QUESTIONS

1. A client is scheduled for a sigmoidoscopy. What instruction should the nurse provide the
client in preparation for this diagnostic procedure?
 Have an enema the morning of the test.
 A chalklike substance will have to be swallowed.
 Withhold food for twenty-four hours before the test.
 A sterile container will be provided for the collection of a stool specimen.

2. A health care provider orders a sigmoidoscopy for one client and a barium enema for
another client. What is a nursing responsibility common to preparing both of these clients
for these procedures?
 Withholding food for several hours
 Giving castor oil the afternoon before
 Administering soapsuds enemas until clear
 Ensuring an understanding of the procedure

3. During administration of an enema, a client reports having intestinal cramps. What

4. Client has a nasogastric feeding tube inserted, and the health care provider orders the
prescribed feeding to be instituted immediately. What should the nurse do first?
 Instill normal saline into the tube to maintain patency.
 Obtain an x-ray to verify that the tube is in the stomach.
 Auscultate the epigastric area while instilling 15 mL of air.
 Withdraw 30 mL of stomach contents to verify tube placement.

5. A client with inflammatory bowel disease is receiving total parenteral nutrition (TPN) via
an infusion pump. What is most important for the nurse to do when administering TPN?
 Monitor the client's blood glucose level q2h at the bedside with a glucometer.
 Change the TPN solution bag every 24 hours, even if there is solution left in the bag.
 Instruct the client to breathe shallowly when changing the TPN tubing using sterile
technique.
 Speed up the rate of the TPN infusion if the amount delivered has fallen behind the
prescribed hourly rate.
2
6. A client has a suspected peptic ulcer in the duodenum. What should the nurse expect
the client to report when describing the pain associated with this disease?
 An ache radiating to the left side
 An intermittent colicky flank pain
 A gnawing sensation relieved by food
 A generalized abdominal pain intensified by moving

7. Which statement by a client who is scheduled for bariatric surgery indicates to the nurse
that further preoperative teaching is necessary?
 "I need to eat more high-protein foods."
 "I'm going to have a figure like a model in about a year."
 "I'm going to be out of bed and sitting in a chair the first day after surgery."
 "I will be limiting my intake to 600 to 800 calories a day once I start eating again."

8. A client is discharged the same day after ambulatory surgery for a laparoscopic
cholecystectomy. The nurse is providing discharge teaching about how many days the
client should wait to engage in certain activities. Place in order the activities from the first
to the last in which the client may engage.
 Showering
 Driving a car
 Performing light exercise
 Getting out of bed in a chair
 Lifting objects of more than ten pounds

9. A nurse is caring for a client with cholelithiasis and obstructive jaundice. When assessing
this client, the nurse should be alert for which common clinical indicators associated with
these conditions? Select all that apply.
 Ecchymosis
 Yellow sclera
 Dark brown stool
 Straw-colored urine
 Pain in right upper quadrant

10. For which clinical indicators should the nurse monitor when caring for a client with
cholelithiasis and obstructive jaun-dice? Select all that apply.
 Dark urine
 Yellow skin
 Pain on urination
 Clay-colored stool
 Coffee-ground vomitus
11. A nurse is teaching a class about hepatitis, specifically hepatitis A. Which food should
the nurse explain will most likely remain contaminated with the hepatitis A virus after
being cooked?
 Canned tuna
 Broiled shrimp
 Baked haddock
 Steamed lobster

12. A nurse is teaching a client about prophylactic measures that minimize the risk of
contracting hepatitis B. Which actions should be included in this teaching plan? Select all
that apply.
 Preventing constipation
 Screening of blood donors
 Avoiding shellfish in the diet
 Limiting hepatotoxic drug therapy

13. Maintaining a monogamous sexual relationship nurse is caring for a client who is
positive for hepatitis A. What should the nurse do?
 Wear a gown when entering the client's room.
 Use caution when bringing in the client's food.
 Use gloves when removing the client's bedpan.
 Wear a protective mask when entering the client's room.

14. client who is about to have a blood transfusion asks the nurse, "Which type of hepatitis is
most frequently transmitted by transfusions?" The nurse should respond, "Although the
risk is minimal, the type of hepatitis associated with blood transfusions is hepatitis:
 A."
 B."
 С."
 D."

15. A client with hepatic cirrhosis begins to develop slurred speech, confusion, drowsiness,
and a flapping tremor. With this evidence of impending hepatic coma, which diet can the
nurse expect will be ordered for this client?
 20 g of protein, 2000 calories
 70 g of protein, 1200 calories
 80 g of protein, 2500 calories
 100 g of protein, 1500 calories
16. A nurse is caring for a client with cirrhosis of the liver. Which laboratory test should the
nurse monitor that, when abnormal, might identify a client who may benefit from
neomycin enemas?
 Ammonia level
 Culture and sensitivity
 White blood cell count
 Alanine aminotransferase level

17. A client who had surgery for a ruptured appendix develops peritonitis. What clinical
findings related to peritonitis should the nurse expect the client to exhibit? Select all that
apply.
 Fever
 Hyperactivity
 Extreme hunger
 Urinary retention
 Abdominal muscle rigidity

18. A client had surgery for a perforated appendix with localized peritonitis. In which position
should the nurse place this client?
 Sims
 Semi-Fowler
 Trendelenburg
 Dorsal recumbent

19. An active adolescent is admitted to the hospital for surgery for an ileostomy. When
planning a teaching session about self-care, the nurse includes sports that should be
avoided by a client with an ileostomy. Which should be included on the list of sports to
be avoided? Select all that apply.
 Football
 Swimming
 Ice hockey
 Track events
 Cross-country skiing

