1.
During preparation for bowel surgery, a male client receives an
antibiotic to reduce intestinal bacteria. Antibiotic therapy may
interfere with synthesis of which vitamin and may lead to
hypoprothrombinemia?
A. 
B. 
C. 
D. 
2.
When evaluating a male client for complications of acute pancreatitis, the nurse would observe for:
A. 
Increased intracranial pressure.
B. 
C. 
D. 
3.
A male client with a recent history of rectal bleeding is being prepared for a colonoscopy. How should the nurse position the client for this test initially?
A. 
Lying on the right side with legs straight
B. 
Lying on the left side with knees bent
C. 
Prone with the torso elevated
D. 
Bent over with hands touching the floor
4.
A male client with extreme weakness, pallor, weak peripheral pulses, and disorientation is admitted to the emergency department. His wife reports that he has been “spitting up blood.” A Mallory-Weiss tear is suspected, and the nurse begins taking a client history from the client’s wife. The question by the nurse that demonstrates her understanding of Mallory-Weiss tearing is:
A. 
“Tell me about your husband’s alcohol usage.”
B. 
“Is your husband being treated for tuberculosis?”
C. 
“Has your husband recently fallen or injured his chest?”
D. 
“Describe spices and condiments your husband uses on food.”
5.
Which of the following nursing interventions should the nurse perform for a female client receiving enteral feedings through a gastrostomy tube?
A. 
Change the tube feeding solutions and tubing at least every 24 hours.
B. 
Maintain the head of the bed at a 15-degree elevation continuously.
C. 
Check the gastrostomy tube for position every 2 days.
D. 
Maintain the client on bed rest during the feedings.
6.
A male client is recovering from a small-bowel resection. To relieve pain, the physician prescribes meperidine (Demerol), 75 mg I.M. every 4 hours. How soon after administration should meperidine’s onset of action occur?
A. 
B. 
C. 
D. 
7.
The nurse is caring for a male client with cirrhosis. Which assessment findings indicate that the client has deficient vitamin K absorption caused by this hepatic disease?
A. 
B. 
C. 
D. 
Gynecomastia and testicular atrophy
8.
Which condition is most likely to have a nursing diagnosis of fluid volume deficit?
A. 
B. 
C. 
D. 
9.
While a female client is being prepared for discharge, the nasogastric (NG) feeding tube becomes clogged. To remedy this problem and teach the client’s family how to deal with it at home, what should the nurse do?
A. 
Irrigate the tube with cola.
B. 
Advance the tube into the intestine.
C. 
Apply intermittent suction to the tube.
D. 
Withdraw the obstruction with a 30-ml syringe.
10.
A male client with pancreatitis complains of pain. The nurse expects the physician to prescribe meperidine (Demerol) instead of morphine to relieve pain because:
A. 
Meperidine provides a better, more prolonged analgesic effect.
B. 
Morphine may cause spasms of Oddi’s sphincter.
C. 
Meperidine is less addictive than morphine.
D. 
Morphine may cause hepatic dysfunction.
11.
Mandy, an adolescent girl is admitted to an acute care facility with severe malnutrition. After a thorough examination, the physician diagnoses anorexia nervosa. When developing the plan of care for this client, the nurse is most likely to include which nursing diagnosis?
A. 
B. 
C. 
D. 
12.
Which diagnostic test would be used first to evaluate a client with upper GI bleeding?
A. 
B. 
C. 
Hemoglobin (Hb) levels and hematocrit (HCT)
D. 
13.
A female client who has just been diagnosed with hepatitis A asks, “How could I have gotten this disease?” What is the nurse’s best response?
A. 
“You may have eaten contaminated restaurant food.”
B. 
“You could have gotten it by using I.V. drugs.”
C. 
“You must have received an infected blood transfusion.”
D. 
“You probably got it by engaging in unprotected sex.”
14.
When preparing a male client, age 51, for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis?
A. 
Obstruction of the appendix may increase venous drainage and cause the appendix to rupture.
B. 
Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.
C. 
The appendix may develop gangrene and rupture, especially in a middle-aged client.
D. 
Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage.
15.
A female client with hepatitis C develops liver failure and GI hemorrhage. The blood products that would most likely bring about hemostasis in the client are:
A. 
B. 
Platelets and packed red blood cells.
C. 
Fresh frozen plasma and whole blood.
D. 
Cryoprecipitate and fresh frozen plasma
16.
To prevent gastroesophageal reflux in a male client with hiatal hernia, the nurse should provide which discharge instruction?
A. 
“Lie down after meals to promote digestion.”
B. 
“Avoid coffee and alcoholic beverages.”
C. 
“Take antacids with meals.”
D. 
“Limit fluid intake with meals.”
17.
The nurse caring for a client with small-bowel obstruction would plan to implement which nursing intervention first?
A. 
Administering pain medication
B. 
Obtaining a blood sample for laboratory studies
C. 
Preparing to insert a nasogastric (NG) tube
D. 
Administering I.V. fluids
18.
A female client with dysphagia is being prepared for discharge. Which outcome indicates that the client is ready for discharge?
A. 
The client doesn’t exhibit rectal tenesmus.
B. 
The client is free from esophagitis and achalasia.
C. 
The client reports diminished duodenal inflammation.
D. 
The client has normal gastric structures.
19.
A male client undergoes total gastrectomy. Several hours after surgery, the nurse notes that the client’s nasogastric (NG) tube has stopped draining. How should the nurse respond?
A. 
B. 
C. 
D. 
Increase the suction level
20.
What laboratory finding is the primary diagnostic indicator for pancreatitis?
A. 
Elevated blood urea nitrogen (BUN)
B. 
C. 
Elevated aspartate aminotransferase (AST)
D. 
Increased lactate dehydrogenase (LD)
21.
A male client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note:
A. 
B. 
C. 
D. 
22.
Nurse Hannah is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention:
A. 
A sedentary lifestyle and smoking.
B. 
A history of hemorrhoids and smoking
C. 
Alcohol abuse and a history of acute renal failure.
D. 
Alcohol abuse and smoking
23.
While palpating a female client’s right upper quadrant (RUQ), the nurse would expect to find which of the following structures?
A. 
B. 
C. 
D. 
24.
A male client has undergone a colon resection. While turning him, wound dehiscence with evisceration occurs. The nurse’s first response is to:
A. 
B. 
Place saline-soaked sterile dressings on the wound.
C. 
Take a blood pressure and pulse.
D. 
Pull the dehiscence closed.
25.
The nurse is monitoring a female client receiving paregoric to treat diarrhea for drug interactions. Which drugs can produce additive constipation when given with an opium preparation?
A. 
B. 
C. 
D.