1.

The nurse sees that the new medication noted in a recent medication order is on
the client’s list of allergies. In the role of patient advocate, what actions should the
nurse take to ensure client safety? Select all that apply.
A. Document the medication with times and doses to be given, then administer the medication as
ordered.
B. Notify the physician immediately that the medication ordered is on the client’s list of medication
allergies.
C. Discontinue the medication on the client’s medication administration record.
D. Check the client’s allergy band against the list of client allergies documented in the medical
record

2. A nurse is preparing to care for a female client with esophageal varices who just
had a Sengstaken-Blakemore tube inserted. The nurse gathers supplies, knowing that
which of the following items must be kept at the bedside at all times?
A. An obturator
B. Kelly clamp
C. An irrigation set
D. A pair of scissors

3. A female client being seen in a physician’s office has just been scheduled for a
barium swallow the next day. The nurse writes down which instruction for the client to
follow before the test?
A. Fast for 8 hours before the test
B. Eat a regular supper and breakfast
C. Continue to take all oral medications as scheduled
D. Monitor own bowel movement pattern for constipation

4. The nurse is performing an abdominal assessment and inspects the skin of the
abdomen. The nurse performs which assessment technique next?
A. Palpates the abdomen for size
B. Palpates the liver at the right rib margin
C. Listens to bowel sounds in all for quadrants
D. Percusses the right lower abdominal quadrant

5. The nurse is monitoring a female client for the early signs and symptoms of
dumping syndrome. Which of the following indicate this occurrence?
A. Sweating and pallor
B. Bradycardia and indigestion
C. Double vision and chest pain
D. Abdominal cramping and pain

6. The nurse is caring for a male client postoperatively following creation of a

colostomy. Which nursing diagnosis should the nurse include in the plan of care?
A. Sexual dysfunction
B. Body image, disturbed
C. Fear related to poor prognosis
D. Nutrition: more than body requirements, imbalanced

7. The nurse is performing a colostomy irrigation on a male client. During the irrigation,
the client begins to complain of abdominal cramps. What is the appropriate nursing
action?
A. Notify the physician
B. Stop the irrigation temporarily
C. Increase the height of the irrigation
D. Medicate for pain and resume the irrigation

8. The nurse is teaching a female client how to perform a colostomy irrigation. To

enhance the effectiveness of the irrigation and fecal returns, what measure should the
nurse instruct the client to do?
A. Increase fluid intake
B. Place heat on the abdomen
C. Perform the irrigation in the evening
D. Reduce the amount of irrigation solution

9. Which of the following symptoms indicated diverticulosis

1. No symptoms exist
2. Change in bowel habits
3. Anorexia with low-grade fever
4. Episodic, dull, or steady midabdominal pain

10. Which of the following tests should be administered to a client suspected of having
diverticulosis?
1. Abdominal ultrasound
2. Barium enema
3. Barium swallow
4. Gastroscopy

11. Medical management of the client with diverticulitis should include which of the
following treatments?
a. Reduced fluid intake
b. Increased fiber in diet
c. Administration of antibiotics
d. Exercises to increase intra-abdominal pressure
12. Which of the following conditions can cause a hiatal hernia?
a. Increased intrathoracic pressure
b. Weakness of the esophageal muscle
c. Increased esophageal muscle pressure
d. Weakness of the diaphragmatic muscle

13. Risk factors for the development of hiatal hernias are those that lead to increased
abdominal pressure. Which of the following complications can cause increased
abdominal pressure?
1. Obesity
2. Volvulus
3. Constipation
4. Intestinal obstruction

14. Which of the following symptoms is common with a hiatal hernia?

1. Left arm pain
2. Lower back pain
3. Esophageal reflux
4. Abdominal cramping

15. Which of the following best describes the method of action of medications, such as
ranitidine  (Zantac), which are used in the treatment of peptic ulcer disease?

a. Neutralize acid
b. Reduce acid secretions
c. Stimulate gastrin release
d. Protect the mucosal barrier

16. The hospitalized client with GERD is complaining of chest discomfort that feels like
heartburn following a meal. After administering an ordered antacid, the nurse
encourages the client to lie in which of the following positions?
a. Supine with the head of the bed flat
b. On the stomach with the head flat
c. On the left side with the head of the bed elevated 30 degrees
d. On the right side with the head of the bed elevated 30 degrees.

