Set C

Review Results Assessment SET-C

Email Address: erikajanern@icloud.com

Full Name: Purificacion, Erika Jane
: mindwebph
Respondent ID: 38381
Date Started: 10/09/2023 03:17:42 PM
Date Completed: 10/09/2023 04:03:32 PM
Attempt: 1

Question Topic
Question
Num
Respondent's Answer Correct Answer
Set C
1. A client has been diagnosed with adenocarcinoma of the stomach and is scheduled to undergo a subtotal gastrectomy, Billroth 2
procedure. During pre- operative teaching the nurse is reinforcing information about the surgical procedure. Which of the following
explanations is most appropriate?

( ) The procedure will result in enlargement of the pyloric ( ) The procedure will result in enlargement of the pyloric
sphincter sphincter
(X) The procedure will result in anastomosis of the gastric stump (X) The procedure will result in anastomosis of the gastric stump
to the jejunum to the jejunum
( ) The procedure will result in removal of duodenum ( ) The procedure will result in removal of duodenum
( ) The procedure will result in repositioning of the vagus nerve ( ) The procedure will result in repositioning of the vagus nerve
2. As a result of gastric resection, the client is at risk for development of Dumping syndrome. The nurse would prepare a plan of care
for this client based on knowledge that this problem stems primarily from which of the following gastrointestinal changes?

( ) Excess secretion of digestive enzymes in the intestines ( ) Excess secretion of digestive enzymes in the intestines
(X) Rapid emptying of stomach content into the small intestine (X) Rapid emptying of stomach content into the small intestine
( ) Excess glycogen production by the liver ( ) Excess glycogen production by the liver
( ) Loss of gastric enzymes ( ) Loss of gastric enzymes
3. The client is scheduled to have an upper GIT series. Which of the following treatments should the nurse anticipate after the
examination?

(X) Administering a laxative (X) Administering a laxative

( ) Placing the client on a clear liquid diet ( ) Placing the client on a clear liquid diet
( ) Giving the client a tap water enema ( ) Giving the client a tap water enema
( ) Starting an IV infusion ( ) Starting an IV infusion
4. Which goal for the client's care should take priority during the first day of hospitalization for an exacerbation of ulcerative colitis?

( ) Promoting self-care and independence ( ) Promoting self-care and independence

( ) Managing diarrhea (X) Managing diarrhea
(X) Maintaining adequate nutrition ( ) Maintaining adequate nutrition
( ) Promoting rest and comfort ( ) Promoting rest and comfort

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 5. A client with Crohn's disease experiences rectal bleeding along with 15 - 20 watery stools per day. Which of the following signs
would be indicative of dehydration?

(X) Sunken eyeballs (X) Sunken eyeballs

( ) Decreased pulse rate ( ) Decreased pulse rate
( ) Moist skin ( ) Moist skin
( ) Pitting edema ( ) Pitting edema
6. Which of the following medications would the nurse anticipate administering to a client with diverticular disease?

(X) Psyllium hydrophilic mucilloid (X) Psyllium hydrophilic mucilloid

( ) Diphenoxylate with atropine sulfate ( ) Diphenoxylate with atropine sulfate
( ) Diazepam( Valium) ( ) Diazepam( Valium)
( ) Aluminum hydroxide (Amphojel) ( ) Aluminum hydroxide (Amphojel)
7. If a gallstone becomes lodged in the common bile duct , the nurse should anticipate that the client's stools would most likely become
what color?

( ) Green ( ) Green
(X) Gray (X) Gray
( ) Black ( ) Black
( ) Brown ( ) Brown
8. When the client's common bile duct is obstructed , the nurse should evaluate the client for signs of which of the following
complications?

( ) Respiratory distress ( ) Respiratory distress

( ) Circulatory overload ( ) Circulatory overload
( ) Urinary tract infection ( ) Urinary tract infection
(X) Prolonged bleeding time (X) Prolonged bleeding time
9. A client undergoes a traditional cholecystectomy and choledochotomy and returns from surgery with a T- tube. To evaluate the
effectiveness of the T-tube, the nurse should understand that the primary reason for the T-tube is to accomplish which of the
following goals?

( ) Promote wound drainage ( ) Promote wound drainage

( ) Provide a way to irrigate the tract ( ) Provide a way to irrigate the tract
(X) Minimize the passage of bile into the duodenum (X) Minimize the passage of bile into the duodenum
( ) Prevent the bile into the duodenum ( ) Prevent the bile into the duodenum
10. After a cholecystectomy it is recommended that the client follows a low-fat diet at home. Which of the following foods would be most
appropriate to include in a low-fat diet?

( ) Cheese omelet ( ) Cheese omelet

(X) Peanut butter ( ) Peanut butter
( ) Ham salad sandwich ( ) Ham salad sandwich
( ) Roasted beef (X) Roasted beef
11. When providing care for a client with acute pancreatitis, the nurse would anticipate which of the following orders?

( ) Increase oral intake 3000 ml every 24 hours ( ) Increase oral intake 3000 ml every 24 hours
(X) Insert a nasogastric tube and connect it to low suction (X) Insert a nasogastric tube and connect it to low suction
( ) Place the client in the reverse trendelenburg position ( ) Place the client in the reverse trendelenburg position
( ) Place the client on precautions ( ) Place the client on precautions
12. The nurse notes that a client with acute pancreatitis occasionally experiences muscle twitching and jerking. How should the nurse
interpret the significance of these symptoms?

( ) The client maybe developing hypocalcemia (X) The client maybe developing hypocalcemia
( ) The client is experiencing a reaction to meperidine ( ) The client is experiencing a reaction to meperidine
(X) The client has a nutritional imbalance ( ) The client has a nutritional imbalance
( ) The client needs a muscle relaxant to help him rest ( ) The client needs a muscle relaxant to help him rest

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 13. Pancreatic enzyme replacements are ordered for the client with chronic pancreatitis. When should the nurse instruct the client to
take them to obtain the most therapeutic effect?

