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Worksheets

NDEE

Total questions: 75

Worksheet time: 1hrs 10mins

Name
Class
Date
1.

What are the two types of peptic ulcers? SATA

a)

Gastric

b)

Duodenal

c)

Stress

d)

H. pylori

e)

IBS

2.

A client is scheduled for a renal angiography. Which of the following would be appropriate before the test?

a)

Monitor the client for an allergy to iodine contrast material.

b)

Evaluate the client for periorbital edema.

c)

Assess the client's mental changes.

d)

Monitor the client for signs of electrolyte and water imbalance

3.

Which is an effect of aging on upper and lower urinary tract function?

a)

More prone to develop hypernatremia

b)

Acid-base balance

c)

Increased blood flow to the kidneys

d)

Increased glomerular filtration rate

4.

A client presents to the emergency department complaining of a dull, constant ache along the right costovertebral angle along with nausea and vomiting. The most likely cause of the client's symptoms is:

a)

renal calculi.

b)

interstitial cystitis.

c)

an overdistended bladder.

d)

acute prostatitis.

5.

The health care provider ordered four tests of renal function for a patient suspected of having renal disease. Which of the four is the most sensitive indicator?

a)

Uric acid level

b)

Blood urea nitrogen (BUN)

c)

Creatinine clearance level

d)

BUN to creatinine ratio

6.

A nurse is caring for a patient who has a recent history of passing calcium urinary stones. Which of the following is a priority nursing consideration for this patient?

a)

Bowel elimination

b)

Skin care

c)

Bed rest

d)

Hydration

7.

A patient who has had an intestinal bypass has developed a kidney stone. Which of the following types of kidney stone does the nurse recognize that this patient will most likely be treated for?

a)

Cystine

b)

Uric acid

c)

Calcium

d)

Magnesium ammonium

8.

A patient with a history of hypothyroidism is admitted to the intensive care unit unconscious and with a temperature of 95.2ºF. A family member informs the nurse that the patient has not taken thyroid medication in over 2 months. What does the nurse suspect that these findings indicate?

a)

Syndrome of inappropriate antidiuretic hormone (SIADH)

b)

Diabetes insipidus

c)

Myxedema coma

d)

Thyroid storm

9.

For a client with hyperthyroidism, treatment is most likely to include

a)

a thyroid hormone antagonist.

b)

a synthetic thyroid hormone.

c)

thyroid extract.

d)

emollient lotions.

10.

Early this morning, a client had a subtotal thyroidectomy. During evening rounds, the nurse assesses the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness. What is the most likely cause of these signs?

a)

Tetany

b)

Thyroid crisis

c)

Diabetic ketoacidosis

d)

Hypoglycemia

11.

A nurse is caring for a client who was recently diagnosed with hyperparathyroidism. Which statement by the client indicates the need for additional discharge teaching?

a)

"I'll schedule a follow-up visit with my physician as soon as I get home."

b)

"I will increase my fluid and calcium intake."

c)

"I'll call my physician if I notice tingling around my lips."

d)

"I will take my pain medications according to the schedule we developed."

12.

A client is being evaluated for hypothyroidism. During assessment, the nurse should stay alert for:

a)

decreased body temperature and cold intolerance.

b)

flushed, warm, moist skin.

c)

exophthalmos and conjunctival redness.

d)

systolic murmur at the left sternal border.

13.

Cardiac effects of hyperthyroidism include which of the following?

a)

Decreased systolic BP

b)

Palpitations

c)

Bradycardia

d)

Decreased pulse pressure

14.

On the third day after a partial thyroidectomy, a client exhibits muscle twitching and hyperirritability of the nervous system. When questioned, the client reports numbness and tingling of the mouth and fingertips. Suspecting a life-threatening electrolyte disturbance, the nurse notifies the surgeon immediately. Which electrolyte disturbance most commonly follows thyroid surgery?

a)

Hypermagnesemia

b)

Hyperkalemia

c)

Hyponatremia

d)

Hypocalcemia

15.

A nurse is preparing to palpate the thyroid gland. Where would the nurse expect to find this gland?

a)

In the abdomen, directly above the kidneys

b)

In the upper part of the chest near the heart

c)

In the right to left upper quadrant of the abdomen

d)

In the lower neck, anterior to the trachea

16.

A nurse is assessing a client with hyperthyroidism. What findings should the nurse expect?

a)

Weight loss, nervousness, and tachycardia

b)

Weight gain, constipation, and lethargy

c)

Exophthalmos, diarrhea, and cold intolerance

d)

Diaphoresis, fever, and decreased sweating

17.

