1114 Test 5

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MarieRN
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180481
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1114 Test 5
Updated:
2012-10-28 23:32:25
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Med Surg
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Chapters 17, 26, 38, 39 & 41
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  1. Glycopyrrolate (Robinul) is classified as a/an:
    a.       Tranquilizer
    b.      Analgesic
    c.       Anticholinergic
    d.      Sedative or hypnotic
    c
  2. Chloral hydrate (Noctec) is classified as a/an:
    a.       Tranquilizer
    b.      Analgesic
    c.       Anticholinergic
    d.      Sedative or hypnotic
    d
  3. Promethazine hydrochloride (Phenergan) is classified as a/an:
    a.       Tranquilizer
    b.      Analgesic
    c.       Anticholinergic
    d.      Sedative or hypnotic
    d
  4. Pentobarbital sodium (Nembutal Sodium) is classified as a/an:
    a.       Tranquilizer
    b.      Analgesic
    c.       Anticholinergic
    d.      Sedative or hypnotic
    d
  5. Diazepam (Valium) is classified as a/an:
    a.       Tranquilizer
    b.      Analgesic
    c.       Anticholinergic
    d.      Sedative or hypnotic
    a
  6. Atropine sulfate is classified as a/an:
    a.       Tranquilizer
    b.      Analgesic
    c.       Anticholinergic
    d.      Sedative or hypnotic
    c
  7. Meperidine hydrochloride (Demerol HCl) is classified as a/an:
    a.       Tranquilizer
    b.      Analgesic
    c.       Anticholinergic
    d.      Sedative or hypnotic
    b
  8. Secobarbital sodium (Seconal sodium) is classified as a/an:
    a.       Tranquilizer
    b.      Analgesic
    c.       Anticholinergic
    d.      Sedative or hypnotic
    d
  9. Morphine sulfate (MS Contin, Duramorph) is classified as a/an:
    a.       Tranquilizer
    b.      Analgesic
    c.       Anticholinergic
    d.      Sedative or hypnotic
    b
  10. Which postoperative problems are obese surgical patients more likely to have?
    a.       Infection and increased temperature
    b.      Excessive bleeding and hemorrhage
    c.       Headache and bradycardia
    d.      Respiratory and wound healing complications
    d
  11. Electrolyte imbalances may predispose the surgical patient to:
    a.       cardiac arrhythmias.
    b.      lung complications.
    c.       liver malfunction.
    d.      bone tissue loss.
    a
  12. If the patient is a minor, who signs the surgical consent form?
    a.       Physician
    b.      Registered nurse
    c.       Parent or guardian
    d.      Close relative
    c
  13. Shaving the skin in preparation for surgery is often delayed until shortly before surgery in order to:
    a.       improve wound healing.
    b.      control bleeding.
    c.       allow less time for organisms to multiply.
    d.      prevent postoperative edema
    c
  14. The use of local anesthetics that block the conduction of nerve impulses in a specific area is called:
    a.       general anesthesia.
    b.      sedative anesthesia.
    c.       anticonvulsant anesthesia.
    d.      regional anesthesia.
    d
  15. The injection of an anesthetic agent into and under the skin around the area of treatment is called:
    a.       local infiltration.
    b.      topical administration.
    c.       nerve block technique.
    d.      intravenous infusion.
    a
  16. One complication of spinal anesthesia is:
    a.       tachycardia.
    b.      hemorrhage.
    c.       headache.
    d.      shock.
    c
  17. Post-spinal headache can be relieved by:
    a.       elevating the head of the bed.
    b.      lying flat.
    c.       early ambulation.
    d.      coughing and deep-breathing
    b
  18. A "blood patch" may help treat:
    a.       hemorrhage.
    b.      post-spinal headache.
    c.       shock.
    d.      tachycardia.
    b
  19. Which of the following adverse effects of anesthetic agents may be reduced by giving pre-anesthetic medications?
    a.       Tachycardia
    b.      Dry mouth
    c.       Urinary retention
    d.      Vomiting
    d
  20. When peristalsis is slow and there is increased gas buildup, what is the result?
    a.       Abdominal cramping and distention
    b.      Diarrhea and tachycardia
    c.       Fever and infection
    d.      Nausea and vomiting
    a
  21. "Gas pains" typically occur:
    a.       During surgery.
    b.      Immediately after surgery.
    c.       6 hours after surgery.
    d.      On second or third day after surgery.
    d
  22. An outcome criterion related to absence of thrombophlebitis is:
    a.       adequate oxygenation.
    b.      normal arterial blood gases.
    c.       negative Homans sign.
    d.      normal wound healing.
    c
  23. What is used to monitor the oxygenation of the blood?
    a.       Sphygmomanometer
    b.      Incentive spirometer
    c.       Oximeter
    d.      Stethoscope
    c
  24. When regional block anesthesia is used during surgery, the nurse must remember that after surgery:
    a.       sensation in the area is impaired.
    b.      circulation in the area is impaired.
    c.       infection is likely to occur.
    d.      fever may make the patient drowsy.
    a
  25. Once the immediate postoperative phase has passed, which risks lessen?
    a.       Fever and infection
    b.      Pneumonia and atelectasis
    c.       Shock and hemorrhage
    d.      Thrombophlebitis and decubitus ulcer
    c
  26. Clean sutured incisions heal by:
    a.       first intention.
    b.      second intention.
    c.       third intention.
    d.      fourth intention.
    a
  27. A soft tube that permits passive movement of fluids from the wound is called a(n):
    a.       active drain.
    b.      Hemovac.
    c.       Penrose drain.
    d.      Jackson-Pratt drain.
    c
  28. Which sudden change in condition may precede wound dehiscence?
    a.       Decrease in wound drainage
    b.      Increase in wound drainage
    c.       Increase in temperature
    d.      Increase of purulent drainage
    b
  29. If evisceration occurs, the usual practice is to cover the wound with:
    a.       dry sterile dressings.
