1. Leah is developing constipation from 4.

The nurse provides home care

being on bed rest. What measures would instructions to the parents of a child with
you suggest she take to help prevent this? celiac disease. The nurse should teach the
* parents to include which food item in the
child's diet?
A. Eat more frequent small meals instead of
three large one daily A. Rice

B. Walk for at least half an hour daily to B. Oatmeal

stimulate peristalsis
C. Rye toast
C. Drink more milk, increased calcium intake
D. Wheat bread
prevents constipation
5. The nurse is preparing to care for a child
D. Drink eight full glasses of fluid such as
with a diagnosis of intussusception. The
water daily
nurse reviews the child's record and
2. The nurse is caring for a newborn with a expects to note which sign of this disorder
suspected diagnosis of imperforate anus. documented?
The nurse monitors the infant, knowing
A. Watery diarrhea
that which is a clinical manifestation
associated with this disorder? B. Ribbon-like stools

A. Bile-stained fecal emesis C. Profuse projectile vomiting

B. The passage of currant jelly–like stools D. Bright red blood and mucus in the stools

C. Failure to pass meconium stool in the first 6. The nurse is monitoring a client
24 hours after birth admitted to the hospital with a diagnosis
of appendicitis who is scheduled for
D. Sausage-shaped mass palpated in the
surgery in 2 hours. The client begins to
upper right abdominal quadrant
complain of increased abdominal pain and
3. The nurse admits a child to the hospital begins to vomit. On assessment, the nurse
with a diagnosis of pyloric stenosis. On notes that the abdomen is distended and
assessment, which data would the nurse bowel sounds are diminished. Which is the
expect to obtain when asking the parent most appropriate nursing intervention?
about the child's symptoms?
A. Administer the prescribed pain
A. Watery diarrhea medication.

B. Projectile vomiting B. Notify the primary health care provider

(PHCP).
C. Increased urine output

D. Vomiting large amounts of bile

C. Call and ask the operating room team to C. “I’m glad I don’t have to lie still for this
perform surgery as soon as possible. procedure.”

D. Reposition the client and apply a heating D. “I’m glad some intravenous medication
pad on the warm setting to the client’s will be given to relax me.”
abdomen.
10. The nurse is monitoring a client with a
7. A client has developed hepatitis A after diagnosis of peptic ulcer. Which
eating contaminated oysters. The nurse assessment finding would most likely
assesses the client for which expected indicate perforation of the ulcer? *
assessment finding?
A. Bradycardia
A. Malaise
B. Numbness in the legs
B. Dark stools
C. Nausea and vomiting
C. Weight gain
D. A rigid, board-like abdomen
D. Left upper quadrant discomfort
11. The nurse is providing discharge
8. A client has undergone teaching for a client with newly diagnosed
esophagogastroduodenoscopy. The nurse Crohn’s disease about dietary measures to
should place highest priority on which item implement during exacerbation episodes.
as part of the client’s care plan? * Which statement made by the client
indicates a need for further instruction? *
A. Monitoring the temperature
A. “I should increase the fiber in my diet.”
B. Monitoring complaints of heartburn
B. “I will need to avoid caffeinated
C. Giving warm gargles for a sore throat
beverages.”
D. Assessing for the return of the gag reflex
C. “I’m going to learn some stress reduction
9. The nurse has taught the client about an techniques.”
upcoming endoscopic retrograde
D. “I can have exacerbations and remissions
cholangiopancreatography (ERCP)
with Crohn’s disease.”
procedure. The nurse determines that the
client needs further information if the 12. The nurse is reviewing the record of a
client makes which statement? * client with a diagnosis of cirrhosis and
notes that there is documentation of the
A. “I know I must sign the consent form.”
presence of asterixis. How should the
B. “I hope the throat spray keeps me from nurse assess for its presence?
gagging.”

A. Dorsiflex the client’s foot.

B. Measure the abdominal girth. D. Raising the head of the bed on 6-inch (15
cm) blocks
C. Ask the client to extend the arms.
16. Joseph has been diagnosed with
D. Instruct the client to lean forward.
hepatic encephalopathy. The nurse
13. The nurse is doing an admission observes flapping tremors. The nurse
assessment on a client with a history of understands that flapping tremors
duodenal ulcer. To determine whether the associated with hepatic encephalopathy
problem is currently active, the nurse are also known as:
should assess the client for which
A. aphasia
manifestation of duodenal ulcer? *
B. ascites
A. Weight loss
C. astacia
B. Nausea and vomiting
D. asterixis
C. Pain relieved by food intake
17. The nurse is caring for a client who is
D. Pain radiating down the right arm
postoperative following a pelvic
14. A client has just had surgery to create exenteration, and the surgeon changes the
an ileostomy. The nurse assesses the client client’s diet from NPO (nothing by mouth)
in the immediate postoperative period for status to clear liquids. The nurse should
which most frequent complication of this check which priority item before
type of surgery? administering the diet?