17. The nurse is caring for a client following a Billroth II procedure. Billroth II is?
a. Duodenostomy
b. gastroJejunostomy
c. Both a and b
d. None of the above
18. The nurse is caring for a client following a Billroth I procedure. Billroth I is?
a. gastroDuodenostomy
b. gastroJejunostomy
c. Both a and b
d. None of the above

19. A client with suspected gastric cancer undergoes an endoscopy of the stomach.
Which of the following assessments made after the procedure would indicate the
development of a potential complication?
a. The client complains of a sore throat
b. The client displays signs of sedation
c. The client experiences a sudden increase in temperature
d. The client demonstrates a lack of appetite

20. A client has been diagnosed with adenocarcinoma of the stomach and is
scheduled to undergo a subtotal gastrectomy (Billroth II procedure). During pre-
operative teaching, the nurse is reinforcing information about the procedure. Which of
the following explanations is most accurate?
1. The procedure will result in enlargement of the pyloric sphincter
2. The procedure will result in anastomosis of the gastric stump to the jejunum
3. The procedure will result in removal of the duodenum
4. The procedure will result in repositioning of the vagus nerve

21. The client with GERD complains of a chronic cough. The nurse understands that in
a client with GERD this symptom may be indicative of which of the following
conditions?
1. Development of laryngeal cancer
2. Irritation of the esophagus
3. Esophageal scar tissue formation
4. Aspiration of gastric contents

22. Which of the following dietary measures would be useful in preventing esophageal
reflux?
1. Eating small, frequent meals
2. Increasing fluid intake
3. Avoiding air swallowing with meals
4. Adding a bedtime snack to the dietary plan

23. A client is admitted to the hospital after vomiting bright red blood and is diagnosed
with a bleeding duodenal ulcer. The client develops a sudden, sharp pain in the mid
epigastric area along with a rigid, board-like abdomen. These clinical manifestations
most likely indicate which of the following?
1. An intestinal obstruction has developed
2. Additional ulcers have developed
3. The esophagus has become inflamed
4. The ulcer has perforated

24. When obtaining a nursing history on a client with a suspected gastric ulcer, which
signs and symptoms would the nurse expect to see? Select all that apply.
1. Epigastric pain at night
2. Relief of epigastric pain after eating
3. Vomiting
4. Weight loss

25. The nurse is caring for a client who has had a gastroscopy. Which of the following
symptoms may indicate that the client is developing a complication related to the
procedure? Select all that apply.
1. The client complains of a sore throat
2. The client has a temperature of 100*F
3. The client appears drowsy following the procedure
4. The client complains of epigastric pain
5. The client experiences hematemesis

26. A client with peptic ulcer disease tells the nurse that he has black stools, which he
has not reported to his physician. Based on this information, which nursing diagnosis
would be appropriate for this client?
1. Ineffective coping related to fear of diagnosis of chronic illness
2. Deficient knowledge related to unfamiliarity with significant signs and symptoms
3. Constipation related to decreased gastric motility
4. Imbalanced nutrition: Less than body requirements due to gastric bleeding

27. A client with a peptic ulcer reports epigastric pain that frequently awakens her at
night, a feeling of fullness in the abdomen, and a feeling of anxiety about her health.
Based on this information, which nursing diagnosis would be most appropriate?
1. Imbalanced Nutrition: Less than Body Requirements related to anorexia.
2. Disturbed Sleep Pattern related to epigastric pain
3. Ineffective Coping related to exacerbation of duodenal ulcer
4. Activity Intolerance related to abdominal pain

28. While caring for a client with peptic ulcer disease, the client reports that he has
been nauseated most of the day and is now feeling lightheaded and dizzy. Based
upon these findings, which nursing actions would be most appropriate for the nurse to
take? Select all that apply.
1. Administering an antacid hourly until nausea subsides.
2. Monitoring the client’s vital signs
3. Notifying the physician of the client’s symptoms
4. Initiating oxygen therapy
5. Reassessing the client on an hour

29. A client is taking an antacid for treatment of a peptic ulcer. Which of the following
statements best indicates that the client understands how to correctly take the
antacid?
1. “I should take my antacid before I take my other medications.”
2. “I need to decrease my intake of fluids so that I don’t dilute the effects of my antacid.”
3. “My antacid will be most effective if I take it whenever I experience stomach pains.”
4. “It is best for me to take my antacid 1 to 3 hours after meals.”

