Font size
WorksheetsUnit 4 NTB
Total questions: 102
Worksheet time: 1hrs 26mins
A 53-year-old male patient with deep partial-thickness burns from a chemical spill in the workplace experiences severe pain followed by nausea during dressing changes. Which action will be most useful in decreasing the patient’s nausea?
Keep the patient NPO for 2 hours before and after dressing changes.
Avoid performing dressing changes close to the patient’s mealtimes.
Administer the prescribed morphine sulfate before dressing changes.
Give the ordered prochlorperazine (Compazine) before dressing changes.
Which item should the nurse offer to the patient who is to restart oral intake after being NPO due to nausea and vomiting?
Glass of orange juice
Dish of lemon gelatin
Cup of coffee with cream
Bowl of hot chicken broth
A 38-year old woman receiving chemotherapy for breast cancer develops a Candida albicans oral infection. The nurse will anticipate the need for
hydrogen peroxide rinses.
the use of antiviral agents.
administration of nystatin (Mycostatin) tablets.
referral to a dentist for professional tooth cleaning.
Which finding in the mouth of a patient who uses smokeless tobacco is suggestive of oral cancer?
Bleeding during tooth brushing
Painful blisters at the lip border
Red, velvety patches on the buccal mucosa
White, curdlike plaques on the posterior tongue
Which information will the nurse include when teaching adults to decrease the risk for cancers of the tongue and buccal mucosa?
Avoid use of cigarettes and smokeless tobacco.
Use sunscreen when outside even on cloudy days.
Complete antibiotic courses used to treat throat infections.
Use antivirals to treat herpes simplex virus (HSV) infections.
A 46-year-old female with gastroesophageal reflux disease (GERD) is experiencing increasing discomfort. Which patient statement indicates that additional teaching about GERD is needed?
“I take antacids between meals and at bedtime each night.”
“I sleep with the head of the bed elevated on 4-inch blocks.”
“I eat small meals during the day and have a bedtime snack.”
“I quit smoking several years ago, but I still chew a lot of gum.”
A 68-year-old male patient with a stroke is unconscious and unresponsive to stimuli. After learning that the patient has a history of gastroesophageal reflux disease (GERD), the nurse will plan to do frequent assessments of the patient’s...
apical pulse.
bowel sounds.
breath sounds.
abdominal girth.
The nurse explaining esomeprazole (Nexium) to a patient with recurring heartburn describes that the medication
reduces gastroesophageal reflux by increasing the rate of gastric emptying.
neutralizes stomach acid and provides relief of symptoms in a few minutes.
coats and protects the lining of the stomach and esophagus from gastric acid.
treats gastroesophageal reflux disease by decreasing stomach acid production.
Which patient choice for a snack 2 hours before bedtime indicates that the nurse’s teaching about gastroesophageal reflux disease (GERD) has been effective?
Chocolate pudding
Glass of low-fat milk
Cherry gelatin with fruit
Peanut butter and jelly sandwich
The nurse will anticipate teaching a patient experiencing frequent heartburn about
a barium swallow
radionuclide tests.
endoscopy procedures.
proton pump inhibitors.
A 58-year-old woman who recently has been diagnosed with esophageal cancer tells the nurse, “I do not feel ready to die yet.” Which response by the nurse is most appropriate?
“You may have quite a few years still left to live.”
“Thinking about dying will only make you feel worse.”
“Having this new diagnosis must be very hard for you.”
“It is important that you be realistic about your prognosis.”
Which information will the nurse include for a patient with newly diagnosed gastroesophageal reflux disease (GERD)?
“Peppermint tea may reduce your symptoms.”
“Keep the head of your bed elevated on blocks.”
“You should avoid eating between meals to reduce acid secretion.”
“Vigorous physical activities may increase the incidence of reflux.”
Which nursing action should be included in the postoperative plan of care for a patient after a laparoscopic esophagectomy?
Notify the doctor about bloody nasogastric (NG) drainage.
Elevate the head of the bed to at least 30 degrees.
Reposition the NG tube if drainage stops.
Start oral fluids when the patient has active bowel sounds.
When a 72-year-old patient is diagnosed with achalasia, the nurse will teach the patient that
lying down after meals is recommended.
a liquid or blenderized diet will be necessary.
drinking fluids with meals should be avoided.
treatment may include endoscopic procedures.
A 50-year-old man vomiting blood-streaked fluid is admitted to the hospital with acute gastritis. To determine possible risk factors for gastritis, the nurse will ask the patient about
the amount of saturated fat in the diet.
any family history of gastric or colon cancer.
a history of a large recent weight gain or loss.
use of nonsteroidal antiinflammatory drugs (NSAIDs).