( ) Three times daily between meals ( ) Three times daily between meals
( ) With each meal and snack (X) With each meal and snack
(X) In the morning and at bedtime ( ) In the morning and at bedtime
( ) Every 4 hours , at specified times ( ) Every 4 hours , at specified times
14. The nurse should teach the client with chronic pancreatitis to monitor the effectiveness of pancreatic enzyme replacement therapy
by doing which of the following?

( ) Monitoring fluid intake ( ) Monitoring fluid intake

( ) Performing regular glucose fingerstick tests ( ) Performing regular glucose fingerstick tests
(X) Observing stools for steatorrhea (X) Observing stools for steatorrhea
( ) Testing urine for ketones ( ) Testing urine for ketones
15. The nurse is assessing a client who is in the early stage of cirrhosis of the liver . Which of the following signs would the nurse
anticipate finding?

( ) Peripheral edema ( ) Peripheral edema

( ) Ascites ( ) Ascites
(X) Anorexia (X) Anorexia
( ) Jaundice ( ) Jaundice
16. Which diet should be implemented to a client who is in the early stages of cirrhosis?

(X) High calorie, high carbohydrates (X) High calorie, high carbohydrates
( ) High protein, low fat ( ) High protein, low fat
( ) Low fat, low protein ( ) Low fat, low protein
( ) High CHO, low sodium ( ) High CHO, low sodium
17. The client has developed ascites. The nurse should recognize that the pathologic basis for the development of ascites in clients with
cirrhosis is portal hypertension and:

( ) An excess serum sodium level ( ) An excess serum sodium level

( ) An increased metabolism of aldosterone ( ) An increased metabolism of aldosterone
( ) A decreased flow of hepatic lymph ( ) A decreased flow of hepatic lymph
(X) A decreased serum albumin (X) A decreased serum albumin
18. A client with cirrhosis vomits bright red blood and the physician decides to insert a Sengstaken - Blakemore tube. The nurse should
explain to the client that the tube acts by:

( ) Providing a large diameter for effective gastric lavage ( ) Providing a large diameter for effective gastric lavage
( ) Applying direct pressure to gastric bleeding sites ( ) Applying direct pressure to gastric bleeding sites
( ) Blocking blood flow to gastric bleeding sites ( ) Blocking blood flow to gastric bleeding sites
(X) Apply direct pressure to ruptured esophageal varices (X) Apply direct pressure to ruptured esophageal varices
19. The physician orders oral neomycin and neomycin enema for the client with cirrhosis. The nurse understands that the purpose of
this therapy is to:

( ) Reduce abdominal pressure ( ) Reduce abdominal pressure

( ) Prevent straining during defecation ( ) Prevent straining during defecation
(X) Block ammonia formation (X) Block ammonia formation
( ) Reduce bleeding within the intestine ( ) Reduce bleeding within the intestine
20. A client's serum ammonia level is elevated and the physician orders 30 ml. of lactulose. Which of the following side- effects of this
drug would the nurse expect to see?

( ) Increased urine output ( ) Increased urine output

( ) Improved level of consciousness ( ) Improved level of consciousness
(X) Increased bowel movements (X) Increased bowel movements
( ) Nausea and vomiting ( ) Nausea and vomiting

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 21. The nurse is providing discharge instructions for the client with cirrhosis. Which of the following statements best indicates that the
client has understood the teaching?

( ) "I should eat a high protein, high- CHO diet to provide ( ) "I should eat a high protein, high- CHO diet to provide
energy" energy"
( ) "It is safer for me to take acetaminophen for pain instead of ( ) "It is safer for me to take acetaminophen for pain instead of
aspirin" aspirin"
(X) "I should avoid constipation to decrease chances of (X) "I should avoid constipation to decrease chances of
bleeding" bleeding"
( ) "If I get enough rest and follow my diet it is possible for my ( ) "If I get enough rest and follow my diet it is possible for my
cirrhosis to be cured" cirrhosis to be cured"
22. The nurse finds a container with the client's urine specimen sitting on a corner in the bathroom. The client states that the specimen
has been sitting in the bathroom for at least 2 hours. What would be the nurse's most appropriate action?

(X) Discard the urine and obtain a new specimen (X) Discard the urine and obtain a new specimen
( ) Send the urine to the laboratory as quickly as possible ( ) Send the urine to the laboratory as quickly as possible
( ) Add fresh urine to the collected specimen and send the ( ) Add fresh urine to the collected specimen and send the
specimen to the laboratory specimen to the laboratory
( ) Refrigerate the specimen until it can be transported to the ( ) Refrigerate the specimen until it can be transported to the
laboratory laboratory
23. The nurse initiates the client's first hemodialysis treatment. The client develops a headache, confusion and nausea. These
symptoms indicate which of the following potential complications?

(X) Disequilibrium syndrome (X) Disequilibrium syndrome

( ) Myocardial infarction ( ) Myocardial infarction
( ) Air embolism ( ) Air embolism
( ) Peritonitis ( ) Peritonitis
24. The nurse is instructing the student nurse on the correct technique for obtaining a clean - catch urine culture from a client. Which of
the following statements indicates that the student nurse has understood the instructions?

( ) "I will have the client completely empty her bladder into the ( ) "I will have the client completely empty her bladder into the
specimen cup" specimen cup"
( ) "I will need to catheterize the client to get the urine ( ) "I will need to catheterize the client to get the urine
specimen" specimen"
(X) "I will ask the client to cleanse her labia, void into the toilet, (X) "I will ask the client to cleanse her labia, void into the toilet,
and then into the specimen cup" and then into the specimen cup"
( ) "I will obtain the specimen in the afternoon after the client ( ) "I will obtain the specimen in the afternoon after the client
has had plenty of fluids" has had plenty of fluids"
25. The client with chronic renal failure complains of feeling nauseated at least part of everyday. The nurse should explain that the
nausea is the result of:

( ) Acidosis caused by the medications ( ) Acidosis caused by the medications

(X) Accumulation of waste products in the blood (X) Accumulation of waste products in the blood
( ) Chronic anemia and fatigue ( ) Chronic anemia and fatigue
( ) Excess fluid load ( ) Excess fluid load
26. The dialysate solution is warmed before use in peritoneal dialysis primarily to:

(X) Encourage the removal of serum urea (X) Encourage the removal of serum urea
( ) Force potassium back into cells ( ) Force potassium back into cells
( ) Add extra warmth to the body ( ) Add extra warmth to the body
( ) Promote abdominal muscle relaxation ( ) Promote abdominal muscle relaxation
27. During dialysis, the nurse observes that the flow of dialysate stops before all the solution has drained out. The nurse should:

( ) Have the client sit in a chair ( ) Have the client sit in a chair
(X) Turn the client from side to side (X) Turn the client from side to side
( ) Reposition the peritoneal catheter ( ) Reposition the peritoneal catheter
( ) Have the client walk ( ) Have the client walk

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 28. Which of the following nursing interventions should be included in the client's care plan during dialysis therapy?