A nurse is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication?

a)

Laryngeal nerve damage

b)

Hemorrhage

c)

Thyroid storm

d)

Tetany

18.

A client is scheduled for a diagnostic test to measure blood hormone levels. The nurse expects that this test will determine which of the following?

a)

The concentration of a substance in plasma

b)

Details about the size of the organ and its location

c)

The functioning of endocrine glands

d)

-The client's blood sugar level

19.

Trousseau's sign is elicited by which of the following?

a)

Carpopedal spasm is induced by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff

b)

A sharp tapping over the facial nerve just in front of the parotid gland and anterior to the ear causes spasm or twitching of the mouth, nose, and eye.

c)

After making a clenched fist, the palm remains blanched when pressure is placed over the radial artery.

d)

The patient complains of pain in the calf when his foot is dorsiflexed

20.

A client has been diagnosed with myxedema from long-standing hypothyroidism. What clinical manifestations of this disorder does the nurse recognize are progressing to myxedema coma? Select all that apply.

a)

Hypothermia

b)

Hypertension

c)

Hypotension

d)

Hypoventilation

e)

Hyperventilation

21.

A newborn is born with hypothyroidism. A complication of this disorder if it is not recognized and treated is

a)

dehydration

b)

cognitive impairment

c)

muscle spasticity

d)

blindnes.

22.

The most common forms of peptic ulcer are duodenal and gastric ulcers. What are the most common risk factors for peptic ulcer disease?

a)

Spicy foods

b)

Sucralfate

c)

Helicobacter pylori (H. pylori)

d)

Antibiotic

23.

The client who has experienced third-degree burns is susceptible to which specific type of gastrointestinal (GI) ulceration?

a)

Peptic

b)

Stress

c)

Duodenal

d)

Gastric

24.

After several months of persistent heartburn, an adult client has been diagnosed with gastroesophageal reflux disease (GERD). Which treatment regimen is likely to be prescribed for this client's GERD?

a)

Weight loss and administration of calcium channel blocking medications

b)

Proton pump inhibitors; avoiding large meals; remaining upright after meals

c)

Anti-inflammatory medications; avoiding positions that exacerbate reflux; a soft-textured diet

d)

Surgical correction of the incompetent pylorus and limiting physical exercise

25.

The nurse is providing discharge instructions to an older adult client with diverticular disease. Which recommendations should the nurse include? SATA

a)

Increase whole grains

b)

Increase fruits

c)

Increase dairy products

d)

Increase vegetables

e)

Increase protein

26.

An ultrasound confirms appendicitis as the cause of a client's sudden abdominal pain. Which etiologic process is implicated in the development of appendicitis?

a)

Increased osmolality of intestinal contents

b)

Obstruction of the intestinal lumen

c)

Elimination of normal intestinal flora

d)

Sloughing of the intestinal mucosa

27.

Inflammatory bowel disease (IBD) is used to designate two related inflammatory intestinal disorders: Crohn disease and ulcerative colitis. The nurse recognizes the difference between the distribution pattern between Crohn disease and ulcerative colitis. Which pattern describes Crohn's disease?

a)

Primarily rectum and colon involvement

b)

Development of cancer

c)

Skip lesions

d)

Continuous involvement of the colon starting at the rectum

28.

A client with a history of peptic ulcer disease presents to the emergency department with the following symptoms: early satiety, feeling of epigastric fullness and heaviness after meals, weight loss, and vomiting. The nurse suspects that the peptic ulcer has caused which problem?

a)

Penetration

b)

Obstruction

c)

Obtrusion

d)

Perforation

29.

An older adult client presents with a perforation of a peptic ulcer. The nurse will monitor for signs and symptoms of which problem?

a)

Vomiting

b)

Peritonitis

c)

Diarrhea

d)

Fecal impaction

30.

A client has been admitted to the hospital with an exacerbation of peptic ulcer disease. The nurse is aware the client is at risk for:

Select all that apply.

a)

Hemorrhage

b)

Weight gain

c)

Perforation

d)

Increased urinary output

e)

Obstruction

31.

A patient with a diagnosis of peptic ulcer disease has just been prescribed omeprazole (Prilosec). How should the nurse best describe this medication's therapeutic action?

a)

"This medication will reduce the amount of acid secreted in your stomach."

b)

"This medication will specifically address the pain that accompanies peptic ulcer disease."

c)

"This medication will make the lining of your stomach more resistant to damage."

d)

"This medication will help your stomach lining to repair itself."

