
86. Answer A. Diazepam is absorbed by the plastic I.V.
tubing and should be given in the port closest to the
vein.
87. Answer A. For the first few days to a week, slight
bleeding normally occurs when the stoma is
touched because the surgical site is still new. She
should report profuse bleeding immediately.
88. Answer D. To wash away tissue debris and drainage
effectively, irrigate the wound until the solution
becomes clear or all the solution is used.
89. Answer A. Ammonia levels increase d/t improper
shunting of blood, causing ammonia to enter
systemic circulation, which carries it to the brain.
90. Answer D. Saline solution is isotonic, or close to
body fluids in content, and is used along with sterile
dressings to cover an eviscerated wound and keep
it moist.
91. Answer B. Crohn’s disease penetrates the mucosa
of the colon through all layers and destroys the
colon in patches, which creates a cobblestone
appearance.

92. Answer A. Stomach pain is often a late sign of
 stomach cancer; outcomes are particularly poor
when the cancer reaches that point. Surgery,
 chemotherapy, and radiation have minimal positive
effects. TPN may enhance the growth of the cancer.
93. Answer C.
HOME
Melena is the passage
NURSING NOTES 
of dark, tarry
stools that contain a large amount of digested
CAREblood.
PLANS TOOLS
It occurs with&bleeding
APPS from BULLETS
the upper GI
tract.
94. Answer A. A patient with an acute upper GI
CAREhemorrhage
PLANS must be
TOOLS treated forBULLETS
& APPS hypovolemia and
hemorrhagic shock. You as a nurse can’t diagnose
the problem. Controlling the bleeding may require
surgery or intensive medical treatment.
95. Answer D. To stabilize a patient with acute bleeding,
NS or LR solution is given I.V. until BP rises and
urine output returns to 30ml/hr.
96. Answer A. Initially, you should assess the patient’s
knowledge about colostomies and how it will affect
his lifestyle.
97. Answer B. An inflammatory condition that affects
the surface of the colon, ulcerative colitis causes
friability and erosions with bleeding. Patients with
ulcerative colitis are at increased risk for bowel
perforation, toxic megacolon, hemorrhage, cancer,
and other anorectal and systemic complications.
98. Answer C. Medications to control inflammation
such as corticosteroids are used for long-term
treatment.
99. Answer A. Meats and beans are high-protein foods.
In liver failure, the liver is unable to metabolize
protein adequately, causing protein by-products to
build up in the body rather than be excreted.
100. Answer B. A gastric residual greater than 2 hours
worth of feeding or 100-150ml is considered too
high. The feeding should be stopped; NG tube

clamped, and then allow time for the stomach to
 empty before additional feeding is added.


King James Bible Study
KJV
CARE PLANS Over 11&million
TOOLS APPS downloads
BULLETS
INSTALL
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HOME NURSING NOTES  PRACTICE EXAMS  MNEMONICS ARTICLES

What are you looking for? 

HOME NURSING NOTES  PRACTICE EXAMS  MNEMONICS ARTICLES

CARE PLANS TOOLS & APPS BULLETS  

NCLEX Practice Exam for

Practice Mode – Questions and choices are randomly NCLEX

2. A male client who is recovering from surgery has

4. Nurse Oliver checks for residual before administering

A. Hold the feeding

5. A nurse is inserting a nasogastric tube in an adult

7. A nurse is preparing to remove a nasogartric tube

8. Nurse Joy is preparing to administer medication

A. Position the client supine to assist in medication

HOME NURSING NOTES  PRACTICE EXAMS  MNEMONICS ARTICLES

10. Dr. Smith has determined that the client with

11. A client is suspected of having hepatitis. Which

A. Elevated hemoglobin level

 12. The nurse is reviewing the physician’s orders written

13. A female client being seen in a physician’s office has

A. Fast for 8 hours before the test

14. The nurse is performing an abdominal assessment

A. Palpates the abdomen for size

15. Polyethylene glycol-electrlyte solution (GoLYTELY) is

17. The nurse is reviewing the medication record of a

18. The nurse is assessing a male client 24 hours

A. Clamp the T tube

 19. The nurse is monitoring a female client with a

A. Halts stress reactions

21. The nurse is caring for a female client following a

22. The nurse is providing discharge instructions to a

A. Ambulate following a meal

 23. The nurse is monitoring a female client for the early

CARE PLANS and

24. The nurse is preparing a discharge teaching plan for

A. Irrigating the drain

25. The nurse is instructing the male client who has an

A. Limit oral fluid

26. The nurse is caring for a hospitalized female client

HOME NURSING NOTES  PRACTICE EXAMS  MNEMONICS ARTICLES

28. The nurse is reviewing the record of a female client

29. The nurse is performing a colostomy irrigation on a

A. Notify the physician

30. The nurse is teaching a female client how to perform

HOME NURSING NOTES  PRACTICE EXAMS  MNEMONICS ARTICLES

32. You’re assessing the stoma of a patient with a

A. Pale, pink and moist

33. You’re caring for a patient with a sigmoid

HOME NURSING NOTES  PRACTICE EXAMS  MNEMONICS ARTICLES

A. To the exact size of the stoma.

36. You’re performing an abdominal assessment on

A. Observation, percussion, palpation, auscultation

37. You’re doing preoperative teaching with Gertrude

A. A reservoir is created that exits through the

A. There is no need to change eating habits.

40. Arthur has a family history of colon cancer and is

A. “I know just how you feel.”

41. You’re caring for Beth who underwent a Billroth II

 A. Flushed, dry skin.

HOME NURSING NOTES  PRACTICE EXAMS  MNEMONICS ARTICLES

43. You’re caring for Lewis, a 67 y.o. patient with liver

44. You’re caring for Jane, a 57 y.o. patient with liver

A. Empty her bladder.

45. After abdominal surgery, your patient has a severe