Question 1

After abdominal surgery, a patient must cough and take deep breaths.How can the nurse best achieve this with this patient?

Accepted Answer

A)  Withhold analgesics until the patient performs this task. 
B)  Help the patient splint the incision with a pillow. 
C)  Explain that pneumonia occurs if deep breathing is not carried out every 4 hours. 
D)  Ambulate the patient 40 feet to increase his need for oxygen. 
A)  Withhold analgesics until the patient performs this task. 
B)  Help the patient splint the incision with a pillow. 
C)  Explain that pneumonia occurs if deep breathing is not carried out every 4 hours. 
D)  Ambulate the patient 40 feet to increase his need for oxygen. B

Question 2

Which patient assessment indicates hyperglycemia with TPN feeding?

Accepted Answer

A)  Increase of urine output 
B)  Sudden diarrhea 
C)  Abdominal distention 
D)  Tachycardia 
A)  Increase of urine output 
B)  Sudden diarrhea 
C)  Abdominal distention 
D)  Tachycardia A

Question 3

The TPN feeding is running at 20 mL and is 1 hour behind schedule.What is the most appropriate initial nursing intervention?

Accepted Answer

A)  Increase the flow rate to 22 mL/hr (10%)and inform the charge nurse. 
B)  Reposition the patient to the right side and lower the head of the bed. 
C)  Dilute the thick feeding formula with 10 mL of sterile water and inform the charge nurse. 
D)  Document the event and inform the charge nurse. 
A)  Increase the flow rate to 22 mL/hr (10%)and inform the charge nurse. 
B)  Reposition the patient to the right side and lower the head of the bed. 
C)  Dilute the thick feeding formula with 10 mL of sterile water and inform the charge nurse. 
D)  Document the event and inform the charge nurse. D

Question 4

What is the most current endoscopic procedure for examining the small intestine?

Accepted Answer

A)  Capsule camera 
B)  Fiberoptic light probe 
C)  Rigid lighted tubes 
D)  Flat plate 
A)  Capsule camera 
B)  Fiberoptic light probe 
C)  Rigid lighted tubes 
D)  Flat plate

Question 5

A patient inquires if this newer type of gastric analysis is going to require passage of a nasogastric tube.What is the nurse's most accurate reply?

Accepted Answer

A)  "Yes, but just for the instillation of the dye." 
B)  "No.You take a dye orally, which will be excreted in the urine in approximately 2 hours." 
C)  "Yes.You will take the dye orally, and then several gastric withdrawals through the tube will show the dye." 
D)  "Yes.Only one withdrawal will be made through the tube, which will be treated with dye and read in approximately 2 hours." 
A)  "Yes, but just for the instillation of the dye." 
B)  "No.You take a dye orally, which will be excreted in the urine in approximately 2 hours." 
C)  "Yes.You will take the dye orally, and then several gastric withdrawals through the tube will show the dye." 
D)  "Yes.Only one withdrawal will be made through the tube, which will be treated with dye and read in approximately 2 hours."

Question 6

After receiving a tube feeding, a nurse assesses the patient to be sweaty with abdominal distention and diarrhea.What is the most likely cause of this response?

Accepted Answer

A)  Expected reaction to the tube feeding 
B)  Dumping syndrome 
C)  Gastric reflux syndrome 
D)  Onset of gastroenteritis 
A)  Expected reaction to the tube feeding 
B)  Dumping syndrome 
C)  Gastric reflux syndrome 
D)  Onset of gastroenteritis

Question 7

What information about when and where specific digestion of food takes place should be included in a patient teaching plan? (Select all that apply.)

Accepted Answer

A)  Renin breaks down milk protein in the stomach. 
B)  Lipase breaks down fats in the stomach. 
C)  Pepsin begins to break down proteins in the stomach. 
D)  Liver and pancreatic secretions break down fats in the small bowel. 
E)  Ptyalin (amylase)breaks down carbohydrates in the colon. 
A)  Renin breaks down milk protein in the stomach. 
B)  Lipase breaks down fats in the stomach. 
C)  Pepsin begins to break down proteins in the stomach. 
D)  Liver and pancreatic secretions break down fats in the small bowel. 
E)  Ptyalin (amylase)breaks down carbohydrates in the colon.