32.

A nurse is assessing a patient who has peptic ulcer disease. The patient requests more information about the typical causes of Helicobacter pylori infection. What would it be appropriate for the nurse to instruct the patient?

a)

Most affected patients acquired the infection during international travel.

b)

Infection typically occurs due to ingestion of contaminated food and water.

c)

Many people possess genetic factors causing a predisposition to H. pylori infection.

d)

The H. pylori microorganism is endemic in warm, moist climates.

33.

A patient with a history of peptic ulcer disease has presented to the emergency department (ED) in distress. What assessment finding would lead the ED nurse to suspect that the patient has a perforated ulcer?

a)

The patient has abdominal bloating that developed rapidly.

b)

The patient has a rigid, "board like" abdomen that is tender

c)

The patient is experiencing intense lower right quadrant pain.

d)

The patient is experiencing dizziness and confusion with no apparent hemodynamic changes

34.

A nurse is assessing a patient who has been diagnosed with cholecystitis, and is experiencing localized abdominal pain. When assessing the characteristics of the patient's pain, the nurse should anticipate that it may radiate to what region?

a)

Left upper chest

b)

Inguinal region

c)

Neck or jaw

d)

Right shoulder

35.

A patient has been scheduled for an ultrasound of the gallbladder the following morning. What should the nurse do in preparation for this diagnostic study?

a)

Have the patient refrain from food and fluids after midnight.

b)

Administer the contrast agent orally 10 to 12 hours before the study.

c)

Administer the radioactive agent intravenously the evening before the study.

d)

Encourage the intake of 64 ounces of water 8 hours before the study.

36.

A student nurse is caring for a patient who has a diagnosis of acute pancreatitis and who is receiving parenteral nutrition. The student should prioritize which of the following assessments?

a)

Fluid output

b)

Oral intake

c)

Blood glucose levels

d)

BUN and creatinine levels

37.

A physician suspects that a client has peptic ulcer disease. With which of the following diagnostic procedures would the nurse most likely prepare to assist?

(a)  

38.

A client comes to the clinic reporting urinary symptoms. Which statement would most likely alert the nurse to suspect benign prostatic hyperplasia (BPH)?

a)

"I've had a fever and noticed I've been running to the bathroom more often."

b)

"I'm waking up at night to urinate and I've noticed some burning, too."

c)

"I've had trouble getting started when I urinate, often straining to do so."

d)

"I've had some pain in my lower abdomen lately and felt a bit sick to my stomach."

39.

A nurse in a provider's office is obtaining a history from a client who is being evaluated for benign prostatic hyperplasia. Which of the following findings are indicative of this condition? (select all)

a)

backache

b)

frequent UTIs

c)

weight loss

d)

hematuria

e)

urinary incontinence

40.

A nurse is caring for a client who has a new dx of BPH. The nurse should anticipate a Rx for which of the following medications?

a)

oxybutynin (Ditropan)

b)

diphenhydramine (Benadryl)

c)

ipratropium (Atrovent)

d)

tamsulosin (Flomax)

41.

The nurse is explaining to a client with benign prostatic hyperplasia (BPH) the diagnostic tests that are used to differentiate BPH from prostate cancer. The nurse includes which of the following in the explanation? (Select all that apply.)

a)

PSA level

b)

Blood chemistry

c)

Sperm count

d)

Digital rectal examination

e)

Pelvic ultrasound

42.

The nurse is caring for a patient with severe pain related to ureteral colic. What medication can the nurse administer with a physician's order that will inhibit the synthesis of prostaglandin E, thereby reducing swelling and facilitating passage of the stone?

a)

Morphine sulfate

b)

Meperidine (Demerol)

c)

Ketoralac (Toradol)

d)

Aspirin

43.

After teaching a group of students about irritable bowel syndrome and antidiarrheal agents, the instructor determines that the teaching was effective when the students identify which of the following as an example of an opiate-related antidiarrheal agent?

a)

Loperamide

b)

Linaclotide

c)

Amitriptyline

d)

Rifaximin

44.

A client is using psyllium hydrophilic mucilloid to promote evacuation of stool. What is the action of this medication?

a)

It increases mass and water content of stool, promoting evacuation.

b)

It irritates the intestinal mucosa, thus increasing intestinal motility.

c)

It creates a barrier between the colon wall and feces.

d)

It reduces the surface tension of bowel contents.