    b.      saline-soaked gauze with a dry dressing over it.
    c.       antibiotic ointment and dry dressings.
    d.      steroid ointment and dry dressings.
    b
  30. Signs and symptoms of wound infection usually do not develop until:
    a.       the first hour after surgery.
    b.      12 hours after surgery.
    c.       the first and second days after surgery.
    d.      the third to fifth day after surgery.
    d
  31. A postoperative patient complains of pain, fever, swelling, and purulent drainage. These signs and symptoms are indications of:
    a.       thrombophlebitis.
    b.      evisceration.
    c.       dehiscence.
    d.      wound infection.
    d
  32. Pulmonary emboli usually originate from thrombi that develop in veins of the:
    a.       chest.
    b.      arms and shoulders.
    c.       legs and pelvis.
    d.      abdomen.
    c
  33. Emboli may be treated with:
    a.       phenytoin (Dilantin) and anticonvulsants.
    b.      morphine and analgesics.
    c.       heparin and thrombolytic agents.
    d.      furosemide (Lasix) and diuretics.
    c
  34. Catheterization is usually done postoperatively if the patient does not void in:
    a.       2 hours.
    b.      4 hours.
    c.       8 hours.
    d.      10 hours.
    c
  35. When a patient passes small amounts of urine frequently without feeling relief of fullness, this indicates:
    a.       Retention with overflow.
    b.      Stress incontinence.
    c.       Urge incontinence.
    d.      Kidney failure.
    a
  36. Some agencies have policies that limit the amount of urine that can be drained from a full bladder at one time; these limits are usually:
    a.       5-10 ml.
    b.      50-100 ml.
    c.       400-500 ml.
    d.      750-1000 ml.
    d
  37. When do most patients pass flatus?
    a.       15 minutes after surgery
    b.      1 hour after surgery
    c.       48 hours after surgery
    d.      1 week after surgery
    c
  38. Which surgical drain works be creating negative pressure when the receptacle is compressed?
    a.       Penrose
    b.      Urinary
    c.       Hemovac
    d.      Passive
    c
  39. Which drug supplements the effects of local anesthetics?
    a.       Propranolol (Inderal)
    b.      Atropine
    c.       Morphine
    d.      Epinephrine
    c
  40. A patient states that his wound feels as if it is "pulling apart." This is an indication of:
    a.       healing by first intention.
    b.      dehiscence.
    c.       evisceration.
    d.      singultus.
    b
  41. Which of the following postoperative drugs causes urinary retention?
    a.       Antibiotics
    b.      Thrombolytics
    c.       Opioid analgesics
    d.      Anticoagulants
    c
  42. The use of IV drugs to reduce pain intensity or awareness without loss of reflexes is called:
    a.       regional anesthesia.
    b.      conscious sedation.
    c.       general anesthesia.
    d.      balanced anesthesia.
    b
  43. Which is a commonly used IV drug for conscious sedation?
    a.       Succinylcholine
    b.      Isoflurane
    c.       Nitrous oxide
    d.      Midazolam (Versed)
    d
  44. Enfulrane (Ethrane) and nitrous oxide are administered by:
    a.       inhalation.
    b.      IV infusion.
    c.       intramuscular (IM) injection.
    d.      rectal insertion.
    a
  45. The surgical patient who is malnourished is at risk for:
    a.       excessive bleeding and hemorrhage.
    b.      drug toxicity and ineffective metabolism.
    c.       cardiac complications and dyspnea.
    d.      poor wound healing and infection.
    d
  46. The patient develops rupture of the suture line and states: "My incision is breaking open." Which of the following actions should the nurse take to prevent complications in this patient?
    a.       Keep the patient in bed.
    b.      Administer opioid analgesics as ordered.
    c.       Have the patient cough and deep-breathe every 2 hours.
    d.      Auscultate breath sounds.
    a
  47. After the first 24 hours following surgery, which finding should be reported to the physician if it is observed?
    a.       Respirations of 20/minute
    b.      Temperature of 98.8⁰ F
    c.       Blood pressure of 110/70 mm Hg
    d.      Continued or excessive bleeding
    d
  48. Which finding in a postoperative patient should be reported to the physician?
    a.       Redness that spreads to the surrounding area
    b.      Redness at the wound suture site
    c.       Low-grade fever
    d.      Serosanguineous drainage
    a
  49. A week after surgery, the patient develops pain, fever, swelling, and purulent drainage around the wound site. Which of the following actions should the nurse take to prevent complications?
    a.       Keep the patient in bed
    b.      Early, frequent ambulation
    c.       Monitor intake and output
    d.      Good hand hygiene
    d
  50. What is the priority nursing diagnosis during the immediate postoperative period?
    a.       Acute pain
    b.      Impaired tissue integrity
    c.       Shock
    d.      Urinary retention
    c
  51. An opening created to drain contents of an organ
    a.       Prolapse
    b.      Stoma
    c.       Ureterostomy
    d.      Vesicostomy
    b
  52. A surgically created opening in the kidney to drain urine
    a.       Colostomy
    b.      Continent
    c.       Ileostomy
    d.      Nephrostomy
    d
  53. A surgically created opening into the urinary bladder
    a.       Vesicostomy
    b.      Ureterostomy
    c.       Stoma
    d.      Ostomy
    a
  54. A surgical procedure that creates an opening into a body structure
    a.       Ostomy
    b.      Ileostomy
    c.       Stoma
    d.      Anastomosis
    a
  55. What is capable of controlling natural impulses; in relation to an ostomy, able to retain feces or urine
    a.       Anastomosis
    b.      Colostomy
    c.       Continent
    d.      Ileostomy
    c
  56. A surgically created opening in the ureter
    a.       Nephrostomy
    b.      Ureterostomy
    c.       Vesicostomy
    d.      Colostomy
    b
  57. A downward placement
    a.       Prolapse
    b.      Stoma
    c.       Colostomy
    d.      Continent
    a
  58. A communication or connection between two organs or parts of organs
    a.       Prolapse
    b.      Stoma
    c.       Ostomy
    d.      Anastomosis
    d
  59. A surgically created opening in the ileum
    a.       Continent
    b.      Ileostomy
    c.       Nephrostomy
    d.      Ostomy
    b
  60. A surgically created opening in the colon
    a.       Anastomosis
    b.      Colostomy
    c.       Continent
    d.      Ileostomy
    b
  61. If edema occurs after the first week postoperatively, this most likely indicates:
    a.       improperly fitting collection device.
