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Worksheets

Worksheet Questions

Total questions: 99

Worksheet time: 50mins

Name
Class
Date
1.

A 72-year-old patient with urinary frequency and confusion but no fever is most likely experiencing which of the following?

a)

Acute pyelonephritis

b)

Urosepsis

c)

Urinary tract infection with atypical presentation in elderly

d)

Stress urinary incontinence

2.

Which action is most important when caring for a patient with a new indwelling urinary catheter to prevent CAUTI?

a)

Irrigate catheter daily with normal saline

b)

Maintain a closed drainage system and proper hygiene

c)

Empty drainage bag when it is half full only

d)

Disconnect tubing for peri-care twice daily

3.

A patient with diarrhea presents with dry mucous membranes, tachycardia, and decreased skin turgor. The nurse’s priority is:

a)

Administer antidiarrheal medication immediately

b)

Assess serum electrolytes and initiate IV fluids as ordered

c)

Encourage clear liquids only and hold medications

d)

Apply skin barrier cream to prevent breakdown

4.

Which stool characteristic is most consistent with C. difficile infection?

a)

Small, hard stools with pellet consistency

b)

Large-volume, watery stools with foul odor

c)

Black, tarry stools

d)

White, clay-colored stools

5.

A patient on opioids complains of constipation. Which intervention is highest priority?

a)

Administer a stimulant laxative PRN

b)

Encourage fiber and fluids and plan scheduled bowel regimen

c)

Teach Kegel exercises

d)

Order suppository only when impaction occurs

6.

Which finding suggests paralytic ileus rather than mechanical obstruction?

a)

High-pitched bowel sounds above obstruction

b)

Absent bowel sounds with abdominal distention and vomiting

c)

Intermittent cramping pain relieved by flatus

d)

Visible peristaltic waves and localized tenderness

7.

A nurse is teaching bowel training for fecal incontinence. Which instruction is most appropriate?

a)

Delay responding to urge for several hours

b)

Increase daily fiber and establish a timed toileting schedule

c)

Avoid all forms of laxatives forever

d)

Restrict fluids to reduce stool frequency

8.

A patient with acute pyelonephritis would likely present with:

a)

Dysuria and suprapubic pressure only

b)

Flank pain, fever, and malaise

c)

Constipation and abdominal distention

d)

Painless hematuria only

9.

Which medication produces orange-red urine and is used for urinary analgesia?

a)

Phenazopyridine (Pyridium)

b)

Nitrofurantoin (Macrodantin)

c)

Ciprofloxacin (Cipro)

d)

Tamsulosin (Flomax)

10.

Which teaching point is most important for a patient prescribed tamsulosin (Flomax) for urinary retention due to BPH?

a)

Avoid grapefruit juice

b)

Rise slowly from sitting/lying to prevent orthostatic hypotension

c)

Report blood in stool

d)

Expect orange urine

11.

Which of the following best describes the early neurovascular sign of compartment syndrome?

a)

Increasing pain out of proportion to exam and paresthesia

b)

Pallor and absent pulses as the first sign

c)

Coolness that improves with elevation

d)

Moderate, controllable pain relieved by opioids

12.

After a fracture with a cast, the nurse should instruct the patient to:

a)

Elevate and apply ice continuously for 48 hours to reduce swelling

b)

Report increasing pain, numbness, or inability to move toes/fingers immediately

c)

Remove padding at home to relieve pressure if needed

d)

Perform heavy resistance exercises to maintain muscle tone

13.

A post-op hip fracture patient is at high risk for VTE. Which is an appropriate preventative nursing intervention?

a)

Encourage prolonged bedrest for 7 days

b)

Apply sequential compression devices and encourage ROM/ambulation as ordered

c)

Withhold prophylactic anticoagulants due to bleeding risk in all patients

d)

Have patient perform Valsalva maneuvers frequently

14.

Which clinical manifestation most suggests fat embolism syndrome after a long-bone fracture?

a)

Petechial rash, acute respiratory distress, and confusion

b)

Sharp localized leg pain with calf swelling only

c)

Increasing urine output and brisk capillary refill

d)

Fever and purulent drainage from the wound

15.