( ) Limit the client's visitors ( ) Limit the client's visitors

(X) Monitor client's BP (X) Monitor client's BP
( ) Pad the side rails of the bed ( ) Pad the side rails of the bed
( ) Keep the client NPO ( ) Keep the client NPO
29. What is the most potentially dangerous complication of peritoneal dialysis?

( ) Abdominal pain ( ) Abdominal pain

( ) GIT bleeding ( ) GIT bleeding
(X) Peritonitis (X) Peritonitis
( ) Muscle cramps ( ) Muscle cramps
30. Aluminum hydroxide (Amphojel) is prescribed for the client with chronic renal failure (CRF) to take at home. What is the purpose of
giving this drug to a client with CRF?

( ) To relieve the pain of gastric hyperacidity ( ) To relieve the pain of gastric hyperacidity
( ) To prevent Curling's stress ulcers ( ) To prevent Curling's stress ulcers
(X) To bind phosphate in the intestines (X) To bind phosphate in the intestines
( ) To reverse metabolic acidosis ( ) To reverse metabolic acidosis
31. The client with chronic renal failure told the nurse, he takes milk of magnesia at home for constipation. The nurse suggests that the
client switch to psyllium hydrophilic muciloid because:

( ) Milk of magnesia can cause magnesium intoxication (X) Milk of magnesia can cause magnesium intoxication
(X) Milk of magnesia is too harsh on the bowel ( ) Milk of magnesia is too harsh on the bowel
( ) Metamucil is more palatable ( ) Metamucil is more palatable
( ) Milk of magnesia is high in sodium ( ) Milk of magnesia is high in sodium
32. The nurse helps the client with CRF develop a home diet plan with the goal of helping the client maintain adequate nutritional
intake. Which of the following diets would be most appropriate for a client with CRF ?

( ) High CHO, High CHON ( ) High CHO, High CHON

( ) High Ca, High K, High CHON ( ) High Ca, High K, High CHON
(X) Low CHON,Low NA, Low K (X) Low CHON,Low NA, Low K
( ) Low CHON, High K ( ) Low CHON, High K
33. Sexual problems can be troublesome to clients with CRF. Which one of the following strategies would be most useful in helping a
client cope with such a problem?

( ) Help the client to accept that sexual activity will be decreased ( ) Help the client to accept that sexual activity will be decreased
( ) Tell the client to plan rest periods after sexual activity ( ) Tell the client to plan rest periods after sexual activity
(X) Suggest using alternative forms of sexual expression and (X) Suggest using alternative forms of sexual expression and
intimacy intimacy
( ) Suggest that the client avoid sexual activity to prevent ( ) Suggest that the client avoid sexual activity to prevent
embarrassment embarrassment
34. The nurse is planning to teach the client with acute glomerulonephritis about dietary restrictions. The nurse should include in the
plan for which of the following disorders?

( ) Limit fluid intake to 500 mL per day. ( ) Limit fluid intake to 500 mL per day.
(X) Restrict protein-intake by limiting meats and other high (X) Restrict protein-intake by limiting meats and other high
protein foods. protein foods.
( ) Increase intake of high-fiber foods, such as bran cereal. ( ) Increase intake of high-fiber foods, such as bran cereal.
( ) Increase intake of potassium-rich food such as bananas and ( ) Increase intake of potassium-rich food such as bananas and
cantaloupe. cantaloupe.
35. The nurse would assess a client with kidney stones for which of the following to best determine whether the client is developing
renal colic?

(X) Flank pain (X) Flank pain

( ) Difficult urination ( ) Difficult urination
( ) Absence of urine ( ) Absence of urine
( ) Headache ( ) Headache

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 36. A client seen in the emergency department complaints of painful urination, frequency, and urgency. Which of the following
conditions would the nurse suspect?

( ) Renal calculi ( ) Renal calculi

(X) Cystitis (X) Cystitis
( ) Glomerulonephritis ( ) Glomerulonephritis
( ) Polycystic kidney disease ( ) Polycystic kidney disease
37. When caring for a client diagnosed with end-stage renal failure, which of the following diets should the nurse recommend?

( ) Increased protein, decreased carbohydrates. ( ) Increased protein, decreased carbohydrates.

(X) Restricted protein, increased carbohydrates. (X) Restricted protein, increased carbohydrates.
( ) Oxybutinin chloride (Ditropan) ( ) Oxybutinin chloride (Ditropan)
( ) Restricted phosphorus and magnesium. ( ) Restricted phosphorus and magnesium.
38. The client diagnosed with cystitis will be given a prescription for an antibiotic. The nurse explains to the client that which of the
following medications that is combined with the antibiotic will reduce the symptom os dysuria?

(X) Phenazopyridine (Pyridium) (X) Phenazopyridine (Pyridium)

( ) Bethanechol chloride (Urecholine) ( ) Bethanechol chloride (Urecholine)
39. The client has developed urolithiasis, and it is determined that the client has uric acid stone. The nurse instructs the client to limit
which of the following foods in the diet that was previously eaten regularly?

( ) Orange ( ) Orange
( ) Cheese ( ) Cheese
(X) Liver (X) Liver
( ) Eggs ( ) Eggs
40. A client complaints of inability to inhibit urine flow long enough to reach the toilet. The nurse documents the presence of which type
of urinary incontinence?

( ) Stress ( ) Stress
( ) Reflex ( ) Reflex
(X) Urge (X) Urge
( ) Functional ( ) Functional
41. The nurse is caring for a client with a history of renal disease. The nurse most closely monitors the client for signs of nephrotoxicity
if the client is ordered to received which of the following medications?

