The patient has a Salem Sump nasogastric tube (NGT) connected to low intermitted

suction whose "pigtail" is draining stomach contents. What should the nurse do?
A. Clamp the pigtail to prevent gastric leakage
B. Insert 30 mL of air into the pigtail to spear the drainage
C. Call the surgeon to check placement of the NGT
D. Increase the suction to high continuous suction

The nurse is caring for a patient is the post anesthesia care unit (PACU) 2 hours after
abdominal surgery. The nurse auscultates the patient's abdomen and notes that there
are no bowel sounds. What action should the nurse take?
A. Palpate the bladder and measure abdominal girth
B. Document the finding and continue to monitor
C. Insert a nasogastric tube to low intermittent suction
D. Position the patient of the left side with the bed flat

The post-operative patient has been transferred from the Post Anesthesia Care Unit
(PACU) to the medical-surgical unit. What should the nurse do first?
A. Assess airway and oxygenation
B. Check the dressing for any drainage
C. Provide pain medication as ordered
D. Perform a neurological check

The nurse's abdominal assessment of a post-operative patient reveals the patient's

abdomen is flat, non distended, and no bowel sounds are audible. What is the best
explanation of the finding?

A. Exposure of the patient to the cold operating room causes bowel sounds to stop
B. Permanent loss of bowel sounds occurs with certain types of abdominal surgery
C. Due to the effects of general anesthesia, the patient has a paralytic ileus
D. Bowel sounds are absent as a result of the narcotics given for pain control

A patient is prescribed fluticasone (Flovent) via metered-dose inhaler (MDI) BID. What
actions indicate the patient is using the MDI correctly? (Select all that apply)
A. The patient waits 5 minutes between puffs
B. The mouth is rinsed with water after administration
C. the inhaler is held upright
D. The patient lies supine for 15 minutes following administration
E. The patient breathes in quickly and shallowly

A post-operative patient who is on bed rest asks why intermittent compression devices
are needed. How should the nurse respond?
A. "These are more comfortable than compression stockings"
B. "These remind you to keep still and avoid around too much"
C. "These will improve the arterial circulation in your body"
D. "These help prevent clot formation in your legs while you are inactive"

A patient with asthma reports "not being able to take deep breaths." The nurse
auscultates decreased breath sounds in the bases and no wheezes. What is the nurse's
best action?
A. Have the patient cough forcefully
B. Encourage the patient to stay calm and take deep breaths
C. Assess the patient's oxygen saturation
D. Document the findings and continue to monitor

The nurse is evaluating a patient's response to medication therapy to asthma. The

patient has a peak flowmeter reading in the yellow zone. What does the nurse do next?
A. Nothing: this is an acceptable range
B. Assist the patient to use a reliever (rescue) inhaler
C. Assess the patient's lungs
D. Teach the patient to take deeper breaths

The nurse is teaching a patient with asthma about self-management. Which statement
by the nurses the best?
A. Keep a daily symptoms and intervention diary
B. Establish your personal best peak expiratory flow during an attack
C. Note your symptoms when you don't take your medications
D. Exercise before and after taking inhalers and compare tolerance

A patient with emphysema has a respiratory rate of 24 breaths per minute, bilateral
crackles, and is coughing but unable to expectorate sputum. Which nursing diagnosis is
the priority for the patient?
A. Impaired Gas Exchange r/t ventilation-perfusion mismatch
B. Ineffective Airway Clearance r/t inability to expectorate sputum
C. Risk for Decreased Cardiac Output secondary to for pulmonale
D. Ineffective Breathing Pattern r/t increased work of breathing

What statement but the nurse indicated the understanding of the administration of
oxygen to the patient with emphysema?
A. High oxygen concentration will cause coughing and dyspnea
B. Administration of oxygen is contraindicated in patients who use bronchodilators
C. High oxygen concentration may inhibit the hypoxic stimulus to breathe
D. Increased oxygen use will cause the patient to become dependent on the oxygen

What outcome is appropriate for the patient with emphysema who has been discharged
to home?
A. The patient states he will call the health care provider if dyspnea on exertion occurs
B. The patient promises to do pursed-lip breathing at home if short of breath
C. The patient states he will use oxygen via nasal cannula at 5 L/minute
D. The patient verbalizes actions to reduce and manage pain

