Universidad de Zamboanga Tiguma, Pagadian City Competency Appraisal II Pre Final Exam

A. normal B. overweight C. underweight D. obese

Name: ________________________________________ Date:__________________ Test I. Multiple Choice. Encircle the BEST CORRECT answer. No ERASURES or SUPERIMPOSITIONS ALLOWED. Situation 1: Mrs. Cruz was admitted in the Medical Floor due to pyrosis, dyspepsia and difficulty of swallowing. 1. Based from the symptoms presented, Nurse Yoshi might suspect: A. Esophagitis B. Hiatal hernia C. GERD D. Gastric Ulcer 2. What diagnostic test would confirm the type of problem Mrs. Cruz have? A. barium enema B. barium swallow C. colonoscopy D. lower GI series 3. Mrs. Cruz complained of pain and difficulty in swallowing. This term is referred as: A. Odynophagia B. Dysphagia C. Pyrosis D. Dyspepsia 4. To avoid acid reflux, Nurse Yoshi should advice Mrs. Cruz to avoid which type of diet? A. cola, coffee and tea B. high fat, carbonated and caffeinated beverages C. beer and green tea D. lechon paksiw and bicol express 5. Mrs. Cruz body mass index (BMI) is 25. You can categorized her as:

6. What diagnostic test would yield good visualization of the ulcer crater? A. Endoscopy B. Gastroscopy C. Barium Swallow D. Histology 7. Peptic ulcer disease particularly gastric ulcer is thought to be cause by which of the following microorgamisms? A. E. coli B. H. pylori C. S. aureus D. K. pnuemoniae 8. She is for occult blood test, what specimen will you collect? A. Blood B. Urine C. Stool D. Gastric Juice 9. Preparation of the client for occult blood examination is: A. Fluid intake limited only to 1 liter/day B. NPO for 12 hours prior to obtaining of specimen C. Increase fluid intake D. Meatless diet for 48 hours prior to obtaining of specimen Situation 5: IBD is a common inflammatory functional bowel disorder also known as spastic bowel, functional colitis and mucous colitis. 10.The client with IBS asks Nurse June what causes the disease. Which of the following responses by Nurse June would be most appropriate?

A. This is an inflammation of the bowel caused by eating too much roughage B. IBS is caused by a stressful lifestyle C. The cause of this condition is unknown D. There is thinning of the intestinal mucosa caused by ingestion of gluten 11.Which of the following alimentary canal is the most common location for Chrons disease? A. Descending colon B. Jejunum C. Sigmoid Colon D. Terminal Ileum 12.Which of the following factors is believed to be linked to Chrons disease? A. Diet B. Constipation C. Heredity D. Lack of exercise 13.How about ulcerative colitis, which of the following factors is believed to cause it? A. Acidic diet B. Altered immunity C. Chronic constipation D. Emotional stress 14.Mr. Jung, had ulcerative colitis for 5 years and was admitted to the hospital. Which of the following factors was most likely of greatest significance in causing an exacerbation of the disease? A. A demanding and stressful job B. Changing to a modified vegetarian diet C. Beginning a weight training program D. Walking 2 miles everyday Situation 6: A patient was admitted in the Medical Floor at St. Lukes Hospital. He was asymptomatic. The doctor suspects diverticulosis.

15.Which of the following definitions best describes diverticulosis? A. An inflamed outpouching of the intestine B. A non inflamed outpouching of the intestine C. The partial impairment of the forward flow of instestinal contents D. An abnormal protrusions of an oxygen through the structure that usually holds it 16.Which of the following types of diet is implicated in the development of diverticulosis? A. Low fiber diet B. High fiber diet C. High protein diet D. Low carbohydrate diet 17.Which of the following tests should be administered to client with diverticulosis? A. Proctosocpy B. Barium enema C. Barium swallow D. Gastroscopy 18.To improve Mr. Trinidads condition, your best nursing intervention and teaching is: A. Reduce fluid intake B. Increase fiber in the diet C. Administering of antibiotics D. Exercise to increase intraabdominal pressure Situation 7: Manny, 6 years old was admitted at Cardinal Santos Hospital due to increasing frequency of bowel movements, abdominal cramps and distension. 19.Diarrhea is said to be the leading cause of morbidity in the Philippines. Nurse Harry knows that diarrhea is present if: A. passage of stool is more than 3 bowel movements per week

B. passage of stool is less than 3 bowel movements per day C. passage of stool is more than 3 bowel movements per day D. passage of stool is less than 3 bowel movements per week 20.Diarrhea is believed to be caused by all of the following except A. increase intestinal secretions B. altered immunity C. decrease mucosal absorption D. altered motility 21.What life threatening condition may result in persistent diarrhea? A. hypokalemia B. dehydration C. cardiac dysrhytmias D. leukocytosis 22.Voluminous, watery stools can deplete fluids and electrolytes. The acid base imbalance that can occur is: A. metabolic alkalosis B. metabolic acidosis C. respiratory acidosis D. respiratory alkalosis 23.What is the immediate home care management for diarrhea? A. Milk B. Imodium C. Water D. Oresol Situation 8: Mr. Sean is admitted to the hospital with a bowel obstruction. He complained of colicky pain and inability to pass stool. 24.Which of these findings by Nurse Leonard, would indicate that the obstruction is in the early stages? A. high pitched tinkling or rumbling bowel sounds B. hypoactive bowel sounds C. no bowel sounds auscultated D. normal bowel sounds heard in all four quadrants 25.Nasogastric tube was inserted to Mr. Sean. The NGTs primary purpose is: A. nutrition B. decompression of bowel C. passage for medication D. aspiration of gastric contents 26.Mr. Sean has undergone surgery. Post operatively, which of the following findings is normal? A. absent bowel sounds B. bleeding C. hemorrhage D. bowel movement 27.Client education should be given in order to prevent constipation. Nurse Leonards health teaching should include which of the following? A. use of natural laxatives B. fluid intake of 6 glasses per day C. use of OTC laxatives D. complete bed rest