The nurse determines that teaching regarding cobalamin injections has been effective when the patient with chronic atrophic gastritis states which of the following?
“The cobalamin injections will prevent gastric inflammation.”
“The cobalamin injections will prevent me from becoming anemic.”
“These injections will increase the hydrochloric acid in my stomach.”
“These injections will decrease my risk for developing stomach cancer.”
Which medications will the nurse teach the patient about whose peptic ulcer disease is associated with Helicobacter pylori?
Sucralfate (Carafate), nystatin (Mycostatin), and bismuth (Pepto-Bismol)
Amoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec)
Famotidine (Pepcid), magnesium hydroxide (Mylanta), and pantoprazole (Protonix)
Metoclopramide (Reglan), bethanechol (Urecholine), and promethazine (Phenergan)
Which action should the nurse in the emergency department anticipate for a 23-year-old patient who has had several episodes of bloody diarrhea?
Obtain a stool specimen for culture.
Administer antidiarrheal medication.
Provide teaching about antibiotic therapy.
Teach about adverse effects of acetaminophen (Tylenol).
The nurse will anticipate preparing a 71-year-old female patient who is vomiting “coffee-ground” emesis for
endoscopy.
angiography.
barium studies.
gastric analysis.
A 57-year-old man with Escherichia coli O157:H7 food poisoning is admitted to the hospital with bloody diarrhea and dehydration. Which order will the nurse question?
Infuse lactated Ringer’s solution at 250 mL/hr.
Monitor blood urea nitrogen and creatinine daily.
Administer loperamide (Imodium) after each stool.
Provide a clear liquid diet and progress diet as tolerated.
Which information will the nurse include when teaching a patient with peptic ulcer disease about the effect of ranitidine (Zantac)?
“Ranitidine absorbs the gastric acid.”
“Ranitidine decreases gastric acid secretion.”
“Ranitidine constricts the blood vessels near the ulcer.”
“Ranitidine covers the ulcer with a protective material.”
A family member of a 28-year-old patient who has suffered massive abdominal trauma in an automobile accident asks the nurse why the patient is receiving famotidine (Pepcid). The nurse will explain that the medication will
decrease nausea and vomiting.
inhibit development of stress ulcers.
lower the risk for H. pylori infection.
prevent aspiration of gastric contents.
A 68-year-old patient with a bleeding duodenal ulcer has a nasogastric (NG) tube in place, and the health care provider orders 30 mL of aluminum hydroxide/magnesium hydroxide (Maalox) to be instilled through the tube every hour. To evaluate the effectiveness of this treatment, the nurse
monitors arterial blood gas values daily.
periodically aspirates and tests gastric pH.
checks each stool for the presence of occult blood.
measures the volume of residual stomach contents.
A 44-year-old man admitted with a peptic ulcer has a nasogastric (NG) tube in place. When the patient develops sudden, severe upper abdominal pain, diaphoresis, and a firm abdomen, which action should the nurse take?
Irrigate the NG tube.
Check the vital signs.
Give the ordered antacid.
Elevate the foot of the bed.
A 50-year-old patient who underwent a gastroduodenostomy (Billroth I) earlier today complains of increasing abdominal pain. The patient has no bowel sounds and 200 mL of bright red nasogastric (NG) drainage in the last hour. The highest priority action by the nurse is to
contact the surgeon.
irrigate the NG tube.
monitor the NG drainage.
administer the prescribed morphine.
Which patient statement indicates that the nurse’s teaching following a gastroduodenostomy has been effective?
“Vitamin supplements may prevent anemia.”
“Persistent heartburn is common after surgery.”
“I will try to drink more liquids with my meals.”
“I will need to choose high carbohydrate foods.”
At his first postoperative checkup appointment after a gastrojejunostomy (Billroth II), a patient reports that dizziness, weakness, and palpitations occur about 20 minutes after each meal. The nurse will teach the patient to
increase the amount of fluid with meals.
eat foods that are higher in carbohydrates.
lie down for about 30 minutes after eating.
drink sugared fluids or eat candy after meals.
A 62-year-old man patient who requires daily use of a nonsteroidal antiinflammatory drug (NSAID) for the management of severe rheumatoid arthritis has recently developed melena. The nurse will anticipate teaching the patient about
substitution of acetaminophen (Tylenol) for the NSAID.
use of enteric-coated NSAIDs to reduce gastric irritation.
reasons for using corticosteroids to treat the rheumatoid arthritis.
misoprostol (Cytotec) to protect the gastrointestinal (GI) mucosa.