45.

A prescriber adds psyllium to the medication administration record for a client experiencing diarrhea. Which is the best rationale for the addition of psyllium?

a)

It binds and expels toxins into the stool

b)

It causes bloating and swells the colon.

c)

It absorbs toxins and water, decreasing fluidity of stools

d)

It reduces exchange of proteins and mucus in the stools.

46.

A nurse is performing discharge teaching with a client who had a total gastrectomy. Which statement indicates the need for further teaching?

a)

I'm going to visit my pastor weekly for a while."

b)

"I will have to take vitamin B12 shots up to 1 year after surgery."

c)

"I will call my physician if I begin to have abdominal pain."

d)

"I will weight myself each day and record the weight."

47.

Which medication classification represents a proton (gastric acid) pump inhibitor?

a)

Omeprazole

b)

Sucralfate

c)

Famotidine

d)

Metronidazole

48.

A nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to:

a)

restrict fluid intake to 1 qt (1,000 ml)/day.

b)

drink liquids only with meals.

c)

don't drink liquids 2 hours before meals.

d)

drink liquids only between meals.

49.

Which diagnostic test would be used first to evaluate a client with upper GI bleeding?

a)

Upper GI series

b)

Endoscopy

c)

Hemoglobin and hematocrit

d)

Arteriography

50.

A client with severe peptic ulcer disease has undergone surgery and is several hours postoperative. During assessment, the nurse notes that the client has developed cool skin, tachycardia, labored breathing, and appears to be confused. Which complication has the client most likely developed?

a)

Hemorrhage

b)

Penetration

c)

Perforation

d)

d. Pyloric obstruction

51.

A client is in the hospital for the treatment of peptic ulcer disease. The client reports vomiting and a sudden severe pain in the abdomen. The nurse then assesses a board-like abdomen. What does the nurse suspect these symptoms indicate?

a)

Ineffective treatment for the peptic ulcer

b)

A reaction to the medication given for the ulcer

c)

Gastric penetration

d)

Perforation of the peptic ulcer

52.

A client is prescribed a histamine (H2)-receptor antagonist. The nurse understands that this might include which medication(s)? Select all that apply.

a)

Nizatidine

b)

Lansoprazole

c)

Famotidine

d)

Cimetidine

e)

Esomeprazole

53.

The nurse is caring for a client who has just returned from the PACU after surgery for peptic ulcer disease. For what potential complications does the nurse know to monitor? Select all that apply.

a)

Hemorrhage

b)

Inability to clear secretions

c)

Perforation

d)

Penetration

e)

Pyloric obstruction

54.

A client has been taking famotidine at home. What teaching should the nurse include with the client?

a)

Famotidine will inhibit gastric acid secretions.

b)

Famotidine will neutralize acid in the stomach.

c)

Famotidine will shorten the time required for digestion in the stomach.

d)

Famotidine will improve the mixing of foods and gastric secretions.

55.

A nurse practitioner prescribes drug therapy for a patient with peptic ulcer disease. Choose the drug that can be used for 4 weeks and has a 90% chance of healing the ulcer.

a)

Nizatidine

b)

Cimetidine

c)

Famotidine

d)

Omeprazole

56.

A health care provider suspects that a client has peptic ulcer disease. With which diagnostic procedure would the nurse most likely prepare to assist?

a)

Barium study of the upper gastrointestinal tract

b)

Endoscopy

c)

Gastric secretion study

d)

Stool antigen test

57.

A patient's health history is suggestive of inflammatory bowel disease. Which of the following would suggest Crohn's disease, rather that ulcerative colitis, as the cause of the patient's signs and symptoms?

a)

A pattern of distinct exacerbations and remissions

b)

Severe diarrhea

c)

An absence of blood in stool

d)

Involvement of the rectal mucosa

58.

A nurse is preparing to provide care for a patient whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, the nurse would anticipate that the patient's stools will have what characteristics?

a)

Watery with blood and mucus

b)

Hard and black or tarry

c)

Dry and streaked with blood

d)

Loose with visible fatty streaks

59.

A client with complaints of right lower quadrant pain is admitted to the emergency department. Blood specimens are drawn and sent to the laboratory. Which laboratory finding should be reported to the physician immediately?

a)

Hematocrit 42%

b)

Serum sodium 135 mEq/L

c)

Serum potassium 4.2 mEq/L

d)

White blood cell (WBC) count 22.8/mm3

60.