20. A client is scheduled for a colonoscopy, and the health care provider orders a tap water
enema. In which position should the nurse place the client during the enema?
 Left Sims
 Back lying
 Knee chest
 Mid-Fowler
21. A nurse is caring for a client with a new colostomy. Which client outcome is most
important for achievement of long-range goals associated with adjusting to a new
colostomy?
 Mastery of techniques of colostomy care
 Readiness to accept an altered body function
 Awareness of available community resources
 Knowledge of the necessary dietary modifications

22. Neomycin 1 g is prescribed preoperatively for a client with a diagnosis of cancer of the
colon. The client asks why neomycin is being given. Which is the best response by the
nurse?
 "It will decrease your kidney function and lessen urine production during surgery."
 "It will kill the bacteria in your bowel and decrease the risk of infection after surgery."
 "It is used to alter the body flora, which reduces the spread of the tumor to adjacent
organs."
 "It is used to prevent you from getting an infection, particularly a bladder infection, before
surgery."

23. A client had a colon resection and formation of a colostomy 2 days ago. What color does
the nurse expect the stoma to be when assessing its viability?
 Pink
 Gray
 Brick red
 Dark purple

24. A female client with the diagnosis of Crohn disease tells the nurse that her boyfriend
dates other women. She believes that this behavior causes an increase in her
symptoms. What should the nurse do first when counseling this client?
 Help the client explore attitudes about herself.
 Educate the client's boyfriend about her illness.
 Suggest the client should not see her boyfriend for a while.
 Schedule the client and her boyfriend for a counseling session.
25. A nurse is teaching a client who has a full-time job how to care for a new colostomy, At
which time should the nurse suggest scheduling the colostomy irrigations?
 When it is most convenient for the client
 Approximately a half hour after breakfast
 Halfway between the two largest meals of the day
 At the time the client had bowel movements before surgery
26. After having a transverse colostomy, the client asks what physical effect the surgery will
have on future sexual rela-tionships. Which information should the nurse include in a
teaching plan for this client?
 "You will be able to resume usual sexual relationships."
 "Surgery will temporarily decrease your sexual impulses."
 "Your sexual activity must be curtailed for several weeks."
 "Partners should be told about the surgery before any sexual activity."

27. During a colostomy irrigation, a client reports feeling abdominal cramps. What should the
nurse do in response to the client's statement?
 Discontinue the irrigation.
 Lower the container of Aluid
 Clamp the catheter for a few minutes.
 Advance the catheter approximately an inch.

28. How many inches should the nurse insert a catheter into the stoma when performing a
transverse colostomy irrigation?
 5 cm (2 inches)
 8 cm (3 inches)
 15 cm (6 inches)
 20 cm (8 inches)

29. When teaching irrigation of a colostay ho many inched above the stoma should the
nurse teach the dient to place the container?
 15 cm (6 inches)
 25 cm (10 inches)
 30 cm (12 inches)
 45 cm (18 inches)

30. A client is diagnosed with cancet of the rectum and has surgery for an abdominoperinea
resection and colostomy. Which nursing care should be implemented during the
postoperative period?
 Limiting fluid intake for several days
 Withholding fluids for seventy-two hours
 Having the client change the colostomy bag
 Keeping the client's skin around the stoma clean

31. Before discharge, a client who had a colostomy for colorectal cancer questions the nurse
about resuming activity. What should the nurse teach the client about activity?
 "With guidance, a near-normal lifestyle, including complete sexual function, is possible."
 "Activities of daily living should be resumed as quickly as possible so you avoid being
depressed."
 "Most sports activities, except for swimming, can be resumed based on your overall
physical condition."
 "After surgery, changes in activities must be made to accommodate for the physiologic
changes caused by the operation."

32. A client is scheduled for ligation of hemorrhoids. Which diet does the nurse expect to be
ordered in preparation for this surgery?
 Bland
 Clear liquid
 High-protein
 Low-residue

33. A nurse is assessing a client with the diagnosis of hemor-rhoids. Which factors in the
client's history probably played a role in the development of the client's hemorrhoids?
Select all that apply.
 Constipation
 Hypertension
 Eating spicy foods
 Bowel incontinence
 Numerous pregnancies

34. A client is diagnosed as having the hepatitis B virus (HBV). The nurse reviews the
client's health history for possible situations in which exposure may have occurred.
Which event does the nurse determine is the most likely source of this infection?
 Had a small tattoo on the arm 3 months ago
 Assisted in the emergency birth of a baby 2 weeks ago
 Worked for a month in an undeveloped area in Mexico 4 months ago
 Attended an ecologic conference in a large urban center 2 months ago

35. client who is receiving TPN reports experiencing nausea, thirst, and a headache. Which
clinical factor should the nurse monitor initially to further assess the client's status?
 Blood glucose
 Urinary output
 Blood pressure
 Oral temperature
36. A low-residue diet is recommended for a client. Which food should the nurse encourage
the client to select from a menu?
 Steamed broccoli
 Creamed potatoes
 Raw spinach salad
 Baked sweet potato

ANSWERS
1. 1
2. 4
3. 4
4. 2
5. 2
6. 3
7. 2
8. 4,3,1,2,5
9. 1,2,5
10. 1,2,4
11. 4
12. 2,5
13. 3
14. 3
15. 1
16. 1
17. 1,5
18. 2
19. 1,3
20. 1
21. 2
22. 2
23. 3
24. 1
25. 2
26. 1
27. 3
28. 2
29. 3
30. 4
31. 1
32. 4
33. 1,5
34. 1
35. 1
36. 2