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    Exam Review

    1. A client admitted with appendicitis who is scheduled for surgery in 2 hours complains of increased abdominal pain, vomiting, distended abdomen, and diminished bowel sounds. What is the most appropriate nursing intervention?
      A)
      Administer a laxative to promote bowel movement
      B)
      Offer the client pain medication
      C)
      Assist the client to ambulate in the hallway
      D)
      Notify the healthcare provider immediately
    2. A nurse is collecting data from a client who has gastroesophageal reflux disease (GERD) and reports having heartburn every night. Which of the following actions should the nurse identify as a contributing factor to the client's heartburn?
      A)
      Drinking orange juice regularly
      B)
      Sleeping on a large wedge-style pillow
      C)
      Consuming low-fat meats
      D)
      Eating dinner early in the evening
    3. A nurse is reinforcing discharge instructions to a client who has a peptic ulcer. Which of the following information should the nurse reinforce to the client prior to discharge?
      A)
      "Monitor for any changes in the color of your urine such as maroon or red-colored urine."
      B)
      "Monitor for the appearance of ecchymosis on the sides of your abdomen/pelvic areas."
      C)
      "Monitor for any increase or unintentional weight gain."
      D)
      "Monitor for any changes in the color of your stool such as dark or black-colored stool."
    4. A nurse is collecting data on a client who has acute pancreatitis. Which of the following factors should the nurse anticipate in the client's history?
      A)
      Diabetes mellitus
      B)
      Shock
      C)
      GERD
      D)
      Gallstones
    Page 1 of 13

    Exam Review

    1. A nurse is contributing to the plan of care for a client who has cirrhosis of the liver. Which of the following interventions should the nurse include in the plan? (Select all that apply.)
      (SATA)
      A)
      Implement fall precautions.
      B)
      Administer enemas to manage constipation.
      C)
      Initiate a low sodium diet.
      D)
      Measure abdominal girth daily.
      E)
      Obtain a weekly weight.
    2. A nurse is collecting data from a client who has a gastric ulcer. Which of the following should the nurse identify as a priority finding and notify the provider?
      A)
      Weight loss of 2 lb (0.91 kg) from baseline
      B)
      Dyspepsia
      C)
      Reports being thirsty
      D)
      Abdominal pain radiating to the shoulder
    3. A nurse is assessing a client who has advanced cirrhosis. Which of the following manifestation should the nurse expect to find?
      A)
      Increased body hair
      B)
      Dark colored stools
      C)
      Spider angioma
      D)
      Weak pulse
    4. A nurse is contributing to a plan of care for a client who has Hepatitis B. Which of the following should the nurse include in the plan?
      A)
      Use disposable plates and utensils.
      B)
      Limit activity.
      C)
      Administer antibiotics.
      D)
      Provide a high-fat diet.
    Page 2 of 13

    Exam Review

    1. A nurse is caring for a client who has liver cirrhosis with ascites and bleeding esophageal varices. Which of the following laboratory findings indicates that the client's gastrointestinal (GI) tract is digesting and absorbing blood?
      A)
      Elevated HbA1c
      B)
      Decreased chloride
      C)
      Decreased bilirubin
      D)
      Elevated BUN
    2. A nurse is caring for a client who states their parent died from complications of a GI bleed. Which of the following reinforcements by the nurse will help the client decrease their risk of developing a peptic ulcer?
      A)
      "Avoid consuming undercooked foods."
      B)
      "Avoid foods that have been fried."
      C)
      "Avoid using decongestants for seasonal allergies/colds due to their positive link to developing a peptic ulcer."
      D)
      "Avoid using hormone replacement therapy as this can increase your risk for a peptic ulcer."
    3. A client with ulcerative colitis is experiencing persistent diarrhea. What should the nurse anticipate during the assessment of the client?
      A)
      Hypotension due to vasodilation
      B)
      Dehydration due to fluid loss
      C)
      Hyperkalemia due to potassium retention
      D)
      Weight gain due to improved absorption
    4. A nurse on a medical surgical unit is collecting data from an older adult client who has a large amount of abdominal ascites. The client is alert and oriented x3 and states that they walk independently at home and normally use a cane but forgot to bring it to the hospital. Which of the following measures are important for the nurse to initiate first?
      A)
      Skin safety protocol
      B)
      Fall risk protocol
      C)
      Bleeding precaution protocol
      D)
      Sodium restriction diet
    Page 3 of 13