When instructing patient on how to decrease the risk of chronic obstructive pulmonary
disease (COPD). What should the nurse emphasize?
A. Avoid exposure to people with known respiratory infections
B. Abstain from cigarette smoking
C. Participate regularly in aerobic exercises
D. Maintain a high protein diet

The nurse explains to the patient with gastroesophageal reflux disease that this
disorder:

A. results in acid erosion and ulceration of the esophagus caused by frequent vomiting,
B. will require surgical wrapping or repair of the pyloric sphincter to control the
symptoms,
C. is the protrusion of a portion of the stomach into to esophagus through an opening in
the diaphragm,
D. often involves relaxation of the lower esophageal sphincter, allowing stomach
contents to back up into the espophagus

Which of the following types of gastritis is

associated with Helicobacter pylori and duodenal ulcers?

1. Erosive (hemorrhagic) gastritis

2. Fundic gland gastritis (type A)
3. Antral gland gastritis (type B)
4.Aspiring-induced gastric ulcer

Gastroesophageal reflux disease (GERD) weakens the lower esophageal sphincter,

predisposing older persons to risk for impaired swallowing. In managing the symptoms
associated with GERD, the nurse should assign the highest priority to which of the
following interventions?

1. Decrease daily intake of vegetables and water, and ambulate frequently

2. Drink coffee diluted with milk at each meal, and remain in an upright position for 30
minutes.
3. Eat small, frequent meals, and remain in an upright position for at least 30 minutes
after eating
4. Avoid over-the-counter drugs that have antacids in them
The client with a hiatal hernia chronically experiences heartburn following meals. The
nurse plans to teach the client to avoid which action because it is contraindicated with
hiatal hernia?

1. Lying recumbent following meals

2. Taking in small, frequent, bland meals
3. Raising the head of the bed on 6-inch blocks
4. Taking H2-receptor antagonist medication

1. To repair a hole in the stomach

2. to reduce the ability of the stomach to produce acid
3. to prevent the stomach from sliding into the chest
4. to remove a potentially malignant lesion in the stomach

Which assessment data support the client's diagnosis of gastric ulcer?

1. Presence of blood in the client's stool for the past month.

2.Complaints of a burning sensation that moves like a wave.
3.Sharp pain in the upper abdomen after eating a heavy meal.
4.Comparison of complaints of pain with ingestion of food and sleep

When assessing the client with the diagnosis of peptic ulcer disease, which physical
examination should the nurse implement first?
1. Auscultate the client's bowel sounds in all four quadrants.
2.Palpate the abdominal area for tenderness.
3.Percuss the abdominal borders to identify organs.
4.Assess the tender area progressing to nontender

The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment
finding would most likely indicate perforation of the ulcer?
1. Bradycardia
2. Numbness in the legs
3. Nausea and vomiting
4. A rigid, board-like abdomen

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

The nurse is teaching the patient a client with a

peptic ulcer discharge instructions. The client
asks the nurse which type of analgesic he may
take. Which of the following responses by the
nurse would be most accurate?
1. Aspirin
2. Acetaminophen
3. Naproxen
4. Ibuprofen

Which dietary modifications should be included in the plan of care?

1. Allow any of the client's favorite foods as long as the amount is limited.
2. Have the client perform eructation exercises several times a day.
3. Eat four (4) to six (6) small meals a day and limit fluids during mealtimes.
4. Encourage the client to consume a glass of red wine with one (1) meal a day

Which of the following types of gastritis ic associated with Helicobacter pylori and
duodenal ulcers?
1. Erosive (hemorrhagic) gastritis
2. Fundic gland gastritis (type A)
3. Antral gland gastritis (type B)
4. Aspiring-induced gastric ulcer

The client with hiatal hernia chronically experiences heartburn following meals. The
nurse plans to teach the client to avoid which action because it is contraindicated with a
hiatal hernia?
1. Lying recumbent following meals.
2. Taking in small, frequent bland meals.
3. Raising the head of the bed on 6-inch block.
4. Taking H2-receptor antagonist medication