A patient with suspected rhabdomyolysis should be monitored primarily for:

a)

Hyperkalemia and acute kidney injury

b)

Hypoglycemia from muscle breakdown

c)

Decreased CK levels

d)

Hyponatremia only

16.

For a patient with osteoarthritis, which daily activity modification is recommended?

a)

Avoid all exercise to prevent further wear

b)

Use heat before activity and rest during flare; maintain low-impact exercise to preserve function

c)

Increase high-impact activities to strengthen joints

d)

Consume high-purine foods to improve cartilage

17.

A patient with rheumatoid arthritis is starting methotrexate. The nurse should teach:

a)

Methotrexate is safe during pregnancy

b)

Expect immediate symptom cure within days

c)

Routine blood monitoring (CBC, LFTs) is required due to toxicity risk

d)

No need to avoid live vaccines while on therapy

18.

Which lab test helps differentiate Crohn’s disease from ulcerative colitis definitively?

a)

Serum amylase

b)

Synovial fluid analysis

c)

Colonoscopy with biopsy showing transmural inflammation and skip lesions (Crohn’s)

d)

H. pylori breath test

19.

A patient with ulcerative colitis has 12 bloody stools per day and tachycardia. The nurse recognizes the patient is at risk for:

a)

Toxic megacolon and requires emergent assessment

b)

Appendicitis only

c)

Hemorrhoids and can be managed outpatient

d)

Chronic constipation

20.

When teaching a patient with Crohn’s disease about nutrition during a flare, the best advice is:

a)

High-fiber, high-residue diet to stimulate peristalsis

b)

High-calorie, high-protein, low-fiber diet; consider supplemental nutrition if needed

c)

Avoid protein to prevent inflammation

d)

Unlimited dairy to calm bowel

21.

Which medication is the first-line acute treatment for gout pain?

a)

Allopurinol daily to lower uric acid immediately

b)

Colchicine or NSAID for acute attack

c)

Methotrexate for inflammation control

d)

Prednisone only for chronic gout

22.

A patient with COPD and chronic steroid use is at increased risk for which GI complication listed in the inflammation slides?

a)

Peptic ulcer disease (stress ulcers)

b)

Hepatitis A infection

c)

Crohn’s disease onset

d)

Cholecystitis only

23.

A 45-year-old with sudden RUQ pain radiating to right shoulder, fever, and jaundice likely has:

a)

Acute pancreatitis

b)

Cholecystitis with possible obstructive jaundice

c)

Hepatitis A only

d)

Peptic ulcer disease

24.

In acute pancreatitis, the nurse should anticipate which immediate order?

a)

Encourage oral intake of fatty meals

b)

NPO, IV hydration, pain control, and possible NG decompression

c)

Begin high-dose steroids immediately

d)

Apply ice to abdomen and give antacids PO

25.

Which lab is most specific to pancreatitis diagnosis?

a)

ALT only

b)

Serum amylase and lipase elevations (especially lipase)

c)

Serum glucose alone

d)

Complete urinalysis

26.

A patient with hepatitis A acquired by fecal-oral transmission most likely needs:

a)

Long-term antiviral therapy

b)

Supportive care and prevention education; vaccine prevents A if given before exposure

c)

Immediate interferon therapy

d)

Lifelong isolation

27.

A nurse teaching about H. pylori-related peptic ulcer disease should include which point?

a)

Triple therapy (two antibiotics + PPI) is commonly used to eradicate H. pylori

b)

H. pylori is always viral and self-resolves without treatment

c)

Antacids alone will cure infection

d)

Avoid endoscopy for diagnosis

28.

Which finding indicates GI bleeding from a peptic ulcer?

a)

Hematemesis or coffee-ground emesis; melena; orthostatic hypotension and tachycardia

b)

Steady high blood pressure only

c)

Increased bowel sounds and flatulence

d)

White, chalky stools

29.

A patient after cholecystectomy complains of severe RUQ pain, fever, and elevated bilirubin — the nurse suspects:

a)

Postoperative pneumonia only

b)

Retained common bile duct stone or complication such as bile leak or obstruction — notify provider

c)

New onset pancreatitis unrelated to surgery

d)

Migraine

30.

An ileostomy stoma should appear:

a)

Dusky blue and dry permanently

b)

Pink/red and moist; report pale, purple, or black stoma immediately

c)

Gray and flat as normal

d)

Covered with a hard scab

31.