(X) Aminoglycoside antibiotics (X) Aminoglycoside antibiotics

( ) Aspirin-containing drugs ( ) Aspirin-containing drugs
( ) Loop Diuretics ( ) Loop Diuretics
( ) Potassium supplements. ( ) Potassium supplements.
42. The client with hypothyroidism is taking Synthroid(levothyroxine). Which of the following should be checked before giving the
medication?

(X) Pulse and blood pressure (X) Pulse and blood pressure
( ) BP and temperature ( ) BP and temperature
( ) Respiration and BP ( ) Respiration and BP
( ) Pulse and respiration ( ) Pulse and respiration
43. The nurse anticipates that a client being evaluated for erectile dysfunction may receive a prescription for which of the following
medications?

( ) Propranolol ( ) Propranolol
( ) diazepam ( ) diazepam
(X) sildenafil (X) sildenafil
( ) Progesterone ( ) Progesterone

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 44. The nurse is caring for a client with diverticulitis. Which of the following diets would be essential to include in the client's plan of
care?

( ) High fiber diet ( ) High fiber diet

( ) Low-fat, high-carbohydrate, and high-protein diet, avoiding ( ) Low-fat, high-carbohydrate, and high-protein diet, avoiding
alcohol alcohol
(X) High-calorie, high-carbohydrate and low-fat diet ( ) High-calorie, high-carbohydrate and low-fat diet
( ) Diet high in protein and calories, low in residue, and milk free (X) Diet high in protein and calories, low in residue, and milk free
45. The nurse is collecting a nursing history from a client suspected of having an obstruction of the alimentary canal. Which of the
following question should the nurse ask first to elicit the most accurate assessment?

( ) "Are you frequently awakened during the middle of the night ( ) "Are you frequently awakened during the middle of the night
because of pain?" because of pain?"
( ) "Have you recently lost a lot of weight?" ( ) "Have you recently lost a lot of weight?"
(X) "Do you have difficulty swallowing food or liquids?" (X) "Do you have difficulty swallowing food or liquids?"
( ) "Have you experienced any bleeding?" ( ) "Have you experienced any bleeding?"
46. When preparing a client for insertion of NG tube , it is essential for the nurse to include which of the following aspects of the
procedure?

( ) Instruct the client to avoid swallowing when the tube is felt in ( ) Instruct the client to avoid swallowing when the tube is felt in
the backof the throat. the backof the throat.
( ) Assist the client to assume a left- side lying or recumbent ( ) Assist the client to assume a left- side lying or recumbent
position position
( ) Tilt the client's head back when the tube is being inserted ( ) Tilt the client's head back when the tube is being inserted
(X) Measure the tube from the tip of the nose to the earlobe to (X) Measure the tube from the tip of the nose to the earlobe to
the xiphoid process the xiphoid process
47. The nurse monitors a client for signs of Dumping syndrome. The following manifestations are expected by the nurse, except:

(X) Hematemesis (X) Hematemesis

( ) Vertigo ( ) Vertigo
( ) Sweating ( ) Sweating
( ) Diarrhea ( ) Diarrhea
48. A client scheduled for a vagotomy asks the nurse what a vagotomy is. Which of the following statements by the nurse best
describes the purpose of vagotomy?

( ) "It decreases food transit time in the stomach" ( ) "It decreases food transit time in the stomach"
( ) "It regenerates the gastric mucosa" ( ) "It regenerates the gastric mucosa"
(X) "It reduces the stimulus to acid secretion" (X) "It reduces the stimulus to acid secretion"
( ) "It stops stress- related reactions" ( ) "It stops stress- related reactions"
49. The nurse is admitting a client with a diagnosis of preicteric hepatitis. Which of the following would the nurse expect to be the
priority assessment finding?

( ) clay- colored stools ( ) clay- colored stools

(X) anorexia (X) anorexia
( ) jaundice ( ) jaundice
( ) pruritus ( ) pruritus
50. The nurse performs which part of the GIT assessment first?

( ) auscultation ( ) auscultation
( ) palpation ( ) palpation
(X) inspection (X) inspection
( ) percussion ( ) percussion

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 51. When preparing a client for a colonoscopy, it would be essential for the nurse to explain which of the following aspects of the
procedure?

( ) stools will be white until all the barium is expelled ( ) stools will be white until all the barium is expelled
( ) bowel sounds will be monitored hourly for 12 hours ( ) bowel sounds will be monitored hourly for 12 hours
( ) the client will be positioned on the right side with the legs ( ) the client will be positioned on the right side with the legs
straight straight
(X) the client must begin a clear liquid diet beginning at noon the (X) the client must begin a clear liquid diet beginning at noon the
day before day before
52. A client experiences regurgitation and dyspepsia. The nurse assists the client to assume an upright position . Which of the following
statements by the nurse would best describe the purpose of this measure?

(X) "It prevents the flow of gastric contents into the esophagus" (X) "It prevents the flow of gastric contents into the esophagus"
( ) "It decreases the inflammatory changes in the esophagus" ( ) "It decreases the inflammatory changes in the esophagus"
( ) "It enhances and strengthens esophageal peristalsis" ( ) "It enhances and strengthens esophageal peristalsis"
( ) "It increases the lower esophageal pressure" ( ) "It increases the lower esophageal pressure"
53. Because the client has Crohn's disease , plans for nursing intervention should include:

( ) weight reduction measures and low- calorie diet ( ) weight reduction measures and low- calorie diet
( ) frequent application of lubricant lotion and discouraging ( ) frequent application of lubricant lotion and discouraging
scratching. scratching.
( ) Teaching the importance of follow- up liver function test after ( ) Teaching the importance of follow- up liver function test after
discharge discharge
(X) Perineal care and restoration of fluids and electrolytes (X) Perineal care and restoration of fluids and electrolytes
54. The nurse is evaluating the pain complaints of four clients. Which client does the nurse report to the physician as indicative of PUD?