The nurse teaches the client about an anti-ulcer diet. Which of the following statements
by the client indicates to the nurse that dietary teaching was successful?
1. "I must eat bland foods to help my stomach heal."
2. "I can eat most foods, as long as they don't bother my stomach."
3. "I cannot eat fruits and vegetables because they cause too much gas."
4. "I should eat a low-fiber diet to delay gastric emptying -
Which assessment data support to the the nurse the client's diagnosis of gastric ulcer?
A. Presence of blood in the client's stool for the past month?
B. Reports of a burning sensation moving like a wave.
C. Sharp pain in the upper abdomen after eating a heavy meal.
D. Complaints of epigastric pain 30-60 minutes after ingesting food

A patient with a history of peptic ulcer disease has presented to the emergency
department with complaints of severe abdominal pain and a rigid, boardlike abdomen,
prompting the health care team to suspect a perforated ulcer. Which of the following
actions should the nurse anticipate?
A. Providing IV fluids and inserting a nasogastric tube
B. Administering oral bicarbonate and testing the patient's gastric pH level.
C. Performing a fecal occult blood test and administering IV calcium gluconate.
D. Starting parenteral nutrition and placing the patient in high-Fowler's position

The nurse is caring for a female client with active upper GI bleeding. What is the
appropriate diet for this client during the first 24 hours after admission? a. regular diet
b. skim milk
c. nothing by mouth
d. clear liquids

The teaching plan for the patient being discharged following an acute episode of upper
GI bleeding will concern information concerning the importance of (select all that apply)
a. only taking aspirin with milk or bread products
b. avoiding taking aspirin and drugs containing aspirin
c. taking only drugs prescribed by the health care provider
d. taking all drugs 1 hour before mealtime to prevent further bleeding e. reading all OTC
drug labels to avoid those containing stearic acid and calcium

The male client tells the nurse he has been experiencing "heartburn" at night that
awakens him. Which assessment question should the nurse ask? A. How much weight
have you gained recently?
B. What have you done to alleviate the heartburn?
C. Do you consume many milk and dairy products?
D Have you been around anyone with a stomach virus

A patient has a vagotomy with antrectomy to treat a duodenal ulcer. Postoperatively, the
patient develops dumping syndrome. Which of the following statements, if made by the
patient, should indicate to the nurse that further dietary teaching is needed?
1. I should eat bread with each meal
2. I should eat smaller meals more frequently.
3. I should lie down after eating.
4. I should avoid drinking fluids with my meals
The results of a patient's recent endoscopy indicate the presence of peptic ulcer
disease (PUD). Which of the following teaching points should the nurse provide to the
patient in light of his new diagnosis?
A) "You'll need to drink at least two to three glasses of milk daily."
B) "It would likely be beneficial for you to eliminate drinking alcohol."
C) "Many people find that a minced or pureed diet eases their symptoms of PUD."
D) "Your medications should allow you to maintain your present diet while minimizing
symptoms

The client with hiatal hernia chronically experiences heartburn following meals. The
nurses plans to teach the client to avoid which action because it is contraindicated with
a hiatal hernia?

1. Lying recumbent following meals

2. Taking in small, frequent, bland meals
3. Raising the head of bed on 6-inch blocks
4. Taking H2-receptor antagonist medication
"The nurse has instructed the client who is experiencing diarrhea associated with
irritable bowel syndrome on dietary changes to prevent diarrhea. The nurse knows the
client understands the dietary changes if the client selects which of the following menu
choices?

a) Yogurt, crackers and sweet tea

b) Salad with chicken, whole wheat crackers
c) Bacon, tomato, lettuce with mayonnaise and a soft drink
d) Tuna on white bread and coconut cake

A client receives a local anesthetic to suppress the gag reflex for a diagnostic procedure
of the upper GI tract. Which of the following nursing interventions is advised for this
patient?
a The client should be monitored for any breathing related disorder or discomforts
b) The client should not be given any food and fluids until the gag reflex returns,
c. The client should be monitored for cramping or abdominal distention,
d) The client's fluid output should be measured for at least 24 hours after the procedure