A patient with IBS (irritable bowel syndrome) should be advised:

a)

That IBS is the same as IBD and leads to colon cancer

b)

Use a symptom diary, identify triggers, and manage stress; meds for symptom control as needed

c)

Always avoid all carbohydrates forever

d)

Immediate surgery is the cure

32.

When performing a rectal exam for suspected fecal impaction, the nurse should first:

a)

Insert stool softener without assessment

b)

Assess methods, pain level, and perform digital exam per protocol with privacy and lubrication

c)

Manually remove impaction without consent

d)

Always insert an enema first without assessment

33.

Which medication class is commonly used to treat overactive bladder (urge incontinence)?

a)

Anticholinergics (oxybutynin) or beta-3 agonists (mirabegron)

b)

Alpha-blockers only

c)

Insulin injections

d)

Antibiotics

34.

A patient with acute urinary retention becomes hypertensive and bradycardic after bladder distention — this could indicate:

a)

Benign prostatic hyperplasia only

b)

Autonomic dysreflexia (in spinal cord injury pts) or cardiovascular reflex; treat promptly

c)

Normal response to retention

d)

Hypovolemia

35.

Which is an appropriate nursing action to reduce skin breakdown around a stoma?

a)

Change pouching only once a week regardless of leak

b)

Keep skin clean and dry; use appropriate pouching and barrier products; address leaks immediately

c)

Use alcohol to clean the peristomal skin daily

d)

Apply petroleum to the stoma

36.

A patient with Parkinson’s disease is taking carbidopa/levodopa. A teaching point is:

a)

Medication eliminates all symptoms permanently

b)

Expect improved mobility but monitor for dyskinesias and avoid high-protein meals interfering with absorption

c)

Stop the med if constipation occurs

d)

It causes immediate muscle strengthening

37.

For patients with multiple sclerosis (MS), which intervention helps reduce secondary complications?

a)

Avoid all vaccines and any infection prevention

b)

Promote physical therapy, mobility aids, bladder/bowel management, and infection prevention

c)

Encourage high-impact exercise exclusively

d)

Prescribe high-dose NSAIDs daily

38.

A patient has an amputation and is experiencing phantom limb pain. Best initial nursing approach:

a)

Tell them it’s not real and will go away without treatment

b)

Assess pain, provide analgesia, and use nonpharmacologic strategies (mirror therapy, TENS) and refer for rehab

c)

Prescribe high-dose antibiotics

d)

Ignore the complaint to avoid reinforcing it

39.

Which is the earliest lab change expected with rhabdomyolysis?

a)

Decreased potassium

b)

Markedly increased creatine kinase (CK) and possible hyperkalemia/myoglobinuria

c)

Low creatinine kinase only

d)

Hypovolemia without CK change

40.

A patient with an open fracture is at highest immediate risk for:

a)

Loss of hair

b)

Infection and contamination of the wound — requires prompt cleansing and antibiotics as ordered

c)

Diabetes mellitus onset

d)

Immediate bone healing without intervention

41.

When a patient has a suspected fracture, the first nursing action is:

a)

Move the limb to a neutral position regardless of pain

b)

Immobilize the limb, neurovascular checks distal to injury, and plan analgesia as ordered

c)

Apply heat directly to fracture site

d)

Encourage weight bearing to test stability

42.

A patient with a cast reports a “musty” odor and increasing pain. The nurse should:

a)

Reassure the patient odors are normal with cast

b)

Assess for infection, drainage, increased swelling; notify provider — may need cast removal

c)

Suggest perfuming the cast to mask odor

d)

Soak cast in warm water

43.

Which sign indicates impending shock from GI bleed?

a)

Bradycardia and stable BP

b)

Tachycardia, hypotension, orthostatic changes, cool clammy skin, altered mentation

c)

Elevated urine output and pink urine

d)

Improved skin turgor

44.

For a patient with diverticulitis, recommended acute-phase management includes:

a)

High-fiber, high-residue diet during acute inflammation

b)

NPO or low-residue, antibiotics, analgesia, and possible surgery if complications occur

c)

Immediate colonoscopy during flare without bowel prep

d)

Laxative use to hasten bowel movements

45.