( ) Low, colicky abdominal pain ( ) Low, colicky abdominal pain

(X) A gnawing epigastric pain relieved by food (X) A gnawing epigastric pain relieved by food
( ) Left upper quadrant pain that radiates to the back ( ) Left upper quadrant pain that radiates to the back
( ) Right upper quadrant pain- radiating to the right shoulder ( ) Right upper quadrant pain- radiating to the right shoulder
55. The nurse is assessing a client postoperatively following a hemorrhoidectomy. Which of the following assessments would be most
important for the nurse to include?

( ) The client's ability to assume a sitting position ( ) The client's ability to assume a sitting position
( ) The degree of embarrassment the client expresses ( ) The degree of embarrassment the client expresses
(X) Inspection of the rectal area for bleeding (X) Inspection of the rectal area for bleeding
( ) Presence of nausea and vomiting ( ) Presence of nausea and vomiting
56. The nurse is caring for a client two hours after hemorrhoidectomy. The client asks the nurse , "Should I be having severe pain?" The
most appropriate response by the nurse would be:

(X) "Yes and I'll get you your pain medication" (X) "Yes and I'll get you your pain medication"
( ) "This is a minor surgery and the pain is also minor" ( ) "This is a minor surgery and the pain is also minor"
( ) "I'll call your physician because I don't know why you are ( ) "I'll call your physician because I don't know why you are
having so much pain" having so much pain"
( ) "Try changing your position and take some deep breaths to ( ) "Try changing your position and take some deep breaths to
relax you" relax you"
57. A client with a colostomy is experiencing an increased odor and asks the nurse what is contributing to this. The most appropriate
response by the nurse is:

( ) "There are no foods that affect odor"
(X) "Food such as eggs, asparagus, fish, and brocolli will
increase the odor"
( ) "The odor is normal but a pouch deodorant will help"
( ) "changing the pouch and washing the stoma daily will
eliminate the odor"
( ) "There are no foods that affect odor"
(X) "Food such as eggs, asparagus, fish, and brocolli will
increase the odor"
( ) "The odor is normal but a pouch deodorant will help"
( ) "changing the pouch and washing the stoma daily will
eliminate the odor"

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 58. The nurse evaluates which of the following clients to be a greatest risk for developing Laennec's cirrhosis?

(X) A 55 - year- old male who has chronic alcoholism (X) A 55 - year- old male who has chronic alcoholism
( ) A 28 year - old male who had a recent exposure to a ( ) A 28 year - old male who had a recent exposure to a
hepatotoxic drug hepatotoxic drug
( ) A 70 year - old male who has a history of right- sided heart ( ) A 70 year - old male who has a history of right- sided heart
failure failure
( ) A 40 year - old female who has a biliary obstruction ( ) A 40 year - old female who has a biliary obstruction
59. Mr. Cabarubias is diagnosed with compartment syndrome of his right arm. To decrease tissue pressure and maintain arterial
perfusion to the lower arm, the nurse would prepare to assist the doctor in:

( ) Giving vasodilators I.V. ( ) Giving vasodilators I.V.

(X) Splitting or removing the cast (X) Splitting or removing the cast
( ) Taking him to the operating room ( ) Taking him to the operating room
( ) Elevating the arm on a pole ( ) Elevating the arm on a pole
60. The nurse reinforces the doctor's description of a fasciotomy for the patient . When a fasciotomy is performed to alleviate
compartment syndrome, the fascia is opened along the length of the muscle compartment and:

( ) The skin is sutured loosely ( ) The skin is sutured loosely

( ) A pressure dressing is applied ( ) A pressure dressing is applied
(X) The skin is left open (X) The skin is left open
( ) A skin graft is placed ( ) A skin graft is placed
61. SITUATION: Mr. Reyes comes to his doctor's office complaining of the inability to bear weight on his right foot. Assessment reveals
swelling and tenderness of the right great toe. The diagnosis of gout is made.

Mr. Reyes has blood tests done to confirm the diagnosis of gout. The tests should include :

( ) CBC and creatinine level ( ) CBC and creatinine level

(X) Uric acid level and ESR (X) Uric acid level and ESR
( ) Rheumatoid factor and RBC count ( ) Rheumatoid factor and RBC count
( ) Glucose and calcium levels ( ) Glucose and calcium levels
62. Mr. Reyes' gout is probably due to:

(X) His long term use of hydrochlorothiazide (X) His long term use of hydrochlorothiazide
( ) His history of heart failure ( ) His history of heart failure
( ) Inactivity ( ) Inactivity
( ) A low protein diet ( ) A low protein diet
63. The goal of drug therapy during an acute episode of gout is to:

(X) Relieve pain and inflammation as soon as possible (X) Relieve pain and inflammation as soon as possible
( ) decrease uric acid blood levels ( ) decrease uric acid blood levels
( ) prevent infection ( ) prevent infection
( ) prevent kidney damage ( ) prevent kidney damage
64. The nurse assess which of the following clients to most likely develop a problem with constipation?

( ) A client who consumes a high- fiber diet ( ) A client who consumes a high- fiber diet
( ) A client who is receiving Bactrim ( ) A client who is receiving Bactrim
(X) A client who is receiving Bentyl (X) A client who is receiving Bentyl
( ) A client who has a 1,500 ml of fluid intake per day. ( ) A client who has a 1,500 ml of fluid intake per day.
65. Which of the following should be included as part of the home care instructions for a patient with epididymitis and orchitis?

(X) Take prescribed antibiotics (X) Take prescribed antibiotics

( ) Undertake lifting exercises ( ) Undertake lifting exercises
( ) Apply ice to area after scrotal swelling subsides ( ) Apply ice to area after scrotal swelling subsides
( ) Resume sexual intercourse ( ) Resume sexual intercourse

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 66. Which of the following terms refers to the surgical removal of one of the testes?

(X) orchiectomy (X) orchiectomy

( ) circumcision ( ) circumcision
( ) vasectomy ( ) vasectomy
( ) hydrocelectomy ( ) hydrocelectomy
67. Which of the following is associated with build up of fibrous plaques in the sheath of the corpus cavernosum causing curvature of
the penis when it is erect?

( ) Bowen's disease ( ) Bowen's disease

( ) Phimosis ( ) Phimosis
(X) Peyronie's disease (X) Peyronie's disease
( ) Priapism ( ) Priapism
68. Which of the following is a failure of one or both of the testes to descend into the scrotum?