Question 8

Which set of findings best indicates that a patient with intestinal obstruction has achieved normal hydration?

Accepted Answer

A)  Pulse and blood pressure are within the patient's norms, mucous membranes are moist, and fluid intake and output are equal. 
B)  Pulse rate is strong (at least 60 beats/min), bowel sounds are normal, and a respiratory rate of 22 breaths/min is recorded. 
C)  Blood pressure is within the patient's norm, the temperature is below normal, and adequate tissue turgor is observed. 
D)  Mucous membranes are moist, the 24-hour fluid intake is higher than the 24-hour output, and the pulse rate is elevated. 
A)  Pulse and blood pressure are within the patient's norms, mucous membranes are moist, and fluid intake and output are equal. 
B)  Pulse rate is strong (at least 60 beats/min), bowel sounds are normal, and a respiratory rate of 22 breaths/min is recorded. 
C)  Blood pressure is within the patient's norm, the temperature is below normal, and adequate tissue turgor is observed. 
D)  Mucous membranes are moist, the 24-hour fluid intake is higher than the 24-hour output, and the pulse rate is elevated.

Question 9

A nurse administers promethazine (Phenergan)for nausea.Which extra precautionary action should the nurse implement because of the common side effect of antiemetic medications?

Accepted Answer

A)  Check vital signs for erratic blood pressure. 
B)  Add a blanket to prevent chilling. 
C)  Provide extra water to combat thirst. 
D)  Put up side rails to prevent falls. 
A)  Check vital signs for erratic blood pressure. 
B)  Add a blanket to prevent chilling. 
C)  Provide extra water to combat thirst. 
D)  Put up side rails to prevent falls.

Question 10

A patient complains about the placement of the total parenteral nutrition (TPN)line and asks why it cannot be inserted in the arm.What fact regarding the placement of this line should the nurse base a response on?

Accepted Answer

A)  Arm would limit patient mobility. 
B)  Subclavian artery allows for ease in dressing the puncture site. 
C)  Arm prevents the use of large-bore cannulas. 
D)  Subclavian artery allows for rapid dilution. 
A)  Arm would limit patient mobility. 
B)  Subclavian artery allows for ease in dressing the puncture site. 
C)  Arm prevents the use of large-bore cannulas. 
D)  Subclavian artery allows for rapid dilution.

Question 11

A nurse has collected several stool specimens for ova and parasites that are to be sent to the laboratory.What action is most appropriate for the nurse to implement?

Accepted Answer

A)  Immediately take the specimens to the laboratory to be tested for parasites and ova. 
B)  Take the specimens to the laboratory to be tested for culture and sensitivity and leave them for later pickup. 
C)  Take the specimens to the refrigerator to be tested later for parasites and ova. 
D)  Leave the specimens in a warm place until convenient time to deliver to the laboratory. 
A)  Immediately take the specimens to the laboratory to be tested for parasites and ova. 
B)  Take the specimens to the laboratory to be tested for culture and sensitivity and leave them for later pickup. 
C)  Take the specimens to the refrigerator to be tested later for parasites and ova. 
D)  Leave the specimens in a warm place until convenient time to deliver to the laboratory.

Question 12

A nurse is preparing to give a tube feeding using a large syringe.What action should the nurse implement before starting the infusion?

Accepted Answer

A)  Roll the patient flat. 
B)  Check for a residual formula and return the residual to his or her stomach. 
C)  Place the end of the tube in water and check for bubbles. 
D)  Flush the tube. 
A)  Roll the patient flat. 
B)  Check for a residual formula and return the residual to his or her stomach. 
C)  Place the end of the tube in water and check for bubbles. 
D)  Flush the tube.

Question 13

Stool softeners are prescribed to promote normal elimination of feces.What is the most appropriate way to ensure effectiveness of this type of drug?

Accepted Answer

A)  Mouth care 
B)  Ambulation 
C)  Adequate fluid intake 
D)  High-fiber diet 
A)  Mouth care 
B)  Ambulation 
C)  Adequate fluid intake 
D)  High-fiber diet

Question 14

A patient is being seen for the first time at a physician's office.When assisting with the assessment, a nurse notices abdominal striae.What alternative term should the nurse use when the patient asks what it is all over her abdomen?