A. Folate deficiency 1. Bowel sounds

B. Malabsorption of fat 2. Ability to ambulate

C. Intestinal obstruction 3. Incision appearance

D. Fluid and electrolyte imbalance 4. Urine specific gravity

15. A client with hiatal hernia chronically 18. Michiel, A male patient diagnosed with
experiences heartburn following meals. colon cancer was newly put in colostomy.
The nurse should plan to teach the client to
Michiel shows the BEST adaptation with
avoid which action because it is
the new colostomy if he shows which of
contraindicated with a hiatal hernia?
the following?
A. Lying recumbent following meals
A. Look at the ostomy site
B. Consuming small, frequent, bland meals
B. Participate with the nurse in his daily
C. Taking H2 -receptor antagonist ostomy care
medication
C. Ask for leaflets and contact numbers of A. Ask to defer colostomy care to another
ostomy support groups individual

D. Talk about his ostomy openly to the nurse B. Promises he will begin to listen the next
and friends day

19. The nurse plans to teach Michiel about C. Agrees to look at the colostomy
colostomy irrigation. As the nurse prepares
D. States that colostomy care is the function
the materials needed, which of the
of the nurse while he is in the hospital
following item indicates that the nurse
needs further instruction? * 23. While irrigating the client’s colostomy,
Michiel suddenly complains of severe
A. Plain NSS / Normal Saline
cramping. Initially, the nurse would
B. K-Y Jelly
A. Stop the irrigation by clamping the tube
C. Tap water
B. Slow down the irrigation
D. Irrigation sleeve
C. Tell the client that cramping will subside
20. The nurse should insert the colostomy and is normal
tube for irrigation at approximately *
D. Notify the physician
A. 1-2 inches
24. The next day, the nurse will assess
B. 3-4 inches Michiel’s stoma. The nurse noticed that a
prolapsed stoma is evident if she sees
C. 6-8 inches
which of the following?
D. 12-18 inches
A. A sunken and hidden stoma
21. The maximum height of irrigation
B. A dusky and bluish stoma
solution for colostomy is *
C. A narrow and flattened stoma
A. 5 inches
D. Protruding stoma with swollen
B. 12 inches
appearance
C. 18 inches
25. Michiel asked the nurse, what foods
D. 24 inches will help lessen the odor of his colostomy.
The nurse best response would be
22. Which of the following behavior of the
client indicates the best initial step in A. Eat eggs
learning to care for his colostomy?
B. Eat cucumbers

C. Eat beet greens and parsley

D. Eat broccoli and spinach diagnosis of chronic gastritis. The nurse
monitors the client, knowing that this
26. The nurse knew that the normal color
client is at risk for which vitamin
of Michiel’s stoma should be
deficiency?
A. Brick Red
a. Vitamin A
B. Gray
b. Vitamin B12
C. Blue
c. Vitamin C
D. Pale Pink
d. Vitamin E
27. The nurse is caring for several patients
30. The nurse is providing discharge
with gastrointestinal problems. Which
instructions to a client following
patient is most likely to need a guaiac
gastrectomy and should instruct the client
(hemooccult) test?
to take which measure to assist in
a. patient reports dark amber-colored urine preventing dumping syndrome?

b. patient reports black discoloration of a. Ambulate following a meal.

stool
b. Eat high-carbohydrate foods.
c. Patient vomits small amounts of yellow
c. Limit the fluids taken with meals.
emesis
d. Sit in a high Fowler's position during
d. patient complains of right upper
meals.
quadrant pain
31. The nurse is doing an admission
28. The nurse hears in report that a patient
assessment on a client with a history of
is suspected of having ascites. Which
duodenal ulcer. To determine whether the
action is the nurse most likely to initiate for
problem is currently active, the nurse
this specific condition?
should assess the client for which
a. Elevate the head of the bed 30-45 symptom(s) of duodenal ulcer?
degrees.
a. Weight loss
b. Assess for pain every 30-60 minutes
b. Nausea and vomiting
c. Perform serial measurements of
c. Pain relieved by food intake
abdominal girth
d. Pain radiating down the right arm
d. Slightly elevate legs and buttocks to help
expel flatus 32. The nurse assesses a client diagnosed
with a retractable gastric peptic ulcer and
29. The nurse is caring for a client with a
has undergone gastric vagotomy. Which
factor does the nurse identify as increasing C. "Do not eat red meat for at least 3 days
due to vagotomy? before collecting the specimen."