    b.      infection.
    c.       capillary hemorrhage.
    d.      poor circulation.
    a
  62. What type of medication can be inserted into a colostomy stoma to stimulate evacuation?
    a.       Laxative liquid
    b.      Hyperosmolar laxative
    c.       Rectal suppository
    d.      Nystatin
    b
  63. What is the treatment for yeast infections around the ureterostomy stoma?
    a.       Nystatin powder
    b.      Antibiotic ointment
    c.       Steroid ointment
    d.      Soap and water
    a
  64. If odor is a problem with ureterostomy, the pouch can be soaked for 20-30 minutes in:
    a.       50% alcohol.
    b.      normal saline.
    c.       vinegar water.
    d.      baking soda and water.
    c
  65. A colostomy is performed by bringing a loop of the intestine through the wall of the:
    a.       bladder.
    b.      rectum.
    c.       abdomen.
    d.      stomach.
    c
  66. Which complication of colostomy involves the narrowing of the abdominal opening around the base of the stoma?
    a.       Prolapse
    b.      Stenosis
    c.       Obstruction
    d.      Evisceration
    b
  67. What is the result of the loss of bicarbonate in ileostomy drainage?
    a.       Hypokalemia
    b.      Hypercalcemia
    c.       Metabolic acidosis
    d.      Fluid volume excess
    c
  68. The nurse notices that the patient's ileal conduit stomas has turned black. The nurse notifies the physician immediately, because it may mean that:
    a.       ureteral obstruction has occurred.
    b.      circulation is impaired.
    c.       wound infection is present.
    d.      prolapse has occurred.
    b
  69. After bowel resection for the ileal conduit procedure, the nurse should expect:
    a.       necrosis of the wound.
    b.      temporary ileus.
    c.       gray-black stoma.
    d.      ereteral calculi.
    b
  70. The Kock pouch is made with a section of:
    a.       sigmoid colon.
    b.      jejunum.
    c.       ileum.
    d.      ascending colon.
    c
  71. Which foods tend to produce thicker stools?
    a.       Milk and cottage cheese
    b.      Fresh fruits
    c.       Green, leafy vegetables
    d.      Pasta and boiled rice
    d
  72. Why is a nasogastric tube placed in a patient with bowel obstruction?
    a.       Dilate the digestive tract
    b.      Decompress the bowel
    c.       Provide method of feeding
    d.      Improve peristalsis
    b
  73. What is a complication of colostomy irrigation?
    a.       Obstruction
    b.      Diarrhea
    c.       Infection
    d.      Perforated bowel
    d
  74. A patient with an ileoanal reservoir is prescribed metronidazole (Flagyl), and asks the nurse why this drug is prescribed. The nurse answers that Flagyl is given to treat:
    a.       pain.
    b.      bleeding.
    c.       inflammation.
    d.      fluid volume deficit.
    c
  75. A patient with a colostomy is experiencing weakness when the colostomy is irrigated. Which manifestation requires the nurse to contact the physician?
    a.       Prolapse
    b.      Perforated bowel
    c.       Diarrhea
    d.      Red stoma
    b
  76. Which of the following is a sign of bowel obstruction?
    a.       Bloody stools
    b.      Fever
    c.       Abdominal distention
    d.      Hypotension
    c
  77. Which of the following is a major long-term complication caused by coughing in a patient with a colostomy?
    a.       Prolapse
    b.      Stenosis
    c.       Obstruction
    d.      Inflammation
    a
  78. Which is a complication of ureterostomy?
    a.       Obstruction
    b.      Perforation
    c.       Hydronephrosis
    d.      Prolapse
    c
  79. Which drug is used to treat a rash around the stoma of a patient with an ureterostomy?
    a.       Tetracycline
    b.      Neosporin
    c.       Benadryl
    d.      Nystatin
    d
  80. Which group has the highest rate of colon and rectal cancers that are commonly treated with ostomies?
    a.       Asians
    b.      African-Americans
    c.       Caucasians
    d.      Native Americans
    b
  81. Which type of patient with a colostomy should be given a two-piece appliance that allows frequent pouch changes without skin trauma?
    a.       Jewish
    b.      Native American
    c.       Asian
    d.      Muslim
    d
  82. Following ileostomy surgery, the stoma is inspected for bleeding and:
    a.       edema.
    b.      rough edges.
    c.       temperature.
    d.      color.
    d
  83. When does ileostomy drainage occur after surgery?
    a.       First 6 hours
    b.      10-12 hours
    c.       24-48 hours
    d.      After 72 hours
    c
  84. Postoperative ileostomy patients may experience electrolyte imbalances due to:
    a.       passage of liquid stool.
    b.      bleeding around the stoma.
    c.       poor circulation.
    d.      infection.
    a
  85. If the color of the stoma is pale or blue following ileostomy surgery, what should the nurse do?
    a.       Cleanse skin around stoma with soap and water.
    b.      Apply a protective skin barrier before replacing the pouch.
    c.       Notify the physician.
    d.      Check the pouch hourly to detect leakage.
    c
  86. What does a small amount of bleeding around the base of a new stoma indicate?
    a.       Infection
    b.      Tissue injury
    c.       Adequate blood supply
    d.      Poor circulation
    c
  87. A postoperative ileostomy patient becomes confused. What is the nursing intervention for this mental status change?
    a.       Check the pouch hourly.