(X) cryptorchidism (X) cryptorchidism

( ) hydrocele ( ) hydrocele
( ) varicocele ( ) varicocele
( ) phimosis ( ) phimosis
69. Which of the following are age - related changes affecting the male reproductive system?

( ) prostate secretion increases ( ) prostate secretion increases

(X) decrease plasma testosterone levels (X) decrease plasma testosterone levels
( ) Testes become soft ( ) Testes become soft
( ) patency increases ( ) patency increases
70. A patient is to undergo a TURP for BPH. Which of the following is accurate with regard to a TURP?

( ) A TURP causes erectile dysfunction ( ) A TURP causes erectile dysfunction

( ) It is done on an outpatient basis ( ) It is done on an outpatient basis
(X) Urethral strictures are more frequent for TURP than with (X) Urethral strictures are more frequent for TURP than with
nontransurethral procedures nontransurethral procedures
( ) There is no danger of retrograde ejaculation ( ) There is no danger of retrograde ejaculation
71. Nonhormonal drugs such as alendronate (Fosamax) , is used for treating osteoporosis because they:

( ) Inhibit the activity of osteoblasts ( ) Inhibit the activity of osteoblasts

(X) Inhibit the activity of osteoclasts (X) Inhibit the activity of osteoclasts
( ) Increase the production of estrogen ( ) Increase the production of estrogen
( ) Increase vitamin D metabolism ( ) Increase vitamin D metabolism
72. Pain from osteoarthritis is described as mechanical pain, which means:

( ) The pain responds to mechanical device use ( ) The pain responds to mechanical device use
(X) The pain is relieved by rest and worsened by activity (X) The pain is relieved by rest and worsened by activity
( ) The pain is worse at the beginning of the day and improves ( ) The pain is worse at the beginning of the day and improves
with activity with activity
( ) Rest and activity have no effect on the pain ( ) Rest and activity have no effect on the pain
73. The nurse is planning to teach a client with gastroesophageal reflux disease about substances to avoid. Which items should the
nurse include on this list? Select all that apply.

[X] Coffee [X] Coffee

[X] Chocolate [X] Chocolate
[X] Peppermint [X] Peppermint
[ ] Nonfat milk [ ] Nonfat milk
[X] Fried chicken [X] Fried chicken
[ ] Scrambled eggs [ ] Scrambled eggs

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 74. The nurse is reviewing the prescription for a client admitted to the hospital with a diagnosis of acute pancreatitis. Which
interventions would the nurse expect to be prescribed for the client? Select all that apply.

[X] Administer antacids as prescribed. [X] Administer antacids as prescribed.

[X] Encourage coughing and deep breathing. [X] Encourage coughing and deep breathing.
[X] Administer anticholinergics as prescribed. [X] Administer anticholinergics as prescribed.
[ ] Give small, frequent high-calorie feedings. [ ] Give small, frequent high-calorie feedings.
[ ] Maintain the client in a supine and flat position. [ ] Maintain the client in a supine and flat position.
[X] Give meperidine (Demerol) as prescribed for pain [X] Give meperidine (Demerol) as prescribed for pain
75. A histamine (H2)-receptor antagonist will be prescribed for a client. The nurse understands that which medications are H2-receptor
antagonists? Select all that apply.

[X] Nizatidine (Axid) [X] Nizatidine (Axid)

[X] Ranitidine (Zantac) [X] Ranitidine (Zantac)
[X] Famotidine (Pepcid) [X] Famotidine (Pepcid)
[X] Cimetidine (Tagamet) [X] Cimetidine (Tagamet)
[ ] Esomeprazole (Nexium) [ ] Esomeprazole (Nexium)
[ ] Lansoprazole (Prevacid) [ ] Lansoprazole (Prevacid)
76. The nurse has given instructions to a client who has just been prescribed cholestyramine (Questran). Which statement by the client
indicates a need for further instructions?

( ) “I will continue taking vitamin supplements.” ( ) “I will continue taking vitamin supplements.”
( ) “This medication will help lower my cholesterol.” ( ) “This medication will help lower my cholesterol.”
(X) “This medication should only be taken with water.” (X) “This medication should only be taken with water.”
( ) “A high-fiber diet is important while taking this medication.” ( ) “A high-fiber diet is important while taking this medication.”
77. The nurse is assessing a client with epididymitis. The nurse anticipates which findings on physical examination?

( ) Fever, diarrhea, groin pain, and ecchymosis ( ) Fever, diarrhea, groin pain, and ecchymosis
( ) Nausea, vomiting, scrotal edema, and ecchymosis ( ) Nausea, vomiting, scrotal edema, and ecchymosis
(X) Fever, nausea, vomiting, and painful scrotal edema (X) Fever, nausea, vomiting, and painful scrotal edema
( ) Diarrhea, groin pain, testicular torsion, and scrotal edema ( ) Diarrhea, groin pain, testicular torsion, and scrotal edema
78. 78. A client complains of fever, perineal pain, and urinary urgency, frequency, and dysuria. To assess whether the client’s problem
is related to bacterial prostatitis, the nurse reviews the results of the prostate examination for which characteristic of this disorder?

( ) Soft and swollen prostate gland ( ) Soft and swollen prostate gland
( ) Reddened, swollen, and boggy prostate gland ( ) Reddened, swollen, and boggy prostate gland
( ) Tender and edematous prostate gland with ecchymosis ( ) Tender and edematous prostate gland with ecchymosis
(X) Tender, indurated prostate gland that is warm to the touch (X) Tender, indurated prostate gland that is warm to the touch
79. 79. The nurse is collecting data from a client who has a history of benign prostatic hyperplasia. To determine whether the client
currently is experiencing this condition, the nurse should ask the client about the presence of which early symptom?

( ) Nocturia ( ) Nocturia
( ) Urinary retention ( ) Urinary retention
( ) Urge incontinence ( ) Urge incontinence
(X) Decreased force in the stream of urine (X) Decreased force in the stream of urine
80. The nurse monitoring a client receiving peritoneal dialysis notes that the client’s outflow is less than the inflow. Which actions should
the nurse take? Select all that apply.

