1.

Pancreatitis is commonly characterized by:

A. Edema and inflammation.
B. Pleural effusion.
C. Sepsis.
D. Disseminated intravascular coagulopathy.

2. A major symptom of pancreatitis that brings the patient to

medical care is:
A. Severe abdominal pain.
B. Fever.
C. Jaundice.
D. Mental agitation.

3. The nurse should assess for an important early indicator of

acute pancreatitis, which is a prolonged and elevated level of:
A. Serum calcium.
B. Serum lipase.
C. Serum bilirubin.
D. Serum amylase.

4. Nursing measures for pain relief for pancreatitis include:

A. Encouraging bed rest to decrease metabolic rate.
B. Teaching the patient about the correlation between
alcohol intake and pain.
C. Withholding oral feedings to limit the release of secretin.
D. All of the above.

5. Which of the following diagnostic studies could identify an

increase in the diameter of the pancreas?
A. X-ray.
B. Hemoglobin and hematocrit levels.

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 C. Ultrasound.
D. Serum amylase.

6. A positive Rovsing’s sign is indicative of appendicitis. The

nurse knows to assess for this indicator by palpating the:
A. Right lower quadrant.
B. Left lower quadrant.
C. Right upper quadrant.
D. Left upper quadrant.

7. During assessment, the nurse is looking for positive indicators

of appendicitis, which include all of the following except:
A. A low-grade fever.
B. Abdominal tenderness on palpation.
C. Thrombocytopenia.
D. Vomiting.

8. On physical examination, the nurse should be looking for

tenderness on palpation at McBurney’s point, which is
located at the:
A. Left lower quadrant.
B. Left upper quadrant.
C. Right lower quadrant.
D. Right upper quadrant.

9. Symptoms suggestive of acute appendicitis include:

A. A positive Rovsing’s sign.
B. Increased abdominal pain when coughing.
C. Tenderness around the umbilicus.
D. All of the above.

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10. Preparation for an appendectomy includes:
A. An intravenous infusion.
B. Prophylactic antibiotic therapy.
C. Salicylates to lower an elevated temperature.
D. All of the above.

11. During assessment, the nurse should be looking for additional

symptoms diagnostic of peritonitis, which include:
A. Abdominal rigidity.
B. Diminished peristalsis.
C. Leukocytosis.
D. All of the above.

12. The nurse should continue to assess for the common

complications of:
A. Abscess formation.
B. Respiratory arrest.
C. Umbilical hernia.
D. Urinary tract infection.

13. The major cause of death from peritonitis is:

A. Hypovolemia.
B. Sepsis.
C. Shock.
D. Abscess formation.

14. The following are results of diagnostic and imaging studies in

a patient with peritonitis except:
A. Elevated WBC.
B. Air and fluid levels on abdominal xray.
C. Leukopenia.

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 D. Intra-abdominal abscess on MRI.

15. Peritonitis occurs in which part of the GI system?

A. Peritoneum.
B. Appendix.
C. Duodenum.
D. Sigmoid colon

16. Which assessment finding indicates that lactulose is effective

in decreasing the ammonia level in the client with hepatic
encephalopathy?
A. Passage of two or three soft stools daily.
B. Evidence of watery diarrhea.
C. Daily deterioration in the client’s handwriting.
D. Appearance of frothy, foul-smelling stools.

17. For a client with hepatic cirrhosis who has altered clotting
mechanisms, which intervention would be most important?
A. Allowing complete independence of mobility.
B. Applying pressure to injection sites.
C. Administering antibiotics as prescribed.
D. Increasing nutritional intake.

18. A client with advanced cirrhosis has been diagnosed with

hepatic encephalopathy. The nurse expects to assess for:
A. Malaise.
B. Stomatitis.
C. Hand tremors.
D. Weight loss.

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19. A client diagnosed with chronic cirrhosis who has ascites and
pitting peripheral edema also has hepatic encephalopathy.
Which of the following nursing interventions are appropriate
to prevent skin breakdown?
A. Range of motion every 4 hours.
B. Turn and reposition every 2 hours.
C. Abdominal and foot massages every 2 hours.
D. Sit in chair for 30 minutes each shift.

