Professional Documents
Culture Documents
C. Consult with human resources personnel about the issue and needed actions
A. Serum calcium
B. Urine creatinine
C. Serum albumin
D. Urine protein
A. Opiods analgesics
B. Endoscopic retrograde cholangiopancreatography
C. Urosodiol and Chenodiol
D. Magnetic resonance cholangiopancreatography
E. Extra corporeal shock wave lithotripsy
F. Laparoscopic cholecystectomy lap chole
1
5 A client is scheduled for a colonoscopy. Which information should be reported
to the health care provider before sending the client for the procedure?
6 The RN and UAP are caring for a patient who has just returned to the nursing
unit after an esophagogastroduodenoscopy (EGD). Which nursing action
performed by the UAP requires that the RN intervene? The UAP
7 When caring for a patient following a needle biopsy of the liver at the bedside,
the nurse should
8 You assess a patient who is a vegan. The most common nutritional deficiency
related to a strict vegan diet would be manifested by
A. Muscle wasting.
B. Bleeding gums.
C. Pallor and changes in sensation and movement of the extremities.
D. Dry, scaly skin and cracked, painful oral mucous membranes.
2
10 Parenteral nutrition (PN) with a peripherally inserted central catheter (PICC)
was begun at 0800. After 6 hours of PN infusion, the nurse checks the patients
capillary blood glucose level and finds it to be 140 mg/dl. The most appropriate
action by the nurse is to
11 The hospital nurse educator is observing a new RN who is caring for a patient
receiving PN through a single-lumen central line inserted in the right
subclavian vein. Which action by the new RN indicates that the RN can safely
care for the patient?
13. Which of these nursing actions for a patient who is receiving intermittent tube
feedings through a PEG tube is in the scope of practice for an LPN?
14. The nurse notes that the peripheral PN bag is almost empty and a new
PN bag has not yet arrived from the pharmacy. Which action is
appropriate?
A. Decreasing the rate of the current PN infusion to 10 ml/hr until the new bag arrives
B. Infusing 10% dextrose in water until the new PN bag is available from the pharmacy
C. Flushing the peripheral line with saline and wait until the new PN bag is available
D. Monitoring the patients capillary blood glucose until a new PN bag is available
3
15. You attended a conference on catheter related blood stream infections
(CLABSI).What info will you bring back to the staff? Select all that apply
16. A patient returns to the surgical nursing unit following a vertical banded
gastroplasty with a nasogastric tube to low, intermittent suction and a PCA
machine for pain control. During the postoperative care of the patient, the nurse
recognizes the need to
17. A child who has been NPO during treatment for nausea and vomiting caused
by gastric viruses to start oral intake. Which of these should the nurse offer first?
18. You are teaching family health practices to parents of a child with hepatitis.
Which statement demonstrates understanding by the parents?
19. Which information will the nurse include when teaching a patient with newly
diagnosed GERD?
A. Peppermint tea is a natural way and may be helpful in reducing your symptoms.
B. You will need to sleep upright with pillows.
C. You should avoid eating between meals to reduce acid secretion.
D. Vigorous physical activities may increase the incidence of reflux.
4
20. Cobalamin injections are prescribed for a client with chronic atrophic gastritis.
The nurse determines that teaching regarding the injections has been effective
when the client states,
21. A client with an ulcer related to Helicobacter pylori is treated with triple-drug
therapy. The nurse explains to the LPN that the drugs commonly included in this
regimen include:
22. A client vomiting bright red blood is admitted to the emergency department.
Which assessment should the nurse perform first?
5
24. A client who requires daily use of a nonsteroidal anti-inflammatory drug
(NSAID) for management of severe rheumatoid arthritis has recently
developed melena. The nurse will anticipate teaching the patient about
A. The use of OTC ranitidine to decrease the risk for peptic ulcers.
25. The health care provider prescribes antacids and Sucralfate for treatment
of a patients peptic ulcer. The nurse will teach the patient to take
27. A client came to the emergency department with severe abdominal pain
with rebound tenderness, anorexia, and chills. The vital signs include
temperature 101 F (38.3 C), pulse 130, respirations 34, and blood pressure
(BP) 82/50. Of the following collaborative interventions, which one should the
nurse implement first?