[X] Check the level of the drainage bag. [X] Check the level of the drainage bag.
[X] Reposition the client to his or her side. [X] Reposition the client to his or her side.
[ ] Contact the health care provider (HCP). [ ] Contact the health care provider (HCP).
[X] Place the client in good body alignment. [X] Place the client in good body alignment.
[X] Check the peritoneal dialysis system for kinks. [X] Check the peritoneal dialysis system for kinks.
[ ] Increase the flow rate of the peritoneal dialysis solution. [ ] Increase the flow rate of the peritoneal dialysis solution.

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 81. The nurse is conducting health screening for osteoporosis. Which client is at greatest risk of developing this disorder?

( ) A 25-year-old woman who jogs ( ) A 25-year-old woman who jogs

( ) A 36-year-old man who has asthma ( ) A 36-year-old man who has asthma
( ) A 70-year-old man who consumes excess alcohol ( ) A 70-year-old man who consumes excess alcohol
(X) A sedentary 65-year-old woman who smokes cigarettes (X) A sedentary 65-year-old woman who smokes cigarettes
82. The nurse has given instructions to a client returning home after knee arthroscopy. Which statement by the client indicates that the
instructions are understood?

( ) "I can resume regular exercise tomorrow." ( ) "I can resume regular exercise tomorrow."
( ) "I can't eat food for the remainder of the day." ( ) "I can't eat food for the remainder of the day."
( ) "I need to stay off the leg entirely for the rest of the day." ( ) "I need to stay off the leg entirely for the rest of the day."
(X) "I need to report a fever or site inflammation to my health (X) "I need to report a fever or site inflammation to my health
care provider." care provider."
83. The nurse is one of several persons who witnessed a vehicle hit a pedestrian at fairly low speed on a small street. The victim is
dazed and tries to get up. The leg appears fractured. Which intervention should the nurse take?

( ) Try to reduce the fracture manually. ( ) Try to reduce the fracture manually.
( ) Assist the victim to get up and walk to the sidewalk. ( ) Assist the victim to get up and walk to the sidewalk.
( ) Leave the victim for a few moments to call an ambulance. ( ) Leave the victim for a few moments to call an ambulance.
(X) Stay with the victim and encourage the person to remain still. (X) Stay with the victim and encourage the person to remain still.
84. Which cast care instructions should the nurse provide to a client who just had a plaster cast applied to the right forearm? Select all
that apply.

[X] Keep the cast clean and dry. [X] Keep the cast clean and dry.
[X] Allow the cast 24 to 72 hours to dry. [X] Allow the cast 24 to 72 hours to dry.
[X] Keep the cast and extremity elevated. [X] Keep the cast and extremity elevated.
[ ] Expect tingling and numbness in the extremity. [ ] Expect tingling and numbness in the extremity.
[ ] Use a hair dryer set on a warm to hot setting to dry the cast. [ ] Use a hair dryer set on a warm to hot setting to dry the cast.
[ ] Use a soft padded object that will fit under the cast to scratch [ ] Use a soft padded object that will fit under the cast to scratch
the skin under the cast. the skin under the cast.
85. The nurse is evaluating the pin sites of a client in skeletal traction. The nurse would be least concerned with which finding?

( ) Inflammation ( ) Inflammation
(X) Serous drainage (X) Serous drainage
( ) Pain at a pin site ( ) Pain at a pin site
( ) Purulent drainage ( ) Purulent drainage
86. The nurse is assessing the casted extremity of a client. Which sign is indicative of infection?

( ) Dependent edema ( ) Dependent edema

( ) Diminished distal pulse ( ) Diminished distal pulse
(X) Presence of a “hot spot” on the cast (X) Presence of a “hot spot” on the cast
( ) Coolness and pallor of the extremity ( ) Coolness and pallor of the extremity
87. A client has sustained a closed fracture and has just had a cast applied to the affected arm. The client is complaining of intense
pain. The nurse elevates the limb, applies an ice bag, and administers an analgesic, with little relief. Which problem may be causing
this pain?

( ) Infection under the cast ( ) Infection under the cast

( ) The anxiety of the client ( ) The anxiety of the client
(X) Impaired tissue perfusion (X) Impaired tissue perfusion
( ) The recent occurrence of the fracture ( ) The recent occurrence of the fracture
88. The nurse is admitting a client with multiple trauma to the nursing unit. The client has a leg fracture and had a plaster cast applied.
Which position would be best for the casted leg?

( ) Flat for 12 hours, then elevated for 12 hours. ( ) Flat for 12 hours, then elevated for 12 hours.
( ) Elevated for 3 hours and then flat for 1 hour. ( ) Elevated for 3 hours and then flat for 1 hour.
( ) Flat for 3 hours and then elevated for 1 hour. ( ) Flat for 3 hours and then elevated for 1 hour.
(X) Elevated on pillows continuously for 24 to 48 hours. (X) Elevated on pillows continuously for 24 to 48 hours.

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 89. A client is being discharged to home after application of a plaster leg cast. Which statement indicates that the client understands
proper care of the cast?

(X) "I need to avoid getting the cast wet." (X) "I need to avoid getting the cast wet."
( ) "I need to cover the casted leg with warm blankets." ( ) "I need to cover the casted leg with warm blankets."
( ) "I need to use my fingertips to lift and move my leg." ( ) "I need to use my fingertips to lift and move my leg."
( ) "I need to use something like a padded coat hanger end to ( ) "I need to use something like a padded coat hanger end to
scratch under the cast if it itches." scratch under the cast if it itches."
90. Allopurinol (Zyloprim) is prescribed for a client and the nurse provides medication instructions to the client. Which instruction should
the nurse provide?

(X) Drink 3000 mL of fluid a day. (X) Drink 3000 mL of fluid a day.
( ) Take the medication on an empty stomach. ( ) Take the medication on an empty stomach.
( ) The effect of the medication will occur immediately. ( ) The effect of the medication will occur immediately.
( ) Any swelling of the lips is a normal expected response. ( ) Any swelling of the lips is a normal expected response.
91. Colchicine (Colcrys) is prescribed for a client with a diagnosis of gout. The nurse reviews the client's record, knowing that this
medication would be used with caution in which disorder?