Accepted Answer

A)  Scarring 
B)  Lesions 
C)  Rashes 
D)  Stretch marks 
A)  Scarring 
B)  Lesions 
C)  Rashes 
D)  Stretch marks

Question 15

A nurse is caring for a patient receiving total parenteral nutrition (TPN).Which nursing action is most appropriate to implement?

Accepted Answer

A)  Use a clean technique for site care. 
B)  Infuse the solution rapidly. 
C)  Administer medications through the TPN line. 
D)  Monitor the temperature for elevation. 
A)  Use a clean technique for site care. 
B)  Infuse the solution rapidly. 
C)  Administer medications through the TPN line. 
D)  Monitor the temperature for elevation.

Exam 37: Digestive System Introduction

After abdominal surgery, a patient must cough and take deep breaths.How can the nurse best achieve this with this patient?

Which patient assessment indicates hyperglycemia with TPN feeding?

The TPN feeding is running at 20 mL and is 1 hour behind schedule.What is the most appropriate initial nursing intervention?

What is the most current endoscopic procedure for examining the small intestine?

A patient inquires if this newer type of gastric analysis is going to require passage of a nasogastric tube.What is the nurse's most accurate reply?

After receiving a tube feeding, a nurse assesses the patient to be sweaty with abdominal distention and diarrhea.What is the most likely cause of this response?

What information about when and where specific digestion of food takes place should be included in a patient teaching plan? (Select all that apply.)

Which set of findings best indicates that a patient with intestinal obstruction has achieved normal hydration?

A nurse administers promethazine (Phenergan)for nausea.Which extra precautionary action should the nurse implement because of the common side effect of antiemetic medications?

A patient complains about the placement of the total parenteral nutrition (TPN)line and asks why it cannot be inserted in the arm.What fact regarding the placement of this line should the nurse base a response on?

A nurse has collected several stool specimens for ova and parasites that are to be sent to the laboratory.What action is most appropriate for the nurse to implement?

A nurse is preparing to give a tube feeding using a large syringe.What action should the nurse implement before starting the infusion?

Stool softeners are prescribed to promote normal elimination of feces.What is the most appropriate way to ensure effectiveness of this type of drug?

A patient is being seen for the first time at a physician's office.When assisting with the assessment, a nurse notices abdominal striae.What alternative term should the nurse use when the patient asks what it is all over her abdomen?

A nurse is caring for a patient receiving total parenteral nutrition (TPN).Which nursing action is most appropriate to implement?

Aspects of Medical-Surgical Nursing

Medical-Surgical Practice Settings

Medical-Surgical Patients: Individuals, Families, and Communities

Health, Illness, Stress, and Coping

Immunity, Inflammation, and Infection

Fluid, Electrolyte, and Acidbase Imbalance

The Patient With Cancer

Pain

Shock

The Older Adult Patient

Falls

Immobility

Delirium and Dementia

Incontinence

Nutrition

Intravenous Therapy

Surgery

The Patient With an Ostomy

Palliative and Hospice Care

Complementary and Alternative Therapies

Neurologic System Introduction

Neurologic Disorders

Cerebrovascular Accident

Spinal Cord Injury

Respiratory System Introduction

Upper Respiratory Disorders

Acute Lower Respiratory Tract Disorders

Chronic Lower Respiratory Tract Disorders

Hematologic System Introduction

Hematologic Disorders

Immunologic System Introduction

Immunologic Disorders

Cardiovascular System Introduction

Cardiac Disorders

Vascular Disorders

Hypertension

Upper Digestive Tract Disorders

Lower Digestive Tract Disorders

Liver, Gallbladder, and Pancreatic Disorders

Urologic System Introduction

Urologic Disorders

Musculoskeletal System Introduction

Connective Tissue Disorders

Fractures

Amputations

Endocrine System Introduction

Pituitary and Adrenal Disorders

Thyroid and Parathyroid Disorders

Diabetes and Hypoglycemia

Female Reproductive System Introduction

Female Reproductive Disorders

Male Reproductive System Introduction

Male Reproductive Disorders

Sexually Transmitted Infections

Integumentary System Introduction

Skin Disorders

Special Senses Introduction

Eye and Vision Disorders

Ear and Hearing Disorders

Psychobiological Disorders

Substance Abuse

First Aid, Emergency Care, and Disaster Management

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