30. The nurse is caring for a client with chronic gastritis. The nurse monitors the client,
knowing that this client is at risk for which of the following vitamin deficiencies?
1. Vitamin A
2. Vitamin B12
3. Vitamin C
4. Vitamin E

31. Patients with esophageal varices would reveal the following assessment:
A. increased blood pressure.
B. increased heart rate.
C. decreased respiratory rate.
D. increased urinary output.

32. Peritonitis can occur as a complication of:

A. septicemia
B. multiple organ failure
C. hypovolemic shock
D. peptic ulcer disease

33. A romoval of the pyloric(antrum) portion of the stomach with anastomosis to either
the duodenum or jejunum
a. Anrectomes
b. Gastroduodenostomy
c. Jejunostomy
d. None of the above

34. Erosion of ulcer through the gastric serosa into the peritoneal cavity w/o warning
a. Hemorrhage
b. Perforation
c. Peritonitis
d. All of the above
35. An unpleasant set of vasomotor and G.I symptoms that sometimes occur in patient
who have gastric surgery or a form vagotomy caused by rapid emptying of gastric
content into the jejunum
a. PUD
b. ZES
c. Dumping syndrome
d. All of the above

36. Is a term used to describe an abnormal infrequency or irregularity of defecation

a. Diarrhea
b. Diverticulosis
c. Constipation
d. All of the above

37. Stenosis or scarring of the distal pyloric sphincter as a result of alternate healing
and breakdowns
a. Constipation
b. GERD
c. Pyloric obstruction
d. Destruction of the abdomen

38. Bowel twist and turns on occlude the blood supply

a. Intussusception
b. Volvulus
c. Hernia
d. All of the above

39. TWO TIMES THE IDEAL BODY WT >30KG/M2

a. Morbid obesity
b. Pregnancy
c. Ascites
d. All of the above

40. is the removal of a small amount of liver tissue, usually through needle aspiration
a. liver analysis’
b. liver biopsy
c. AST
d. None of the above

41. Increased serum bilirubin levels resulting from several inherited disorders can also
produce jaundice
a. Hyper hemoglobin
b. Hereditary hyperbilirubinemia
c. HCL
d. None of the above

42. Elevated pressure in the portal vein associated with increase resistance to blood
flow through the portal venous system
a. Portal venousity
b. Portal hypertension
c. Esophageal varices
d. None of the above

43. is the removal of fluid from the peritoneal cavity through a small surgical incision or
puncture made through the abdominal wall under sterile conditions
a. thoracentesis
b. paracentesis
c. pneumothorax
d. none of the above

44. Hemorrhagic processes involving dilated tortuous veins in the submucosa of the
lower esophagus
a. Portal venousity
b. Portal hypertension
c. Esophageal varices
d. None of the above

45. flapping tremor of the hands:

a. handle
b. asterixis
c. android
d. stares

46. Liver cirrhosis commonly cause by alcoholism, chronic nutritional deficiency

a. Laennec's
b. Biliary
c. Both a and b
d. None of the above

47. Liver cirrhosis caused bile duct disorder that suppressed bile flow
a. Laennec's
b. Biliary
c. Both a and b
d. None of the above

48. A male client who is recovering from surgery has been advanced from a clear
liquid diet to a full liquid diet. The client is looking forward to the diet change because
he has been “bored” with the clear liquid diet. The nurse would offer which full liquid
item to the client?
A. Tea
B. Gelatin
C. Custard
D. Popsicle

49. Nurse Oliver checks for residual before administering a bolus tube feeding to a
client with a nasogastric tube and obtains a residual amount of 150 mL. What is
appropriate action for the nurse to take?
A. Hold the feeding
B. Reinstill the amount and continue with administering the feeding
C. Elevate the client’s head at least 45 degrees and administer the feeding
D. Discard the residual amount and proceed with administering the feeding
Option 6

50. A nurse is inserting a nasogastric tube in an adult male client. During the
procedure, the client begins to cough and has difficulty breathing. Which of the
following is the appropriate nursing action?
A. Quickly insert the tube
B. Notify the physician immediately
C. Remove the tube and reinsert when the respiratory distress subsides
D. Pull back on the tube and wait until the respiratory distress subsides