A. Gastric motility D. "Do not drink carbonated beverages for 8

hours before collecting the specimen."
B. Gastric acidity
36. The sphincter that prevents allows the
C. Peristalsis
flow of the bile from the gallbladder to the
D. Gastric pH ampulla to the small intestine?

33. The nurse teaches the patient with a a. Lower Esophageal Sphincter
hiatal hernia or GERD to control symptoms
b. Pyloric Sphincter
by:
c. Sphincter of Oddi
a. drinking 10-12 oz of water with meals
d. Ileocecal valve
b. spacing six small meals a day
37. A female client was recently admitted.
c. sleeping with the head of the bed
She has fever, weight loss, and watery
elevated 4-6 inches
diarrhea is being admitted to the facility.
d. performing daily exercises of toe touch
While assessing the client, Nurse Chona
34. Patient admitted to ER has profuse inspects the client’s Abdomen and notice
bright-red hematemesis. During initial care that it is slightly concave, Additional
of the patient, the nurse's first priority is assessment should be proceed in which
to: order:

a. perform a nursing assessment of patient's a. Palpation, Auscultation, and percussion

status
b. Percussion, palpation, and auscultation
b. establish 2 IV sites
c. Palpation, percussion, and auscultation
c. obtain a thorough health history
d. Auscultation, percussion, and palpation
d. administer blood transfusion
38. Pancreatic intestinal juices that splits
35. A patient is to collect a specimen for a lactose into galactose and glucose?
stool guaiac test. Which direction should
a. Amylase
the patient be given? *
b. lactase
A. "Be sure to use a sterile container to
collect the specimen." c. Sucrase

B. "Be sure to take a laxative 2 days prior to d. nucleases

collecting the stool."
39. A patient noted with significant 42. During assessment, auscultation was
amount of fluid in the peritoneal cavity is done to check for bowel sounds. A loud
for Paracentesis. The nurse is incorrect in gurgling sounds resulted from
saying that: hypermotility was heard, this is known as
your:
a. “Patient need to void before the
procedure.” a. Tympanic

b. “Patient need to lie fat through out the b. hyperresonance

procedure”
c. Borborygmus
c. “Patient will be positioned upright at the
d. Paralytic ileus
edge of the bed or high fowlers in bed.”
43. Patient with history of Peptic Ulcer
d. “Consent need to be signed before the
disease suddenly develops melena
procedure.”
associated with mild hematemesis.
40. Which of the following is not used to Interventions will be necessary except:
examines the upper gastrointestinal tract?
a. Keep patient NPO
a. Esophagogastroduodenoscopy
b. Administer Proton Pump Inhibitors as
b. Barrium Swallow ordered.

c. Colonoscopy c. Patient will be prepared for possible

endoscopy or colonoscopy.
d. gastric analysis
d. Give per orem as tolerated preferably
41. The removal of fluid from the
chocolates and meats.
abdominal cavity through paracentesis
may cause some undesirable effects 44. Appendicitis almost always results from
systemically. To prevent this from an obstruction in the appendiceal lumen.
happening, the nurse should take Which problem should the nurse identify
precautions and monitored which of the as the cause of this obstruction? *
following parameters:
A. Monolith
a. Blood pressure
B. Fecalith
b. bleeding time
C. Tonsillolith
c. gag reflex
D. Ptyalith
d. level of consciousness
45. The nurse is providing care for a client d. Blumberg Sign
with a recent transverse colostomy. Which
49. Irritation or pain on hip flexion and
observation requires immediate
abduction
notification of the health care provided?
a. Obturator Sign
a. Stoma is beefy red and shiny
b. Rouvsing Sign
b. Purple discoloration of the stoma
c. Psoas Sign
c. Skin excoriation around the stoma
d. Blumberg Sign
d. . semi-formed stool noted in the ostomy
pouch 50. Irritation or pain on hip flexion

46. A client has just had surgery to create a. Obturator Sign

an ileostomy. The nurse assesses the client
b. Rouvsing Sign
in the immediate post operative period for
which most frequent complication of this c. Psoas Sign
type of surgery?
d. Blumberg Sign
a. Folate deficiency

b. Malabsorption of fat

c. Intestinal Obstruction

d. Fluid and Electrolyte Imbalance

47. Which of the following factors is

believed to cause ulcerative colitis? *

a. Acidic diet

b. Altered immunity

c. Chronic Constipation

d. Emotional Stress

48. Pain on the right lower quadrant upon

palpation of the left lower quadrant

a. Obturator Sign

b. Rouvsing Sign

c. Psoas Sign