The health care provider prescribes antacids and sucralfate (Carafate) for treatment of a patient’s peptic ulcer. The nurse will teach the patient to take
sucralfate at bedtime and antacids before each meal.
sucralfate and antacids together 30 minutes before meals.
antacids 30 minutes before each dose of sucralfate is taken.
antacids after meals and sucralfate 30 minutes before meals.
Which information about dietary management should the nurse include when teaching a patient with peptic ulcer disease (PUD)?
“You will need to remain on a bland diet.”
“Avoid foods that cause pain after you eat them.”
“High-protein foods are least likely to cause you pain.”
“You should avoid eating any raw fruits and vegetables.”
A 73-year-old patient is diagnosed with stomach cancer after an unintended 20-pound weight loss. Which nursing action will be included in the plan of care?
Refer the patient for hospice services.
Infuse IV fluids through a central line.
Teach the patient about antiemetic therapy.
Offer supplemental feedings between meals.
A 26-year-old patient with a family history of stomach cancer asks the nurse about ways to decrease the risk for developing stomach cancer. The nurse will teach the patient to avoid
emotionally stressful situations.
smoked foods such as ham and bacon.
foods that cause distention or bloating.
chronic use of H2 blocking medications.
The nurse is assessing a patient who had a total gastrectomy 8 hours ago. What information is most important to report to the health care provider?
Absent bowel sounds
Complaints of incisional pain
Temperature 102.1° F (38.9° C)
Scant nasogastric (NG) tube drainage
A 58-year-old patient has just been admitted to the emergency department with nausea and vomiting. Which information requires the most rapid intervention by the nurse?
The patient has been vomiting for 4 days.
The patient takes antacids 8 to 10 times a day.
The patient is lethargic and difficult to arouse.
The patient has undergone a small intestinal resection.
A 26-year-old woman has been admitted to the emergency department with nausea and vomiting. Which action could the RN delegate to unlicensed assistive personnel (UAP)?
Auscultate the bowel sounds.
Assess for signs of dehydration.
Assist the patient with oral care.
Ask the patient about the nausea.
A 49-year-old man has been admitted with hypotension and dehydration after 3 days of nausea and vomiting. Which order from the health care provider will the nurse implement first?
Insert a nasogastric (NG) tube.
Infuse normal saline at 250 mL/hr.
Administer IV ondansetron (Zofran).
Provide oral care with moistened swabs.
Which patient should the nurse assess first after receiving change-of-shift report?
A patient with nausea who has a dose of metoclopramide (Reglan) due
A patient who is crying after receiving a diagnosis of esophageal cancer
A patient with esophageal varices who has a blood pressure of 92/58 mm Hg
A patient admitted yesterday with gastrointestinal (GI) bleeding who has melena
A patient returned from a laparoscopic Nissen fundoplication for hiatal hernia 4 hours ago. Which assessment finding is most important for the nurse to address immediately?
The patient is experiencing intermittent waves of nausea.
The patient complains of 7/10 (0 to 10 scale) abdominal pain.
The patient has absent breath sounds in the left anterior chest.
The patient has hypoactive bowel sounds in all four quadrants.
Which assessment should the nurse perform first for a patient who just vomited bright red blood?
Measuring the quantity of emesis
Palpating the abdomen for distention
Auscultating the chest for breath sounds
Taking the blood pressure (BP) and pulse
Which order from the health care provider will the nurse implement first for a patient who has vomited 1200 mL of blood?
Give an IV H2 receptor antagonist.
Draw blood for typing and crossmatching.
Administer 1000 mL of lactated Ringer’s solution.
Insert a nasogastric (NG) tube and connect to suction.
The nurse is administering IV fluid boluses and nasogastric irrigation to a patient with acute gastrointestinal (GI) bleeding. Which assessment finding is most important for the nurse to communicate to the health care provider?
The bowel sounds are hyperactive in all four quadrants.
The patient’s lungs have crackles audible to the midchest.
The nasogastric (NG) suction is returning coffee-ground material.
The patient’s blood pressure (BP) has increased to 142/84 mm Hg.
After the nurse has completed teaching a patient with newly diagnosed eosinophilic esophagitis about the management of the disease, which patient action indicates that the teaching has been effective?
Patient orders nonfat milk for each meal.
Patient uses the prescribed corticosteroid inhaler.
Patient schedules an appointment for allergy testing.
Patient takes ibuprofen (Advil) to control throat pain.