Which patient is at greatest risk for pressure ulcer development after hip fracture?

a)

Active young athlete

b)

Immobilized elderly patient with poor nutrition and incontinence — requires frequent skin care and repositioning

c)

Patient with no comorbidities and rapid mobilization

d)

Patient who ambulates independently postoperatively

46.

A patient with suspected deep vein thrombosis (DVT) should have which intervention delayed until diagnosis?

a)

Apply SCDs and encourage early ambulation

b)

Apply warm compresses and prepare for ultrasound; do NOT massage the leg (risk of embolization)

c)

Ambulate vigorously immediately to dissolve clot

d)

Start anticoagulants only after massaging leg

47.

A patient on warfarin develops tea-colored urine and mucosal bleeding. The nurse recognizes:

a)

Therapeutic anticoagulation without concern

b)

Signs of bleeding — assess INR and notify provider; may require reversal

c)

Normal side effect of all antihypertensive meds

d)

Indication to increase warfarin dose

48.

The nurse explains that osteomyelitis risk after fracture is highest when:

a)

The fracture is closed and treated fast

b)

The fracture is open/compound or there is contamination at injury — risk of bone infection

c)

Only when patient is older than 80

d)

Osteomyelitis is impossible after fractures

49.

A patient with Parkinson’s has dysphagia. The nurse should instruct:

a)

Eat thin liquids quickly and lie flat after meals

b)

Provide small, frequent, easy-to-swallow meals; supervise during eating to prevent aspiration

c)

Rely on high-fat solid meals only

d)

Avoid speech/occupational therapy

50.

Which symptom is most typical of Guillain–Barré syndrome (mentioned under mobility neuro topics)?

a)

Sudden ascending weakness after recent infection; monitor respiratory status and autonomic instability

b)

Chronic unilateral tremor improving with rest

c)

Memory loss as primary symptom

d)

Alopecia

51.

A patient with suspected C. difficile should have which contact precautions?

a)

Standard precautions only

b)

Contact precautions with soap and water handwashing (alcohol less effective vs spores) and dedicated equipment

c)

Airborne precautions with N95 only

d)

No special precautions needed

52.

A postoperative patient with low urine output and muscle pain after trauma likely has:

a)

Normal post-op course

b)

Rhabdomyolysis — assess CK, myoglobin, electrolytes, and monitor urine; aggressive IV fluids to protect kidneys

c)

Early hepatic failure

d)

Migraine

53.

Which assessment suggests developing peritonitis from a perforated ulcer?

a)

Mild tenderness improved by movement

b)

Rigid, board-like abdomen, absent bowel sounds, severe pain, fever — emergent surgical evaluation

c)

Increased appetite and flatulence

d)

Soft, non-tender abdomen

54.

When teaching Kegel exercises for stress incontinence, the nurse should instruct:

a)

Tighten abdominal muscles only

b)

Contract pelvic floor muscles (as if stopping urine), hold and release repeatedly throughout day

c)

No effect on incontinence; recommend surgery only

d)

Only perform once per month

55.

A patient has a large ileostomy producing liquid output. Nursing priority includes:

a)

Limit fluids to reduce output

b)

Monitor fluid/electrolytes, provide hydration, teach pouch care and skin protection

c)

Instruct to use OTC antidiarrheals only without provider input

d)

Encourage high-residue diet to thicken stool immediately

56.

A 28-year-old with Crohn’s disease develops a draining sinus tract (fistula). Best probable next step:

a)

Ignore; fistulas always close spontaneously

b)

Assess for infection, control sepsis, and collaborate for medical/surgical management as needed

c)

Start high-dose NSAIDs at home

d)

Order immediate colonoscopy without stabilization

57.

For a patient on infliximab (Remicade), the nurse should teach:

a)

No infection risk; no monitoring needed

b)

Increased risk of infections and TB screening prior to therapy; monitor for infusion reactions and immunosuppression consequences

c)

It cures IBD in one dose permanently

d)

Avoid hand hygiene while on therapy

58.

A patient with pancreatitis complains of worse pain when eating. The nurse will:

a)

Encourage high-fat nourishment to soothe pancreas

b)

Maintain NPO status, provide IV fluids and pain control, and evaluate for complications

c)

Give oral antacids and send home

d)

Encourage heavy exercise to reduce pain

59.