    b.      Watch for neuromuscular status weakness.
    c.       Measure tissue turgor.
    d.      Monitor serum electrolytes.
    d
  88. A nurse notices that the patient's colostomy is not draining properly. What is the appropriate nursing action to take?
    a.       Place a gloved finger in the stoma to dilate it.
    b.      Use a larger catheter to irrigate.
    c.       Inform the physician.
    d.      Push the catheter in 3 inches.
    c
  89. The nurse is taking care of a patient with an ileostomy. The nurse is watching for signs of small bowel obstruction. To reduce the risk of obstruction, what is the appropriate diet for this patient?
    a.       Low fiber
    b.      Low cholesterol
    c.       Soft, bland foods
    d.      High residue
    a
  90. A patient with an ileostomy one week postoperatively has a pulse of 120 bpm, respirations 28/min, temperature of 101⁰ F, and a rigid abdomen. The nurse suspects that this patient has which complication?
    a.       Obstruction
    b.      Peritonitis
    c.       Inflammation
    d.      Evisceration of the site
    b
  91. Difficulty swallowing
    a.       Dysphagia
    b.      Dyspepsia
    c.       Stomatitis
    d.      Caries
    a
  92. Indigestion
    a.       Dysphagia
    b.      Dyspepsia
    c.       Stomatitis
    d.      Caries
    b
  93. Inflammation of the oral mucosa
    a.       Dysphagia
    b.      Dyspepsia
    c.       Stomatitis
    d.      Caries
    c
  94. Tooth decay
    a.       Dysphagia
    b.      Dyspepsia
    c.       Stomatitis
    d.      Caries
    d
  95. What is an inflammation of the esophagus caused by acidic gastric fluids?
    a.       Gastrectomy
    b.      Esophagitis
    c.       Heartburn
    d.      Palpation
    c
  96. What is a procedure used to assess bowel sounds?
    a.       Hiatus
    b.      Stomatitis
    c.       Auscultation
    d.      palpation
    c
  97. Hiatal hernia is thought to be caused by weakness in the:
    a.       Heartburn
    b.      Stomatitis
    c.       Lower esophageal sphincter
    d.      Pyloric sphincter
    c
  98. The opening in the diaphragm through which the esophagus passes is the esophageal:
    a.       Hiatus
    b.      Hiatal hernia
    c.       Heartburn
    d.      Stomatitis
    a
  99. What is direct examination of the esophagus with an endoscope?
    a.       Gastrectomy
    b.      Esophagoscopy
    c.       Fundoplication
    d.      Percussion
    b
  100. The procedure used to detect the presence of air, fluid, or masses in tissues is known as:
    a.       Stomatitis
    b.      Esophagitis
    c.       Percussion
    d.      Palpation
    c
  101. What is a protrusion of the lower esophagus and stomach upward through the diaphragm into the chest?
    a.       Hernia
    b.      Hiatal hernia
    c.       Palpation
    d.      Auscultation
    b
  102. What is a surgical procedure that strengthens the lower esophageal sphincter by suturing the fundus of the stomach around the esophagus and anchoring it below the diaphragm?
    a.       Auscultation
    b.      Fundoplication
    c.       Percussion
    d.      Palpation
    b
  103. A common symptom of malabsorption is the presence of excessive fat in the stool.
    a.       Diarrhea
    b.      Fecal impaction
    c.       Steatorrhea
    d.      Constipation
    c
  104. A condition in which the large intestine loses the ability to contract effectively enough to propel the fecal mass toward the rectum.
    a.       Megacolon
    b.      Constipation
    c.       Fecal impaction
    d.      Valsalva's maneuver
    a
  105. The passage of loose, liquid stools which increased frequency.
    a.       Fecal impaction
    b.      Steatorrhea
    c.       Constipation
    d.      Diarrhea
    d
  106. Increased pressure in the chest and abdominal cavities caused by straining to have a bowel movement.
    a.       Steatorrhea
    b.      Constipation
    c.       Valsalva's maneuver
    d.      Megacolon
    c
  107. A term used to describe a condition in which one or more nutrients are not digested or absorbed.
    a.       Constipation
    b.      Malabsorption
    c.       Megacolon
    d.      Fecal impaction
    b
  108. A condition in which a person has hard, dry, infrequent stools that are passed with difficulty.
    a.       Megacolon
    b.      Constipation
    c.       Fecal impaction
    d.      Diarrhea
    b
  109. The retention of a large mass of stool in the rectum that the patient is unable to pass.
    a.       Diarrhea
    b.      Fecal impaction
    c.       Constipation
    d.      Megacolon
    b
  110. The repair of the muscle defect in abdominal hernia by suturing.
    a.       Umbilicus
    b.      Hernia
    c.       Truss
    d.      Herniorrhaphy
    d
  111. A pad placed over the hernia to provide support for weak muscles, for patients who cannot tolerate the stress of surgical hernia repair.