D. Obtain a computed tomography (CT) scan of the abdomen with and without contrast.
6
28. A client diagnosed with irritable bowel syndrome (IBS) tells the nurse,
My friends tell me this problem is all in my head. In caring for the client, the
nurse should
A. Discuss the new medication, Linaclotide, which may help with the condition.
B. Inform the patient that IBS has a specific, identifiable cause.
C. Explain that modifications to increase dietary fiber can control the symptoms.
D. Encourage the patient to express feelings and ask questions about IBS.
30. While obtaining a nursing history from a client with IBD, the nurse
recognizes that the patient most likely has ulcerative colitis rather than
Crohns disease when the patient reports experiencing
A. Weight loss.
B. Bloody stools.
C. Abdominal pain and cramping.
D. Disease onset at age 20.
31. A 26-year-old patient with Crohns disease has had frequent diarrhea and
a weight loss of 10 pounds (4.5 kg) over 2 months. The nurse anticipates the
medical regimen and plans to teach the patient about
A. Antibiotic therapy.
B. Fluid restriction.
C. Monoclonal antibodies.
D. Enteral feedings.
32. A patient presents with sudden onset of sharp twisting deep upper
abdominal pain that radiates to the back with nausea/ vomiting. You assess
hypoactive bowel sounds and abdominal tenderness. The provider orders an
IV infusion, and placement of an NG tube. . Which diagnostic tests are likely
at this time? Select all that apply
A. Serum amylase/lipase
B. Abdominal CT.
C. ERCP.
D. Abdominal ultrasound.
E. ABGs
7
33. James, age 38, is admitted for inpatient treatment for his alcoholism. His
employer told him to seek treatment or be fired. James says, I do not have a
problem with alcohol. I can handle my booze. My boss is a jerk The RNs best
response is:
34. Your postoperative assessment of a clients stoma is red and moist with
moderate edema and a small amount of bleeding. The nurse should
35. A patient has a newly formed ileostomy for treatment of ulcerative colitis.
In teaching the patient about the care of the ileostomy, the nurse informs the
patient about the need to
A. Restrict fluid intake to prevent constant liquid drainage from the stoma.
B. Change the pouch every day to prevent leakage of contents onto the skin.
C. Use care when eating high-fiber foods to avoid obstruction of the ileum.
D. Irrigate the ileostomy daily to avoid having to wear a drainage appliance.
36. When implementing the initial plan of care for a patient admitted with
acute diverticulitis, the nurse will
A. Administer IV fluids.
B. Order a diet high in fiber and fluids.
C. Give stool softeners.
D. Prepare the patient for colonoscopy.
8
38. You attended a staff education conference on substance abuse disorders.
Which psychiatric disorders are related to alcoholism?
40. After a patient with inflammatory bowel has had dietary teaching, which
food choice by the patient indicates that the teaching has been successful?
41. The RN and nursing assistant (NA) are caring for a patient with a paralytic
ileus. Which of these nursing activities is appropriate for the nurse to delegate
to the NA?
A. McBurneys point.
B. Rebound pain.
C. Rovsings sign.
D. Cullens sign.
9
43. A nurse in the operating room took a picture of the gallstones and posted
it on social media. What, if any, is the nurse in violation?
45. A patient with cirrhosis has 4+ pitting edema of the feet and legs
and massive ascites had a paracentesis. The priority intervention for
the nurse to monitor post procedure is:
A. Temperature.
B. Blood pressure.
C. Hematocrit.
D. Albumin level
46. Who of the following should the nurse first insert a gastric drainage (NG
tube)? Client who has:
A. Acute pancreatitis.
10
47. A patient with ascites is prescribed spironolactone and furosemide. LABS: a
serum sodium 135 mEq/L and serum potassium 3.2 mEq/L. Before notifying the
health care provider, the nurse should:
D. Withhold both drugs until talking with the health care provider.
49. A patient with cancer of the liver has severe ascites, and the health care
provider plans a paracentesis to relieve the fluid pressure on the diaphragm. To
prepare the patient for the procedure, the nurse will: select all that apply
50. A patient hospitalized with possible acute pancreatitis has severe abdominal
pain and nausea and vomiting. The nurse would expect the diagnosis to rule out
A. Peptic ulcer.
B. Alcoholism.
C. Gall stones.
D. Pregnancy.
11
51. The nurse identifies the collaborative problem of potential complication:
electrolyte imbalance for a patient with severe acute pancreatitis. Assessment
findings that alert the nurse to electrolyte imbalances associated with acute
pancreatitis include
C. Hypotension.
D. Hyperglycemia.
52. The health care provider prescribes pancreatin for a client with chronic
cystic fibrosis. The nurse teaches the patient that the drug is considered
effective if the patient experiences
A. Normal-appearing stools.
B. Decreased jaundice.
C. Improved appetite.
53. A patient who is admitted to the hospital with a sudden onset of severe
right upper-quadrant pain that radiates to the right shoulder is diagnosed with
cholecystitis. Which assessment information will be most important for the
nurse to report to the health care provider?
54. Diane, age 14 has been admitted to the psychiatric unit for anorexia
nervosa. She is emaciated and refuses to eat. What is the most appropriate
response the RN?
B. If you continue to refuse to take food orally, you will need to be fed through a
nasogastric tube.
C. You might as well leave if you are not going to follow your therapy regimen.
D. You dont have to eat if you so not want to. It is your choice, but we will have to
lock your bathroom.
12
55. You are a community health nurse in Flint, MI evaluating the parents of a
child who was treated with succimer chelation. Which statement by the parent
is the best indicator of compliance regimen?
56. The nurse is caring for a client with portal systemic encephalopathy. The
nurse would follow up on which top 5 sign/symptoms? Select all (5)
A. Sleep disturbance.
C. Positive Babinski.
D. Slurred speech
E. Asterixis
G. Tetany
57. The newborn has not had a bowel movement in 48 hours since birth.
Abdomen is soft, distended with diminished bowel sounds. The nurse should:
A. Male baby with a sausage like mass, knees draw and vomiting bile.
C. Male baby with a palpable olive shape mass to the right of the umbilicus.
D. Female baby born preterm, poor weight gain and passive regurgitation.
13
59. A newborn with a cleft lip is being fed by the mother. The nurse knows
that this can be challenging. Which behavior by the mother demonstrates
effective feeding pattern?
B. Mother uses a bulb syringe when the milk escapes through the nose.
60. Which action should the nurse include in the care plan of a client with
advanced liver disease?
14