20. The nurse must be alert for complications with Sengstaken-

Blakemore intubation including:
A. Pulmonary obstruction.
B. Pericardiectomy syndrome.
C. Pulmonary embolization.
D. Cor pulmonale.

21. Ben injects his insulin as prescribed, but then gets busy and
forgets to eat. What will the best assessment of the nurse
reveal?
A. The client will be very thirsty.
B. The client will complain of nausea.
C. The client will need to urinate.
D. The client will have moist skin.

22. Jansen receives metformin (Glucophage). What will the best

plan of the nurse include with regard to patient education
with this drug? Select all that apply.
A. It stimulates the pancreas to produce more insulin.
B. It must be taken with meals.
C. It decreases sugar production in the liver.
D. It inhibits absorption of carbohydrates.
E. It reduces insulin resistance.

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23. Nurse Andy has finished teaching a client with diabetes
mellitus how to administer insulin. He evaluates the learning
has occurred when the client makes which statement?
A. “I should check my blood sugar immediately prior to the
administration.”
B. “I should provide direct pressure over the site following
the injection.”
C. “I should use the abdominal area only for insulin
injections.”
D. “I should only use calibrated insulin syringe for the
injections.”

24. An older woman with diabetes mellitus visits the clinic

concerning her condition. Of which of the following
symptoms might an older woman with diabetes mellitus
complain?
A. Anorexia
B. Pain intolerance
C. Weight loss
D. Perineal itching

25. During a visit to the hospital, the student nurses are asked
which of the following persons would most likely be
diagnosed with diabetes mellitus. They are correct if they
answered a 44-year-old:
A. Caucasian woman.
B. Asian woman.
C. African-American woman.
D. Hispanic male.

26. The following are the functions of the endocrine system,

except?
A. Regulates immune system
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 B. Controls reproductive function
C. Regulate heart rate and blood pressure
D. Water balance
E. Direct blood flow

27. The primary function of T3 and T4 is to:

A. Reduce blood glucose levels
B. Release calcitonin
C. Regulate bone growth
D. Increase metabolic rate

28. Antidiuretic hormone and oxytocin are stored and released

by the:
A. Adrenal cortex
B. Posterior pituitary gland
C. Thyroid gland
D. Pineal gland

29. Which hormone stimulates the male testes to produce sperm

and stimulates the development of the follicle in the female
on a monthly cycle.
A. Luteinizing hormone
B. Somatostatin
C. Follicle-stimulating hormone
D. Thymosin

30. A client with a history of hypertension is admitted due to

primary hyperaldosteronism. This diagnosis indicates that the
client’s hypertension is caused by excessive hormone
secretion from which gland?
A. Pancreas

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 B. Adrenal cortex
C. Thymus gland
D. Adrenal medulla

31. The mineralocorticoids produced by the adrenal glands are

produced within the?
A. Parafollicular cells
B. Zona reticularis
C. Zona glomerulosa
D. Zona fasciculata

32. Which of the following glands is both an endocrine gland and

an exocrine gland, except?
A. Pancreas
B. Kidney
C. Gonads
D. Pituitary gland

33. Which of the following is not true with melatonin?

A. Melatonin induces heat loss, reduces arousal and related
brain activity and delays production of cortisol.
B. It helps regulate biological rhythms such as sleep and
wake cycles.
C. The secretion of melatonin is inhibited by darkness and
triggered by light.
D. The pineal gland produces and secretes the hormone.

34. Part of the effect of growth hormone is influenced by a group

of protein chemical signals called:
A. Somatomedin-C.
B. Gonadotropins

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 C. Prostaglandin
D. Prolactin

35. A client arrived at the emergency department with a possible

diagnosis of hyperparathyroidism. The nurse anticipates
which serum electrolytes finding would be abnormal? Select
all that apply
A. Sodium
B. Calcium
C. Chloride
D. Potassium
E. Phosphorus

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