    a.       Umbilicus
    b.      Hernia
    c.       Truss
    d.      Herniorrhaphy
    c
  112. The bulging portion of the large intestine pushing through the abdominal wall.
    a.       Umbilicus
    b.      Hernia
    c.       Truss
    d.      Herniorrhaphy
    b
  113. Weak location where hernias occur, in addition to the lower inguinal areas of the abdomen.
    a.       Umbilicus
    b.      Hernia
    c.       Truss
    d.      Herniorrhaphy
    a
  114. Treats ulcerative colitis and H. pylori.
    a.       Antifungals
    b.      Antidiarrheals
    c.       Antibacterials
    d.      Antacids
    c
  115. Neutralize gastric acid
    a.       Antacids
    b.      Antiemetics
    c.       Anticholinergics
    d.      Antifungals
    a
  116. Cling to the surface of the ulcer and protect it so that healing can take place
    a.       Mucosal barriers (cytoprotective)
    b.      H2-receptor antagonists
    c.       Anticholinergics
    d.      Proton pump inhibitors
    a
  117. Treat yeast infections in the mouth
    a.       Proton pump inhibitors
    b.      5-HR receptor antagonists
    c.       Antifungals
    d.      Antidiarrheals
    c
  118. Decrease hydrochloric acid production by competing at receptor sites
    a.       Anticholinergics
    b.      H2-receptor antagonists
    c.       Antiemetics
    d.      Antacids
    b
  119. Prevent and treat nausea
    a.       Anticholinergics
    b.      Antacids
    c.       Antiemetics
    d.      Antibacterials
    c
  120. Decrease intestinal motility so liquid portion of feces is reabsorbed
    a.       Antacids
    b.      Antidiarrheals
    c.       Antifungals
    d.      Antiemetics
    b
  121. Reduce gastrointestinal motility and secretions; block acetylcholine
    a.       Anticholinergics
    b.      H2- receptor antagonists
    c.       Mucosal barriers (cytoprotective)
    d.      5-HR receptor antagonists
    a
  122. Prevent nausea and vomiting caused by chemotherapy
    a.       Proton pump inhibitors
    b.      5-HR receptor antagonists
    c.       Proton pump inhibitors
    d.      Anticholinergics
    b
  123. Inhibit gastric acid secretion and are used in peptic ulcer disease and GERD
    a.       Antifungals
    b.      Anticholinergics
    c.       Mucosal barriers (cytoprotective)
    d.      Proton pump inhibitors
    d
  124. A break in the wall of the stomach or the duodenum that permits digestive fluids to leak into the peritoneal cavity.
    a.       Perforation
    b.      Fistula
    c.       Abdominal pain
    d.      Hemorrhage
    a
  125. A common complication of peptic ulcers
    a.       Perforation
    b.      Fistula
    c.       Abdominal pain
    d.      Hemorrhage
    d
  126. In addition to bloody diarrhea, the other most common symptom of inflammatory bowel disease
    a.       Fistula
    b.      Abdominal pain
    c.       Hemorrhage
    d.      Perforation
    b
  127. A complication of diverticulitis in which and abnormal opening develops between the colon and the bladder
    a.       Perforation
    b.      Hemorrhage
    c.       Fistula
    d.      Abdominal pain
    c
  128. The type of acid-base imbalance that results from prolonged vomiting is:
    a.       metabolic acidosis.
    b.      metabolic alkalosis.
    c.       respiratory acidosis.
    d.      respiratory alkalosis.
    b
  129. Normal bowel sounds include:
    a.       minimal clicks and gurgles.
    b.      clicks and gurgles 5-30 times/minute.
    c.       steady, consistent gurgling sounds.
    d.      no sounds for 1 full minute.
    b
  130. Which herb is effective in calming an upset stomach, reducing flatulence, and preventing motion sickness?
    a.       Ginkgo
    b.      Ginseng
    c.       Ginger root
    d.      Garlic
    c
  131. After insertion of a gastric tube, feedings are not started until:
    a.       the patient requests food.
    b.      adequate oxygen levels are achieved on blood gases.
    c.       placement of tube is certain.
    d.      oral fluids are tolerated.
    c
  132. Severe or prolonged vomiting puts the patients at risk for:
    a.       fluid volume deficit.
    b.      altered tissue perfusion.
    c.       hemorrhage.
    d.      infection.
    a
  133. Sudden, sharp pain starting in the midepigastric region and spreading across the entire abdomen in patients with peptic ulcer may indicate:
    a.       infection.
    b.      perforation.
    c.       dyspnea.
    d.      kidney failure.
    b
  134. If the patient's abdomen becomes rigid and tender and he or she draws the knees up to the chest, this may indicate:
    a.       peritonitis.
    b.      perforation.
    c.       kidney failure.
    d.      pyloric obstruction.
    a
  135. The most prominent symptom of pyloric obstruction is persistent:
    a.       eructation.
    b.      heartburn.
    c.       vomiting.
    d.      hemorrhage.
    c
  136. A major complication of appendicitis is:
    a.       diarrhea.
    b.      constipation.
    c.       fluid volume deficit.
    d.      peritonitis.
    d
  137. The classic symptom of appendicitis is pain at:
    a.       McBurney's point.
    b.      the xiphoid process.
    c.       right hypochondriac region.
    d.       inguinal node.
    a
  138. When appendicitis is suspected, the patient is allowed:
    a.       clear liquids.
    b.      full liquids.
    c.       nothing by mouth.
    d.      soft foods.
    c
  139. In addition to deficient fluid volume, patients with peritonitis may go into shock because of:
    a.       edema.
    b.      convulsions.
    c.       septicemia.
    d.      paralysis.
    c
  140. Following abdominoperineal resection, a procedure that cleans, soothes, and increases circulation to the perineum is:
    a.       use of a TENS unit.
    b.      Kegel exercises.
    c.       the sitz bath.
    d.      debridement.
    c
  141. What is the cause of most peptic ulcers?
    a.       Helicobacter pylori
    b.      E. coli
    c.       Stress
    d.      Infection
    a
  142. Ephedra sinica (Ma Huang) should not be used as an over-the-counter weight loss product by a person with:
    a.       a urinary tract infection.
    b.      arthritis.
    c.       dermatitis.
    d.      hypertension.
    d
  143. Which natural substance can help control diarrhea?
    a.       Garlic
    b.      Rice water
    c.       Kava kava
    d.      Ephedra sinica
    b
  144. Which type of laxative may not be effective for several days?
    a.       Bulk-producing laxative
    b.      Intestinal stimulant
    c.       Osmotic suppository
    d.      Stool softener
    d
  145. The major nutritional goal of therapy for diarrhea is to replace:
    a.       potassium.
    b.      sodium.
    c.       calcium.