Post appendectomy, a nurse should assess the patient for abdominal rigidity and tenderness, fever, loss of bowel sounds, and tachycardia, all clinical signs of:

a)

A pelvic abscess

b)

Peritonitis

c)

An ileus

d)

An abscess under the diaphragm

61.

The nurse working in the ED is evaluating a patient for signs and symptoms of appendicitis. Which of the patient's signs/symptoms should the nurse include in the report to the physician on the patient's signs/symptoms of appendicitis?

a)

Left lower quadrant pain

b)

Pain when pressure is applied to the right lower quadrant of the abdomen

c)

High fever

d)

Nausea

62.

Which of the following is a true statement regarding regional enteritis (Crohn's disease)?

a)

It has a progressive disease pattern.

b)

The clusters of ulcers take on a cobblestone appearance.

c)

The lesions are in continuous contact with one another.

d)

It is characterized by lower left quadrant abdominal pain.

63.

What is the most appropriate nursing diagnosis for the client with acute pancreatitis?

a)

Deficient fluid volume

b)

Excess fluid volume

c)

Decreased cardiac output

d)

Ineffective gastrointestinal tissue perfusion

64.

A client with enteritis reports frequent diarrhea. What assessment should the nurse should anticipate?

a)

respiratory acidosis

b)

respiratory alkalosis

c)

metabolic acidosis

d)

metabolic alkalosis

65.

A client with GERD develops esophagitis. Which diagnostic test would the nurse expect the physician to order to confirm the diagnosis?

a)

Barium swallow

b)

Upper endoscopy with biopsy

c)

Stool testing for occult blood

d)

24-hour esophageal pH monitoring

66.

What manifestations would a nurse expect while assessing a client who has recently developed peritonitis?

a)

A board-like abdomen

b)

Sluggish bowel sounds

c)

Intermittent diarrhea

d)

Rectal bleeding

67.

A nurse is assessing a client and obtains the following findings: abdominal discomfort, mild diarrhea, blood pressure of 100/80 mm Hg, pulse rate of 88 beats/minute, respiratory rate of 20 breaths/minute, temperature 100° F (37.8° C). What diagnosis will the nurse suspect for this client?

a)

inflammatory bowel disease (IBD)

b)

colorectal cancer

c)

diverticulitis

d)

liver failure

68.

After assessing a client with peritonitis, how would the nurse most likely document the client's bowel sounds?

a)

Mild

b)

High-pitched

c)

Hyperactive

d)

Absent

69.

A nurse is overseeing the care of a young man whose ulcerative colitis is being treated with oral prednisone. Which action should the nurse take in order to minimize the potential for risks associated with prednisone treatment?

a)

Avoid OTC antacids for the duration of treatment.

b)

Advocate for intravenous, rather than oral, administration.

c)

Teach the client strategies for dealing with headaches.

d)

Carefully assess the client for infections.

70.

A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, the nurse should stress the importance of

a)

increasing fluid intake to prevent dehydration.

b)

B)wearing an appliance pouch only at bedtime.

c)

consuming a low-protein, high-fiber diet.

d)

taking only enteric-coated medications.

71.

A Patient with Inflammatory Bowel Disease (IBD) has an obstruction in their small bowel. What will the nurse anticipate to assess?

a)

Scaphoid Abdomen

b)

Hypovolemia

c)

Passage of Melana

d)

Increased Flatus

72.

Which of the following complications is thought to be the most common cause of appendicitis?

a)

A fecalith

b)

Bowel Kinking

c)

Internal Bowel Occlusion

d)

Abdominal Bowel Swelling

73.

Which of the following is NOT a causative agent for a peptic ulcer?

a)

NSAIDS

b)

Heliobacteria Pylori

c)

Physiological Stress

d)

Augmentin

74.

A nurse reading a sigmoidoscopy report notes that a client was found to have skip lesions. The nurse interprets this as an indication of:

a)

Crohn disease

b)

Ulcerative colitis

c)

Peptic ulcer

d)

Zollinger-Ellison syndrome

75.

A client with Crohn's disease who is taking sulfasalazine asked the nurse why this medication is necessary. Which information should the nurse include in the response?

a)

the drug decreases abdominal cramping by slowing peristalsis

b)

The drug decreases prostaglandin production in the bowel so it decreases inflammation

c)

the drug inhibits neurotransmission of pain impulses

d)

The drug stimulates the release of endorphins so pain is relieved