    Exam Review

    1. A nurse is reinforcing teaching a client who has peptic ulcer disease and is starting therapy with sucralfate. Which of the following instructions should the nurse include in the teaching?
      A)
      Store the medication in the refrigerator.
      B)
      Take the medication with an antacid.
      C)
      Take as needed for pain relief.
      D)
      Take the medication 1 hr before meals.
    2. A nurse in a provider's office is reviewing the health histories of four clients. For which of the following clients should the nurse anticipate scheduling a colonoscopy?
      A)
      32-year-old who has a sister who died of colon cancer
      B)
      56-year-old who had a colonoscopy 6 years ago
      C)
      45-year-old who has Clostridium difficile
      D)
      34-year-old who reports a new onset of constipation
    3. A nurse is collecting data from a client in the health clinic who is reporting epigastric pain. Which of the following statements made by the client should the nurse identify as being consistent with peptic ulcer disease?
      A)
      "The pain radiates down to my lower back."
      B)
      "My pain is relieved by having a bowel movement."
      C)
      "The pain is worse after I eat a meal high in fat."
      D)
      "I feel so much better after eating."
    4. A nurse is preparing a client who has advanced cirrhosis for an abdominal paracentesis. Which of the actions should the nurse take?
      A)
      Assure the client that the procedure is painless.
      B)
      Have the client increase fluid intake after the procedure.
      C)
      Place the client on his back.
      D)
      Instruct the client to empty his bladder.
    Page 4 of 13

    Exam Review

    1. A nurse is caring for a client who is postoperative and has an NG tube that has drained 2,500 mL in the past 6 hr. The nurse should monitor the client for which of the following electrolyte imbalances?
      A)
      Decreased calcium level
      B)
      Elevated sodium level
      C)
      Elevated magnesium level
      D)
      Decreased potassium level
    2. A nurse is caring for a client who has cirrhosis and a prescription for lactulose. Following administration, the nurse should monitor the client for which of the following adverse effects?
      A)
      Diarrhea
      B)
      Peripheral edema
      C)
      Dry mouth
      D)
      Headache
    3. A nurse is assisting with the care of a client who has cirrhosis of the liver with ascites. Which of the following actions should the nurse take?
      A)
      Weigh the client weekly.
      B)
      Position the client flat in bed.
      C)
      Medicate the client with acetaminophen for discomfort.
      D)
      Measure the client's abdominal girth every 8 hr.
    4. A nurse is contributing to the plan of care for a client who has cirrhosis and ascites. Which of the following interventions should the nurse recommend for inclusion in the plan of care?
      A)
      Increase the client's sodium intake.
      B)
      Increase the client's saturated fat intake.
      C)
      Decrease the client's fluid intake.
      D)
      Decrease the client's carbohydrate intake.
    Page 5 of 13

    Exam Review

    1. A nurse is reviewing the plan of care for a client experiencing an acute exacerbation of ulcerative colitis. Which of the following treatments should the nurse expect to administer?
      A)
      Docusate
      B)
      Aspirin
      C)
      A corticosteroid medication
      D)
      A bowel cathartic medication.
    2. A nurse is reinforcing teaching a client who is scheduled for a barium swallow to evaluate dysphagia. Which of the following statements should indicate to the nurse that the client understands the instructions?
      A)
      "I will expect my stool to be black after this procedure."
      B)
      "I will drink plenty of fluids after the test."
      C)
      "I will maintain a clear liquid diet 24 hours before the test."
      D)
      "I will expect a warm feeling when the dye is injected."
    3. A nurse is caring for a client who is 2 days postoperative from abdominal surgery. The client reports discomfort from abdominal distension and flatus. Which of the following suggestions should the nurse include?
      A)
      Drink cold liquids.
      B)
      Assume position with legs and rectum lower than the stomach.
      C)
      Use a straw.
      D)
      Ambulate several times a day.
    4. A nurse is reviewing the medical record of a client who has a peptic ulcer. Which of the following findings should the nurse identify as a risk factor for this condition?
      A)
      Drinks green tea
      B)
      History of ibuprofen use
      C)
      History of bulimia
      D)
      Consumes spicy foods 5 to 8 times weekly
    Page 6 of 13