    d.      fluids.
    d
  146. Which is a sign of intestinal rupture in a patient with intestinal obstruction?
    a.       Sudden vomiting of blood
    b.      Sudden sharp pain
    c.       Sudden increased temperature and chills
    d.      Sudden diarrhea
    b
  147. The Roux-en-Y gastric bypass and the vertical-banded gastroplasty are restrictive procedures used to treat:
    a.       peptic ulcer.
    b.      extreme obesity.
    c.       stomach cancer.
    d.      hiatal hernia.
    b
  148. What is the most serious complication of gastric endoscopy?
    a.       Shock
    b.      Pulmonary embolism
    c.       Infection
    d.      Perforation of digestive tract
    d
  149. What is the most serious complication of gastric ulcers?
    a.       Infection
    b.      Hemorrhage
    c.       Shock
    d.      Intractable pain
    b
  150. Why is the head of the bed elevated during tube feedings to patients?
    a.       Prevent hemorrhage
    b.      Prevent dumping syndrome
    c.       Prevent aspiration
    d.      Prevent hypotension
    c
  151. A patient has just been admitted to the hospital with appendicitis. What is the priority nursing diagnosis for this patient?
    a.       Acute pain related to abdominal cramping and rectal irritation
    b.      Risk for infection (peritonitis) related to rupture
    c.       Deficient fluid volume
    d.      Anxiety related to threat of serious illness
    b
  152. Which patient has the greatest risk for injury related to wound dehiscence?
    a.       Patient with diverticulosis
    b.      Patient with hiatal hernia
    c.       Patient with intestinal obstruction
    d.      Patient with abdominal hernia repair
    d
  153. Which patient is most likely to experience decreased cardiac output related to hypovolemia secondary to dumping syndrome?
    a.       Patient with abdominal hernia
    b.      Patient with anorexia
    c.       Patient who has had gastric surgery
    d.      Patient with peritonitis
    c
  154. What is the diet recommended for acute diarrhea?
    a.       Clear liquids
    b.      Nothing by mouth
    c.       Soft diet
    d.      Bland diet
    a
  155. A male patient has had an abdominal hernia repair. What is a common complication of this procedure?
    a.       Fever
    b.      Vomiting
    c.       Scrotal swelling
    d.      Bradycardia
    c
  156. The vomiting patient who is also unconscious or who has impaired swallowing is at risk for aspiration and should be placed in which position?
    a.       Lying flat in bed
    b.      With head of bed elevated at least 90 degrees
    c.       Side-lying
    d.      With head of bed slightly elevated; for example, at 30 degrees
    c
  157. To prevent nighttime reflux, the sleeping position for patients with hiatal hernia should be:
    a.       side-lying.
    b.      with head of bed at 90-degree angle.
    c.       flat.
    d.      with head of bed elevated 6-12 inches.
    d
  158. Pain is severe for several postoperative days following abdominoperineal resection. At first, the patient will probably be most comfortable in which  position?
    a.       Supine
    b.      Side-lying
    c.       Prone
    d.      Fowler's
    b
  159. Which type of diet is prescribed for moderate inflammatory bowel disease?
    a.       Low-residue diet
    b.      High-fiber diet
    c.       Low-potassium diet
    d.      Low-salt diet
    a
  160. Which side effect of opiates (such as morphine) result in opiates not being given to patients with diverticulosis?
    a.       Respiratory depression
    b.      Constipation
    c.       Hypersensitivity
    d.      Diarrhea
    b
  161. What is a complication that occurs following gastric surgery or when tube feedings of concentrated formula are given rapidly?
    a.       Dumping syndrome
    b.      Orthostatic hypotension
    c.       Diuresis
    d.      Diarrhea
    a
  162. Chronic, progressive liver disease
    a.       Icterus
    b.      Cirrhosis
    c.       Gynecomastia
    d.      Cholecystectomy
    b
  163. Accumulation of exess fluid in the peritoneal cavity
    a.       Cholecystectomy
    b.      Cholebocholithiasis
    c.       Cholelithiasis
    d.      Ascites
    d
  164. Removal of ascitic fluid from the peritoneal cavity
    a.       Paracentesis
    b.      Steatorrhea
    c.       Hepatomegaly
    d.      Icterus
    a
  165. Enlargement of the liver
    a.       Icterus
    b.      Gynecomastia
    c.       Ascites
    d.      Hepatomegaly
    d
  166. Removal of the gallbladder
    a.       Cirrhosis
    b.      Gynecomastia
    c.       Cholecystectomy
    d.      Choledocholithiasis
    c
  167. Presence of gallstones in the gallbladder
    a.       Choledocholithiaseis
    b.      Cholelithiasis
    c.       Ascites
    d.      Gynecomastia
    b
  168. Obstruction in common bile duct
    a.       Icterus
    b.      Hepatomegaly
    c.       Choledocholithiasis
    d.      Steatorrhea
    c
  169. Excess fat in stools
    a.       Steatorrhea
    b.      Paracentesis
    c.       Cirrhosis
    d.      Hepatomegaly
    a
  170. Jaundice
    a.       Paracentesis
    b.      Icterus
    c.       Gynecomastia
    d.      Ascites
    b
  171. Enlargement of breast tissue in males
    a.       Cirrhosis
    b.      Gynecomastia
    c.       Icterus
    d.      Ascites
    b
  172. Patients with liver disease are at increased risk for drug:
    a.       incompatibilities.
    b.      toxicities.
    c.       idiosyncrasies.
    d.      synthesis.
    b
  173. Clay-colored stools are characteristic of:
    a.       bile obstruction.
    b.      pancreatitis.
    c.       gastritis.
    d.      Crohn's disease.
    a
  174. Patients with hepatitis may have imapired skin integrity due to:
    a.       jaundice.
    b.      pruritus or scratching.
    c.       nausea and vomiting.
    d.      fluid volume deficit.