The best test to confirm hepatitis B infection is:

a)

ALT alone

b)

HBsAg (Hepatitis B surface antigen) positive indicates current infection

c)

Anti-HAV IgG only

d)

HCV viral load

60.

A patient with peptic ulcer perforation will most likely exhibit:

a)

Slow, mild epigastric discomfort only

b)

Sudden severe abdominal pain, rigid abdomen, hypotension — immediate surgery required

c)

Gradual weight gain and constipation

d)

No signs on abdominal exam

61.

Which of the following is a priority when caring for a patient with toxic megacolon (complication of IBD)?

a)

Promote laxative use to relieve distention

b)

NPO, IV fluids, antibiotics, and surgical consultation — potential medical emergency

c)

Encourage high-fiber foods immediately

d)

Start immediate colonoscopy with full bowel prep

62.

A patient on corticosteroids for IBD should be taught to monitor for:

a)

Weight loss only

b)

Hyperglycemia, osteoporosis risk, infection susceptibility, and need for gradual tapering

c)

No side effects at all

d)

Increased immune response to vaccines so live vaccines are safe

63.

A nurse notes clay-colored stool and dark urine in a patient. This suggests:

a)

Gallbladder or biliary obstruction causing decreased bilirubin excretion and cholestasis

b)

Normal variant unrelated to disease

c)

Hemorrhoids only

d)

Viral gastroenteritis

64.

A patient with hepatitis C now has a new oral DAA cure regimen option. Nursing education should include:

a)

Treatment is lifelong and never curative

b)

Many direct-acting antivirals can cure HCV with a defined course; adherence and monitoring are crucial

c)

Avoid all medications during therapy including vitamins

d)

No labs are needed during treatment

65.

A postoperative patient on opioids has decreased bowel sounds and abdomen distended; the nurse suspects:

a)

Normal analgesia effect only

b)

Paralytic ileus — NPO, NG decompression if ordered, IV fluids, monitor electrolytes and bowel function

c)

Immediate laxative to force stool

d)

Diarrhea treatment

66.

In caring for a patient with an ostomy, the nurse should assess stoma output and skin. Which finding is expected for an ileostomy?

a)

Formed brown stool similar to colon stool

b)

Frequent liquid output with enzymes that irritate skin — requires careful peristomal skin protection

c)

No output at all is normal

d)

Black, leathery stoma is expected

67.

A nurse is teaching vaccination to prevent hepatitis. Which vaccines are recommended?

a)

Hepatitis A and B vaccines for prevention where indicated

b)

Only hepatitis C vaccine is available and required

c)

No vaccines for any hepatitis viruses exist

d)

Hepatitis D vaccine is given routinely to all

68.

Which is a hallmark sign of acute pancreatitis on exam or labs?

a)

Low serum amylase and lipase

b)

Elevated serum lipase (more specific) and amylase, epigastric pain radiating to back

c)

High platelet count only

d)

Elevated HBsAg

69.

For a patient with suspected fracture and compartment syndrome, the nurse should avoid:

a)

Frequent neurovascular checks

b)

Elevation of the extremity above heart level and application of ice (these can worsen perfusion in compartment syndrome)

c)

Immediate notification of provider for fasciotomy if indicated

d)

Pain control while preparing for intervention

70.

A patient with acute cholecystitis is scheduled for laparoscopic cholecystectomy. Preoperative teaching should include:

a)

There will be a large abdominal incision only

b)

Expect small laparoscopic incisions, early ambulation post-op, and possible temporary dietary changes

c)

No pain expected after surgery

d)

Unlimited fatty foods immediately after surgery

71.

A patient with diverticulosis should be taught to:

a)

Avoid all fiber permanently

b)

Increase dietary fiber and fluids to prevent diverticulitis episodes unless acute inflammation is present

c)

Immediately have surgery for diverticulosis

d)

Take high-dose NSAIDs daily

72.

Which of the following is most consistent with acute bacterial prostatitis causing urinary symptoms in men?

a)

Flank pain and cough only

b)

Dysuria, urinary frequency/urgency, perineal pain, fever; treat with antibiotics and supportive care

c)

Sudden stool incontinence only

d)

Always asymptomatic

73.

