NursGuru

    Exam Review

    1. A patient being admitted with an acute exacerbation of ulcerative colitis. The nurse will plan to:
      A)
      administer cobalamin (vitamin B12) injections.
      B)
      administer IV metoclopramide (Reglan).
      C)
      discontinue the patients oral food intake.
      D)
      teach the patient about anal colectomy surgery.
    2. The nurse will plan to teach a patient with Crohn's disease who has megaloblastic anemia about the need for:
      A)
      cobalamin (B12) spray or injections.
      B)
      iron dextran (Imferon) infusions.
      C)
      oral ferrous sulfate tablets.
      D)
      regular blood transfusions.
    3. A client with chronic kidney disease (CKD) is refusing to take his medications and follow the diet. What should the nurse do first?
      A)
      Reschedule medical appointments to a later date and time.
      B)
      Refer the client to a mental health nurse practitioner.
      C)
      Discuss the option of peritoneal dialysis.
      D)
      Discuss what the treatment means to the client.
    4. The nurse is caring for an acutely ill client. What assessment finding should prompt the nurse to inform the health care provider that the client may be exhibiting signs of acute kidney injury (AKI)?
      A)
      The urine is cloudy and has visible sediment with a foul odor.
      B)
      Average urine output has been 10 mL/hr for several hours.
      C)
      An inability to urinate/voiding for 2 days.
      D)
      Client reports left-sided flank pain.

    Exam Review

    1. A nurse cares for a client who had a colostomy placed in the ascending colon 2 weeks ago. The client states, "The stool in my pouch is still liquid." How would the nurse respond?
      A)
      "Eating additional fiber will bulk up your stool and decrease diarrhea."
      B)
      "This is abnormal, I will contact your primary health care provider."
      C)
      "Your stool will become firmer over the next couple of weeks."
      D)
      "The stool will always be liquid with this type of colostomy."
    2. The nurse plans care for a client with Crohn's disease who has a heavily draining fistula. Which intervention would be the nurse's priority?
      A)
      Skin protection
      B)
      Low-fiber diet
      C)
      Antibiotic administration
      D)
      Intravenous glucocorticoids
    3. A nurse is presenting an educational event to a local community group. When speaking about colorectal cancer, what risk factor should the nurse cite?
      A)
      History of bowel obstruction
      B)
      Longstanding psychosocial stress
      C)
      History of diverticulitis
      D)
      High levels of alcohol consumption
    4. A 28-year-old woman with Crohn's disease develops a fever and symptoms of a urinary tract infection (UTI) with tan, fecal-smelling urine. What information would the nurse add to a general teaching plan about UTIs in order to individualize the teaching for this patient?
      A)
      Empty the bladder before and after sexual intercourse.
      B)
      Drink adequate fluids to maintain normal hydration.
      C)
      Bacteria in the perianal area can enter the urethra.
      D)
      Fistulas can form between the bowel and bladder.

    Exam Review

    1. The nurse is caring for a client in acute kidney injury (AKI). Which complication would most clearly warrant the administration of polystyrene sulfonate?
      A)
      Hypernatremia
      B)
      Hyperkalemia
      C)
      Hypercalcemia
      D)
      Hypomagnesemia
    2. A client with acute kidney injury (AKI) has a blood pressure of 76/55 mm Hg. The primary health care provider prescribed 1000 mL of normal saline to be infused over 1 hour to maintain perfusion. The client starts to develop shortness of breath. What is the nurse's priority action?
      A)
      Decrease the rate of the IV infusion.
      B)
      Calculate the mean arterial pressure (MAP).
      C)
      Take the clients pulse.
      D)
      Ask for insertion of a pulmonary artery catheter.
    3. The nurse assesses a client who is hospitalized with an exacerbation of Crohn disease. Which assessment finding would the nurse expect?
      A)
      Dull, hypoactive bowel sounds in the lower abdominal quadrants
      B)
      High-pitched, rushing bowel sounds in the right lower quadrant
      C)
      Positive Murphy sign with rebound tenderness to palpitation
      D)
      Reports of abdominal cramping that is worse at night
    4. A client with diabetes mellitus type 2 has been well controlled on metformin. The client is scheduled for a magnetic resonance imaging (MRI) scan with contrast. What priority nurse takes at this time?
      A)
      Assess the client's blood urea nitrogen and creatinine.
      B)
      Ask the client if he or she is taking antibiotics.
      C)
      Withhold the client's metformin for 48 hours.
      D)
      Teach the client about the purpose of the MRI.