( ) Myxedema ( ) Myxedema
(X) Kidney disease (X) Kidney disease
( ) Hypothyroidism ( ) Hypothyroidism
( ) Diabetes mellitus ( ) Diabetes mellitus
92. Alendronate (Fosamax) is prescribed for a client with osteoporosis and the nurse is providing instructions on administration of the
medication. Which instruction should the nurse provide?

( ) Take the medication at bedtime. ( ) Take the medication at bedtime.

( ) Take the medication in the morning with breakfast. ( ) Take the medication in the morning with breakfast.
( ) Lie down for 30 minutes after taking the medication. ( ) Lie down for 30 minutes after taking the medication.
(X) Take the medication with a full glass of water after rising in (X) Take the medication with a full glass of water after rising in
the morning. the morning.
93. The nurse is preparing discharge instructions for a client receiving baclofen. Which instruction should be included in the teaching
plan?

( ) Restrict fluid intake. ( ) Restrict fluid intake.

(X) Avoid the use of alcohol. (X) Avoid the use of alcohol.
( ) Stop the medication if diarrhea occurs. ( ) Stop the medication if diarrhea occurs.
( ) Notify the health care provider (HCP) if fatigue occurs. ( ) Notify the health care provider (HCP) if fatigue occurs.
94. 94. The nurse is analyzing the laboratory studies on a client receiving dantrolene sodium (Dantrium). Which laboratory test would
identify an adverse effect associated with the administration of this medication?

( ) Platelet count ( ) Platelet count

( ) Creatinine level ( ) Creatinine level
(X) Liver function tests (X) Liver function tests
( ) Blood urea nitrogen level ( ) Blood urea nitrogen level
95. Cyclobenzaprine hydrochloride (Flexeril) is prescribed for a client for muscle spasms and the nurse is reviewing the client's record.
Which disorder, if noted in the record, would indicate a need to contact the health care provider about the administration of this
medication?

(X) Glaucoma (X) Glaucoma

( ) Emphysema ( ) Emphysema
( ) Hypothyroidism ( ) Hypothyroidism
( ) Diabetes mellitus ( ) Diabetes mellitus

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 96. In monitoring a client’s response to disease-modifying antirheumatic drugs (DMARDs), which assessment findings would the nurse
consider acceptable responses? Select all that apply.

[ ] Symptom control during periods of emotional stress
[ ] Normal white blood cell, platelet, and neutrophil counts
[X] Radiological findings that show no progression of joint
degeneration
[ ] An increased range of motion in the affected joints 3 months
into therapy
[ ] Inflammation and irritation at the injection site 3 days after the
injection is given
[ ] A low-grade temperature on rising in the morning that
remains throughout the day
97. The nurse is administering an intravenous dose of methocarbamol (Robaxin) to a client with multiple sclerosis. For which
side/adverse effects should the nurse monitor?
[X] Symptom control during periods of emotional stress
[X] Normal white blood cell, platelet, and neutrophil counts
[X] Radiological findings that show no progression of joint
degeneration
[X] An increased range of motion in the affected joints 3 months
into therapy
[ ] Inflammation and irritation at the injection site 3 days after the
injection is given
[ ] A low-grade temperature on rising in the morning that
remains throughout the day

( ) Tachycardia ( ) Tachycardia
( ) Rapid pulse ( ) Rapid pulse
(X) Bradycardia (X) Bradycardia
( ) Hypertension ( ) Hypertension
98. A nurse is caring for a client newly diagnosed with osteoporosis. Which statements should the nurse include when teaching the
client about the disease? Select all that apply.

[ ] Osteoporosis is common in females after menopause.
[X] Osteoporosis is a degenerative disease characterized by a
decrease in bone density.
[ ] The disease is congenital, caused by poor dietary intake of
milk products.
[ ] Osteoporosis can cause pain and injury.
[ ] Passive ROM exercises can promote bone growth.
[ ] Weight-bearing exercise should be avoided.
99. A nurse is assigned a client with an acute exacerbation of rheumatoid arthritis (RA). Which medical facts about RA are essential in
developing a plan of care? Select all that apply.
[X] Osteoporosis is common in females after menopause.
[X] Osteoporosis is a degenerative disease characterized by a
decrease in bone density.
[ ] The disease is congenital, caused by poor dietary intake of
milk products.
[X] Osteoporosis can cause pain and injury.
[ ] Passive ROM exercises can promote bone growth.
[ ] Weight-bearing exercise should be avoided.

[X] Onset is acute and usually occurs between ages 20 and 40.
[ ] The client experiences stiff, swollen joints bilaterally.
[ ] The client may not exercise once the disease is diagnosed.
[ ] Erythrocyte sedimentation rate (ESR) is elevated, and x-rays
show erosions and decalcification of involved joints.
[ ] Inflamed cartilage triggers complement activation, which
stimulates the release of additional inflammatory mediators.
[ ] The first-line treatment is gold salts and methotrexate.
100. You are preparing to teach a patient with a new diagnosis of osteoporosis about strategies to prevent falls. Which teaching points
will you be sure to include? (Select all that apply.)
[ ] Onset is acute and usually occurs between ages 20 and 40.
[ ] The client experiences stiff, swollen joints bilaterally.
[ ] The client may not exercise once the disease is diagnosed.
[X] Erythrocyte sedimentation rate (ESR) is elevated, and x-rays
show erosions and decalcification of involved joints.
[X] Inflamed cartilage triggers complement activation, which
stimulates the release of additional inflammatory mediators.
[X] The first-line treatment is gold salts and methotrexate.

[ ] Wear a hip protector when ambulating. [X] Wear a hip protector when ambulating.
[X] Remove throw rugs and other obstacles at home. [X] Remove throw rugs and other obstacles at home.
[ ] Exercise to help build your strength. [X] Exercise to help build your strength.
[ ] Expect a few bumps and bruises when you go home. [ ] Expect a few bumps and bruises when you go home.
[ ] Rest when you are tired. [X] Rest when you are tired.

Time Used: 00:45:50 Final Score: 90%

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