When assessing a patient with suspected osteoarthritis, the nurse expects:

a)

Symmetric joint stiffness lasting hours after rest only

b)

Pain worse with activity, morning stiffness <30 minutes, asymmetric joint involvement, and osteophytes on x-ray

c)

Systemic immune markers strongly elevated

d)

Rapid joint destruction over days

74.

Which instruction is appropriate for a patient starting allopurinol for gout prevention?

a)

Use for acute attack relief immediately only

b)

Take daily to lower uric acid long-term; monitor renal function and encourage hydration

c)

Increase intake of high-purine foods while on drug

d)

Stop drug during intercurrent infection always

75.

A patient with an infected pressure ulcer has erythema, purulent drainage, and fever. The nurse should:

a)

Continue routine dressing changes only

b)

Obtain wound culture, initiate antibiotics as ordered, and manage wound per protocol

c)

Ignore signs since infection is expected

d)

Apply only dry gauze without cleaning

76.

Which is the most important nursing action for a patient with suspected DVT prior to ultrasound?

a)

Forceful massage of the calf to dislodge clot

b)

Elevate leg, limit activity, keep limb supported, and avoid massaging; notify provider for diagnostic ultrasound

c)

Start aggressive exercise of affected limb

d)

Apply hot compress and massage vigorously

77.

A patient with Parkinson’s disease on benztropine (an anticholinergic) should be monitored for:

a)

Increased salivation and urinary frequency

b)

Dry mouth, blurred vision, urinary retention, constipation — interventions include fluids, sugarless candy, and toileting assistance

c)

Hypersalivation only

d)

Immediate seizure activity

78.

A patient with suspected peritonitis will present with which bowel sounds?

a)

Hyperactive, high-pitched bowel sounds throughout

b)

Absent bowel sounds due to paralytic ileus secondary to peritoneal irritation

c)

Normal bowel sounds in all quadrants

d)

Borborygmi only

79.

A nurse is preparing discharge teaching for a patient started on enoxaparin (Lovenox) after hip replacement. Which teaching is essential?

a)

Inject in the anterior abdominal wall, rotate sites, observe for bleeding/bruising, and do not aspirate injection

b)

Take enoxaparin PO with meals

c)

Stop all anticoagulants if constipation occurs

d)

Use a razor blade for shaving to prevent bleeding

80.

Which clinical picture best describes acute bacterial pyelonephritis?

a)

Dysuria only without systemic signs

b)

Fever, flank pain, costovertebral angle tenderness, nausea/vomiting — requires antibiotics and possible IV therapy

c)

Painless hematuria only

d)

Chronic constipation and abdominal bloating

81.

A patient with toxic megacolon is at risk of which electrolyte disturbance from diarrheal fluid losses?

a)

Hypernatremia only

b)

Hypokalemia and dehydration from large watery stools — monitor electrolytes and replace as needed

c)

Hypercalcemia only

d)

No electrolyte issues expected

82.

A patient with a new transurethral catheter shows decreased urine output and bladder distention. The nurse should:

a)

Keep catheter in place and check for kinks/patency; assess for obstruction and notify provider if no improvement

b)

Remove catheter immediately without assessment

c)

Replace bag only and ignore symptoms

d)

Push fluids and walk patient to increase output regardless of catheter patency

83.

In the immediate phase after fracture reduction, the nurse should perform neurovascular checks. Which items are included?

a)

Only temperature of limb

b)

Color, temperature, capillary refill, pulses, sensation, movement, and pain distal to injury

c)

Only pulse and movement

d)

Only subjective pain report

84.

A patient with long-standing liver disease has ascites and spider angiomas. Which lab finding is expected?

a)

Low AST and ALT always

b)

Abnormal LFTs, low albumin, prolonged PT/INR due to decreased hepatic synthetic function

c)

Elevated amylase only

d)

Normal coagulation studies

85.

Which is true about hepatitis D virus?

a)

Hep D can infect independently without any other virus present

b)

Hep D requires Hepatitis B infection to occur; prevention by Hep B vaccination reduces risk

c)

Hep D is fecal-oral like Hep A

d)

Hep D has a routine vaccine separate from Hep B

86.