An 80-year-old who is hospitalized with peptic ulcer disease develops new-onset auditory hallucinations. Which prescribed medication will the nurse discuss with the health care provider before administration?
Sucralfate (Carafate)
Omeprazole (Prilosec)
Metoclopramide (Reglan)
Aluminum hydroxide (Amphojel)
The nurse and a licensed practical/vocational nurse (LPN/LVN) are working together to care for a patient who had an esophagectomy 2 days ago. Which action by the LPN/LVN requires that the nurse intervene?
The LPN/LVN uses soft swabs to provide for oral care.
The LPN/LVN positions the head of the bed in the flat position.
The LPN/LVN encourages the patient to use pain medications before coughing.
The LPN/LVN includes the enteral feeding volume when calculating intake and output.
After change-of-shift report, which patient should the nurse assess first?
42-year-old who has acute gastritis and ongoing epigastric pain
70-year-old with a hiatal hernia who experiences frequent heartburn
53-year-old who has dumping syndrome after a recent partial gastrectomy
60-year-old with nausea and vomiting who has dry oral mucosa and lethargy
Vasopressin (Pitressin) 0.2 units/min infusion is prescribed for a patient with acute arterial gastrointestinal (GI) bleeding. The vasopressin label states vasopressin 100 units/250 mL normal saline. How many mL/hr will the nurse infuse?
(a)
Which action will the nurse include in the plan of care for a 42-year-old patient who is being admitted with Clostridium difficile?
Educate the patient about proper food storage.
Order a diet with no dairy products for the patient.
Place the patient in a private room on contact isolation.
Teach the patient about why antibiotics will not be used.
A 71-year-old male patient tells the nurse that growing old causes constipation so he has been using a suppository for constipation every morning. Which action should the nurse take first?
Encourage the patient to increase oral fluid intake.
Assess the patient about risk factors for constipation.
Suggest that the patient increase intake of high-fiber foods.
Teach the patient that a daily bowel movement is unnecessary.
A 64-year-old woman who has chronic constipation asks the nurse about the use of psyllium (Metamucil). Which information will the nurse include in the response?
Absorption of fat-soluble vitamins may be reduced by fiber-containing laxatives.
Dietary sources of fiber should be eliminated to prevent excessive gas formation.
Use of this type of laxative to prevent constipation does not cause adverse effects.
Large amounts of fluid should be taken to prevent impaction or bowel obstruction.
A 26-year-old woman is being evaluated for vomiting and abdominal pain. Which question from the nurse will be most useful in determining the cause of the patient’s symptoms?
“What type of foods do you eat?”
“Is it possible that you are pregnant?”
“Can you tell me more about the pain?”
“What is your usual elimination pattern?”
A patient complains of gas pains and abdominal distention two days after a small bowel resection. Which nursing action is best to take?
Encourage the patient to ambulate.
Instill a mineral oil retention enema.
Administer the ordered IV morphine sulfate.
Offer the ordered promethazine (Phenergan) suppository.
A 58-year-old man with blunt abdominal trauma from a motor vehicle crash undergoes peritoneal lavage. If the lavage returns brown fecal drainage, which action will the nurse plan to take next?
Auscultate the bowel sounds.
Prepare the patient for surgery.
Check the patient’s oral temperature.
Obtain information about the accident.
A 27-year-old female patient is admitted to the hospital for evaluation of right lower quadrant abdominal pain with nausea and vomiting. Which action should the nurse take?
Encourage the patient to sip clear liquids.
Assess the abdomen for rebound tenderness.
Assist the patient to cough and deep breathe.
Apply an ice pack to the right lower quadrant.
Which nursing action will be included in the plan of care for a 27-year-old male patient with bowel irregularity and a new diagnosis of irritable bowel syndrome (IBS)?
Encourage the patient to express concerns and ask questions about IBS.
Suggest that the patient increase the intake of milk and other dairy products.
Educate the patient about the use of alosetron (Lotronex) to reduce symptoms.
Teach the patient to avoid using nonsteroidal antiinflammatory drugs (NSAIDs).
A patient being admitted with an acute exacerbation of ulcerative colitis reports crampy abdominal pain and passing 15 or more bloody stools a day. The nurse will plan to...
administer IV metoclopramide (Reglan).
discontinue the patient’s oral food intake.
administer cobalamin (vitamin B12) injections.
teach the patient about total colectomy surgery.
Which nursing action will the nurse include in the plan of care for a 35-year-old male patient admitted with an exacerbation of inflammatory bowel disease (IBD)?
Restrict oral fluid intake.
Monitor stools for blood.
Ambulate four times daily.
Increase dietary fiber intake.