    b
  175. Which drugs may be ordered for pruritus in patients with hepatitis?
    a.       Antihistamines
    b.      Antiemetics
    c.       Antibiotics
    d.      Analgesics
    a
  176. Health care workers who work with hospitalized patients whould receive:
    a.       hepatitis B vaccinations.
    b.      herpes zoster vaccine.
    c.       influenza virus vaccine.
    d.      immune globulin.
    a
  177. The medical management of ascites aims to promote reabsorption and elimination of the fluid by means of salt restriction and:
    a.       antihistamines.
    b.      analgesics.
    c.       diuretics.
    d.      antibiotics.
    c
  178. Potential complications of peritoneal-venous shunts used to allow ascitic fluid to drain from the abdomen and return to the blood stream are tubing obstruction and:
    a.       jaundice.
    b.      peripheral neuropathy.
    c.       pruritus.
    d.      peritonitis.
    d
  179. The patient with cirrhosis is at great risk for injury or hemorrhage due to impatied:
    a.       coagulation.
    b.      immunity.
    c.       skin integrity.
    d.      breathing patterns.
    a
  180. What may happen when there is upward movement of the esophageal balloon in the patient with cirrhosis?
    a.       Impaired circulation
    b.      Airway obstruction
    c.       Cardiac shock
    d.      Perforated intestine
    b
  181. When the patient's bile duct responds to obstruction from gallstones with spasms in an effort to move the stone, the intense spasmodic pain would be documented as:
    a.       ascites pain.
    b.      cholelithiasis.
    c.       biliary colic.
    d.      biliary obstruction.
    c
  182. A common symptom of cholecystitis is right upper quadrant pain that radiates to the:
    a.       sternum.
    b.      shoulder.
    c.       umbilicus.
    d.      jaw.
    b
  183. When the cholecystectomy patient first returns from surgery, the drainage from the T-tube may be bloody, but it should soon become:
    a.       dark amber.
    b.      clay-colored.
    c.       bright red.
    d.      greenish brown.
    d
  184. Patients with obstructed bile flow may have a deficiency of vitamin:
    a.       A.
    b.      C.
    c.       D.
    d.      K.
    d
  185. A patient had an endoscopic sphincterotomy and developed pancreatitis as a complication, caused by accidental entry of the endoscope into the pancreatic duct. Early signs of pancreatitis in this patient would be:
    a.       jaundice and confusion.
    b.      nausea and vomiting.
    c.       ascites and hypertension.
    d.      pain and fever.
    d
  186. A gland that has both endocrine and exocrine functions is the:
    a.       pancreas.
    b.      adrenal gland.
    c.       thyroid gland.
    d.      sebaceous gland.
    a
  187. Vitamin K is needed for the production of:
    a.       bile.
    b.      calcium.
    c.       prothrombin.
    d.      thyroxine.
    c
  188. Specific blood studies used to asses pancreatic function include serum:
    a.       bilirubin.
    b.      amylase.
    c.       prothrombin.
    d.      albumin.
    b
  189. The most prominent symptom of pancreatitis is:
    a.       jaundice.
    b.      abdominal pain.
    c.       hypertension.
    d.      diarrhea.
    b
  190. Which of the following is recommended for patients witha cute pancreatitis to remove the stimulus for secretion of pancreatic fluid?
    a.       Nothing my mouth
    b.      Low-fat diet
    c.       Clear-liquid diet
    d.      Low-sodium diet
    a
  191. Which drugs do patients with chronic pancreatitis need to take in order to digest food?
    a.       Analgesics
    b.      Anticholinergics
    c.       Antiemetics
    d.      Pancreatic enzymes
    d
  192. An early sign of shock that may occur in patients with pancreatitis include:
    a.       restlessness.
    b.      bradycardia.
    c.       hypotension.
    d.      easy bruising.
    a
  193. Which herb can harm the liver?
    a.       Garlic
    b.      Ginkgo
    c.       Comfrey
    d.      Ginseng
    c
  194. The bile channels in the liver are compressed in patients with hepatitis, resulting in elevated:
    a.       serum creatinine.
    b.      BUN.
    c.       bilirubin.
    d.      hemoglobin.
    c
  195. Which cultural group has the highest rate of death from cirrhosis of the liver?
    a.       Hispanics
    b.      African-Americans
    c.       Caucasians
    d.      Asians
    a
  196. The medical treatment of hepatic encephalopathy is directed toward:
    a.       raising hemoglobin.
    b.      reducing ammonia formation.
    c.       decreasing urea.
    d.      increasing prothrombin time.
    b
  197. In patients with hepatitis and/or cirrhosis, most of the calories should come from:
    a.       carbohydrates.
    b.      protein.
    c.       saturated fats.
    d.      unsaturated fats.
    a
  198. Which is a common lab finding consistent with hepatitis?
    a.       Decreased levels of serum enzymes (AST, ALT, GT)
    b.      Prolonged prothrombin time
    c.       High albumin
    d.      Low gamma globulin
    b
  199. Which group of drugs is now being used in the treatment of patients with hepatitis (HBV and HBC)?
    a.       Antimicrobials
    b.      Antivirals
    c.       Anticoagulants
    d.      Anticholinergics
    b
  200. Which is a symptom common in cirrhosis that is characterized by tingling or numbness in the extremities thought to be caused by vitamin B deficiencies?
    a.       Peripheral neuropathy
    b.      Hepatic encephalopathy
    c.       Portal hypertension
    d.      Ascites
    a
  201. The nurse should explain to patients with hepatitis that rest is necessary to allow the liver to heal by:
    a.       producing more white blood cells to fight infection.
    b.      producing more platelets to assist in clotting.
    c.       regenerating new cells to replace damaged cells.
    d.      regenerating new blood vessels to replace damaged ones.
    c
  202. The nurse should be alert for signs of fluid retention in patients with hepatitis, which include increasing abdominal girth, rising blood pressure, and:
    a.       dry mucous membranes.