    Exam Review

    1. A 72-year-old male patient with dehydration caused by an exacerbation of ulcerative colitis is receiving 5% dextrose in normal saline at 125 mL/hour. Which assessment finding by the nurse is most important to report to the health care provider?
      A)
      Patient has not voided for the last 4 hours.
      B)
      Crackles are heard halfway up the posterior chest.
      C)
      Skin is dry with poor turgor on all extremities.
      D)
      Patient has had 5 loose stools over the last 6 hours.
    2. A client is admitted with acute kidney injury (AKI) and a urine amount of 2300 mL in 24 hours. The nurse should prioritize assessment of ________________.
      A)
      Cardiac and respiratory status
      B)
      Mental health status
      C)
      Edema and pain
      D)
      Electrolyte and fluid imbalance
    3. A client with chronic kidney disease (CKD) complains of severe itching. Which terms should the nurse use to document this finding? (Select all that apply)
      A)
      Urticaria
      B)
      Atopic dermatitis
      C)
      Excoriation
      D)
      Pruritus
      E)
      Psoriasis
    4. The nurse is providing discharge teaching for a 21-year-old client with a new diagnosis of ulcerative colitis. When planning family assessment, the nurse should recognize that which of the following factors will likely have the greatest impact on the client's coping after discharge?
      A)
      The family's ability to monitor the client's changing health status
      B)
      The family's ability to take care of the client's special diet needs
      C)
      The family's ability to provide emotional support
      D)
      The family's ability to manage the client's medication regimen

    Exam Review

    1. A nurse is providing care for a client whose recent colostomy has contributed to a nursing diagnosis of Disturbed Body Image Related to Colostomy. What intervention best addresses this diagnosis?
      A)
      Emphasize the fact that the colostomy is temporary measure and is not permanent.
      B)
      Encourage the client to conduct online research into colostomies.
      C)
      Emphasize the fact that the colostomy was needed to alleviate a much more serious health problem.
      D)
      Engage the client in dialogue about the implications of having the colostomy.
    2. A nurse is assessing a client's stoma on postoperative day 2. The nurse notes that the stoma has a shiny appearance and a bright red color. How should the nurse respond?
      A)
      Document a nursing diagnosis of Impaired Skin Integrity.
      B)
      Document that the stoma appears healthy and well perfused.
      C)
      Contact the primary care provider to report this finding.
      D)
      Irrigate the ostomy to clear a possible obstruction.
    3. A nurse is assessing a client's stoma on postoperative day 2. The nurse notes that the stoma is moist, bright red, and slightly edematous with a small amount of bleeding noted on the stoma surface during cleaning. The client reports no pain at the site and vital signs are stable. Which nursing action is most appropriate at this time?
      A)
      Apply firm pressure and a sterile dressing over the stoma to control bleeding and prevent further irritation.
      B)
      Notify the healthcare provider because bleeding from a stoma indicates postoperative hemorrhage.
      C)
      Document the findings as expected postoperative assessment findings and continue monitoring the stoma.
      D)
      Apply a specialized ostomy powder to the stoma surface to promote healing and reduce edema.
    4. A nurse reviews the electronic health record of a client who has acute kidney injury (AKI). Which documentation would alert the nurse to urgently contact the primary health care provider for additional prescriptions?
      A)
      Client ate 20% of breakfast meal
      B)
      Client's weight decreased by 3 lb (1.4 kg)
      C)
      White blood cell count of 8200/mm3 (8.2 x 109/L)
      D)
      Serum potassium of 2.6 mEq/L (2.6 mmol/L)

    Exam Review

    1. A nurse assesses a client who has ulcerative colitis and severe anemia. Which assessment should the nurse prioritize?
      A)
      Percussion of abdomen
      B)
      Heart rate and rhythm
      C)
      Inspection of oral mucosa
      D)
      Recent dietary intake
    2. A nurse teaches a client who is at risk for colorectal cancer. Which dietary recommendation would the nurse include?
      A)
      "Eat low-fiber and low-residual foods."
      B)
      "Add vegetables such as broccoli and cauliflower to your diet."
      C)
      "Foods high in animal fat help to protect the intestinal mucosa."
      D)
      "White rice and bread are easier to digest."
    3. The nurse is caring for a client who is prescribed sulfasalazine. Which question would the nurse ask the client before starting this drug?
      A)
      "Do you have insurance to cover this drug?"
      B)
      "Do you have any allergy to sulfa drugs?"
      C)
      "Are you taking Vitamin C or B?"
      D)
      "Can you swallow pills pretty easily?"
    4. A 62-year-old client with a history of colorectal cancer presents to the clinic reporting increasing fatigue, shortness of breath on exertion, and intermittent dizziness over the past several weeks. The client also states that bowel movements have become darker in color recently. Laboratory results reveal hemoglobin of 8.9 g/dL and hematocrit of 27%. Which interpretation by the nurse is most appropriate?
      A)
      The findings most likely indicate chronic gastrointestinal bleeding related to the cancer.
      B)
      The laboratory findings suggest dehydration secondary to decreased fluid intake.
      C)
      The client is experiencing acute intestinal obstruction caused by tumor growth.
      D)
      The symptoms are expected effects of aging and reduced physical activity.