A patient with suspected spinal cord injury develops sudden hypertension, headache, and bradycardia. The nurse suspects:

a)

Normal vitals after injury

b)

Autonomic dysreflexia — assess for bladder or bowel distention (e.g., urinary retention) and treat cause promptly

c)

Sepsis only

d)

Myocardial infarction only

87.

A patient with inflammatory bowel disease on long-term corticosteroids should be monitored for which bone problem?

a)

Osteoporosis — teach calcium, vitamin D, weight bearing exercise and monitor bone density

b)

Increased bone density only

c)

No bone effects are related to steroids

d)

Immediate fracture healing

88.

A postoperative patient complains of sudden shortness of breath and chest pain on day 3 after hip fracture. The nurse suspects:

a)

Atelectasis only

b)

Pulmonary embolism — assess vitals, oxygenate, call rapid response and notify provider immediately

c)

Anxiety only — no interventions needed

d)

MI unrelated to surgery without assessing

89.

Which would be an expected finding in a patient with early hepatic encephalopathy?

a)

Increased platelet count

b)

Mild confusion, asterixis (flapping tremor), and altered sleep pattern — related to accumulation of toxins like ammonia

c)

Decreased bilirubin only

d)

Intense focal limb pain

90.

A patient with ileus is ordered an NG tube to suction. Nursing rationale is:

a)

To provide enteral nutrition only

b)

Decompress stomach to prevent vomiting and reduce aspiration risk while bowel rest is implemented

c)

To speed peristalsis immediately

d)

To remove stool

91.

Which sign suggests a wound infection in a patient with a fracture incision?

a)

Clear drainage and no redness

b)

Increasing pain, redness, warmth, swelling, purulent drainage, and fever — notify provider and start wound management

c)

Mild soreness at incision site only for months

d)

Decreased swelling and improved ROM

92.

A nurse is teaching a patient about colorectal cancer risk in long-term IBD. Which statement is accurate?

a)

IBD does not affect colorectal cancer risk

b)

Long-standing ulcerative colitis or Crohn’s colitis increases colorectal cancer risk; regular surveillance colonoscopies are recommended

c)

Only IBS increases colon cancer risk

d)

Surveillance is unnecessary if symptoms are controlled

93.

Which nursing action is appropriate for a patient with fever, hypotension, and purulent drainage from a surgical fracture site?

a)

Continue routine dressing changes at home

b)

Stat assessment, culture of wound, blood cultures, begin antibiotics as ordered, and notify surgical team — possible sepsis/osteomyelitis risk

c)

Ignore until next day

d)

Only apply topical antiseptic without culture

94.

A patient with HIV co-infection and hepatitis C is asking about cure. The nurse responds:

a)

There is no treatment for HCV

b)

Many DAAs can cure HCV in most patients, even with HIV co-infection — coordinate care and adherence support

c)

HCV cures itself with vitamin C only

d)

HCV vaccine prevents all infection

95.

For a patient with chronic urinary incontinence related to dementia (functional), the best nursing approach includes:

a)

Punish for accidents

b)

Timed voiding, easy access to toileting, toileting assistance, and environmental modifications to reduce episodes

c)

Restrict fluids to 0.5 L/day

d)

Immediate surgery

96.

A patient presents with RUQ pain and elevated amylase/lipase — you consider:

a)

Acute cholecystitis only

b)

Acute pancreatitis possibly due to gallstones or alcohol; evaluate and manage accordingly

c)

UTI only

d)

Migraine

97.

A patient receiving high-dose corticosteroids for IBD should be taught to avoid:

a)

Sun exposure and live vaccines while immunosuppressed, and be aware of infection risks and hyperglycemia

b)

Handwashing to build immunity

c)

All fruits only

d)

Drinking extra fluids only

98.

Which manifestation is characteristic of Crohn’s disease compared with ulcerative colitis?

a)

Continuous colonic involvement beginning at rectum

b)

Skip lesions throughout GI tract, transmural inflammation, risk of fistulas and malabsorption

c)

Always limited to rectum only

d)

No risk of small intestine involvement

99.

A patient with acute pancreatitis has decreased bowel sounds and fever; which complication is the nurse most worried about?

a)

Pancreatic abscess with infection and sepsis risk

b)

Uncomplicated viral gastroenteritis

c)

Pancreatic pseudocyst without infection and no systemic signs

d)

Gastroesophageal reflux disease flare without fever