    b.      tachycardia.
    c.       edema.
    d.      concentrated urine.
    c
  203. The patient with hepatitis may be self-conscious about his or her appearance because of:
    a.       cyanosis.
    b.      redness.
    c.       ulcerations.
    d.      jaundice.
    d
  204. The best position for patients with ascites to help them breathe more easily is:
    a.       side-lying.
    b.      prone.
    c.       supine.
    d.      with the head of the bed elevated.
    d
  205. What type of diet is recommended for aptient with cholecystitis to decrease attacks of biliary colic?
    a.       Low protein
    b.      Low fat
    c.       Low carbohydrate
    d.      Low salt
    b
  206. When patients with pancreatitis are on TPN in order to restrict oral intake and reduce pancreatic fluid secretion, the nurse must monitor for:
    a.       hyperkalemia.
    b.      hypernatremia.
    c.       hyperchloremia.
    d.      hyperglycemia.
    d
  207. Instrument used to measure joint range of motion
    a.       Goniometer
    b.      Tophus
    c.       Arthroplasty
    d.      Bouchard nodes
    a
  208. Within the joint
    a.       Vasculitis
    b.      Intra-articular
    c.       Crepitus
    d.      rheumatoid nodule
    b
  209. Elevated level of uric acid in the blood
    a.       Tophus
    b.      Ankylosis
    c.       Hyperuricemia
    d.      Vasculitis
    c
  210. Deposit of sodium urate crystals under the skin
    a.       Goniometer
    b.      Arthroplasty
    c.       Tophus
    d.      Ankylosis
    c
  211. Protrusions of the distal interphalangeal finger joints; associated with osteoarthritis
    a.       Bouchard nodes
    b.      Rheumatoid nodule
    c.       Tophus
    d.      Heberden nodes
    d
  212. Enlarged proximal interphalangeal joints of the fingers
    a.       Bouchard nodes
    b.      Crepitus
    c.       Ankylosis
    d.      Rheumatoid nodule
    a
  213. Granulations of tissue surrounding cores of fibrous debris
    a.       Rheumatoid nodule
    b.      Bouchard nodes
    c.       Arthroplasty
    d.      Hyperuricemia
    a
  214. Plastic repair of a joint
    a.       Bouchard nodes
    b.      Arthroplasty
    c.       Hyperuricemia
    d.      Ankylosis
    b
  215. Inflammation of blood vessels
    a.       Tophus ankylosis
    b.      Vasculitis
    c.       Crepitus
    d.      Vasculitis
    d
  216. Cracking sound or sensation
    a.       Crepitus
    b.      Tophus
    c.       Heberden nodes
    d.      Goniometer
    a
  217. Joint immobility
    a.       Intra-articular
    b.      Ankylosis
    c.       Vasculitis
    d.      Arthroplasty
    b
  218. Important changes in the connective tissue of the body that occur with aging include loss of bone strength and bone:
    a.       nutrients.
    b.      mass.
    c.       vitamins.
    d.      minerals.
    b
  219. Age-related joint changes are related primarily to changes in:
    a.       blood volume.
    b.      bone strength.
    c.       bone mass.
    d.      cartilage.
    d
  220. When assessing patients for joint pain and range of motion, the nurse watches for signs of pain and listens for the cracking sound called:
    a.       bursitis.
    b.      grinding.
    c.       crepitus.
    d.      scraping.
    c
  221. Which blood test results would the nurse expect to see increase in patients with RA and decrease in patients with OA?
    a.       C-reactive protein
    b.      Creatinine
    c.       White blood cell count
    d.      Erythrocyte sedimentation rate (ESR)
    d
  222. Following joint replacement surgery, a continuous passive motion (COM) machine may be used to prevent formation of scar tissue and promote:
    a.       phagocytosis.
    b.      clotting.
    c.       flexibility.
    d.      circulation.
    c
  223. Often the pain in OA can be controlled with:
    a.       beta blockers.
    b.      salicylates.
    c.       anticholinergics.
    d.      narcotics.
    b
  224. Which is a nursing diagnosis that patients with OA often may have related to pain and limited range of motion?
    a.       Ineffective coping
    b.      Altered self-esteem
    c.       Impaired tissue perfusion
    d.      Impaired physical mobility
    d
  225. A patient who has had hip surgery is showing signs of cerebral blood vessel occlusion, headache, confusion, and loss of consciousness. The nurse will monitor this patient for:
    a.       deep vein thrombosis.
    b.      hemorrhage.
    c.       fat embolus.
    d.      neuropathy.
    c
  226. How should the nurse document the manifestation of pressure caused by edema or constrictive dressings following joint replacement surgery that is causing nerve damage?
    a.       Paresthesia
    b.      Infection
    c.       Positive Homans sign
    d.      Hemorrhage
    a
  227. Which drugs are administered to patients with joint replacements who are at risk for infection?
    a.       Antihistamines
    b.      Antimicrobials
    c.       Antiemetics
    d.      Anticoagulants
    b
  228. A nursing intervention related to the patients high risk for infection is that the nurse will:
    a.       place the call light in easy reach.
    b.      instruct patient to keep legs slightly abducted.
    c.       use strict sterile technique for dressing changes.
    d.      assess nerve and circulatory status.
    c
  229. A measure to control morning pain and stiffness in patients with RA is to:
    a.       take a warm shower.
    b.      increase intake of fluids.
    c.       eat foods low in purines.
    d.      apply ice.
    a
  230. An important teaching point for patients taking antigout medications is to:
    a.       increase potassium intake.
    b.      avoid foods high in vitamin K.
    c.       rise slowly from a sitting position.
    d.      increase fluids.
    d
  231. Which food should be avoided in patients with acute gout?
    a.       Sardines
    b.      Aged cheese
    c.       Bananas
    d.      Orange juice
    a

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