28.Four hours post operatively, Mr. Sean complains of guarding and rigidity of the abdomen. Nurse Leonards initial intervention is: A. B. C. D. assess for signs of peritonitis call the physician administer pain medication ignore the client

Situation 9: Mr. Gerald Liu, 19 y/o, is being admitted to a hospital unit complaining of severe pain in the lower abdomen. Admission vital signs reveal an oral temperature of 101.2 0F. 29.Which of the following would confirm a diagnosis of appendicitis? A. The pain is localized at a position halfway between the umbilicus and the right iliac crest. B. Mr. Liu describes the pain as occurring 2 hours after eating C. The pain subsides after eating D. The pain is in the left lower quadrant 30.Which of the following complications is thought to be the most common cause of appendicitis? A. A fecalith B. Internal bowel occlusion C. Bowel kinking D. Abdominal wall swelling 31.The doctor ordered for a complete blood count. After the test, Nurse Ray received the result from the laboratory. Which laboratory values will confirm the diagnosis of appendicitis? A. RBC 5.5 x 106/mm3 B. Hct 44 % C. WBC 13, 000/mm3 D. Hgb 15 g/dL 32.Signs and symptoms include pain in the RLQ of the abdomen that may be localize at McBurneys point. To relieve pain, Mr. Liu should assume which position? A. Prone B. Supine, stretched out C. Sitting D. Lying with legs drawn upl 33.After a few minutes, the pain suddenly stops without any intervention. Nurse Ray might suspect that: A. the appendix is still distended B. the appendix may have ruptured C. an increased in intrathoracic pressure will occur D. signs and symptoms of peritonitis occur Situation 10: Nurse Nico is caring to a 38year-old female, G3P3 client who has been diagnosed with hemorrhoids. 34.Which of the following factors would most likely be a primary cause of her hemorrhoids?

A. Her age B. Three vaginal delivery pregnancies C. Her job as a school teacher D. Varicosities in the legs 35.Client education should include minimizing client discomfort due to hemorrhoids. Nursing management should include: A. Suggest to eat low roughage diet B. Advise to wear silk undergarments C. Avoid straining during defecation D. Use of sitz bath for 30 minutes 36.Which position would be ideal for the client in the early postoperative period after hemorrhoidectomy? A. High Fowlers B. Supine C. Side lying D. Trendelenburgs 37.Nurse Nico instructs her client who has had a hemorrhoidectomy not to used sitz bath until at least 12 hours postoperatively to avoid which of the following complications? A. Hemorrhage B. Rectal Spasm C. Urinary retention D. Constipation 38.To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instruction? A. "Lie down after meals to promote digestion." B. "Avoid coffee and alcoholic beverages." C. "Take antacids with meals." D. "Limit fluid intake with meals." 39.Nursing assessment of a client with peritonitis (acute or chronic inflammation of the peritoneum) reveals hypotension, tachycardia, and signs and symptoms of dehydration. The nurse also expects to find: A. tenderness and pain in the right upper abdominal quadrant. B. jaundice and vomiting. C. severe abdominal pain with direct palpation or rebound tenderness. D. rectal bleeding and a change in bowel habits. 40.When caring for a client with hepatitis B, the nurse should monitor closely for the development of which finding associated with a decrease in hepatic function? A. Jaundice B. Pruritus of the arms and legs C. Fatigue during ambulation D. Irritability and drowsiness 41.A client has a newly created colostomy. After participating in counseling with the nurse and receiving support from the spouse, the client decides to change the colostomy pouch unaided. Which behavior suggests that the client is

beginning to accept the change in body image? A. The client closes the eyes when the abdomen is exposed. B. The client avoids talking about the recent surgery. C. The client asks the spouse to leave the room. D. The client touches the altered body part. 42.A client with viral hepatitis A is being treated in an acute care facility. Because the client requires enteric precautions, the nurse should: A. place the client in a private room. B. wear a mask when handling the client's bedpan. C. wash the hands after touching the client. D. wear a gown when providing personal care for the client 43. Dr. Smith has determined that the client with hepatitis has contracted the infection form contaminated food. The nurse understands that this client is most likely experiencing what type of hepatitis? A. Hepatitis A B. Hepatitis B C. Hepatitis C D. Hepatitis D 44.A client is suspected of having hepatitis. Which diagnostic test result will assist in confirming this diagnosis? A. Elevated hemoglobin level B. Elevated serum bilirubin level C. Elevated blood urea nitrogen level D. Decreased erythrocycle sedimentation rate 45.The nurse is reviewing the physicians orders written for a male client admitted to the hospital with acute pancreatitis. Which physician order should the nurse question if noted on the clients chart? A. NPO status B. Nasogastric tube inserted C. Morphine sulfate for pain D. An anticholinergic medication 46.A female client being seen in a physicians office has just been scheduled for a barium swallow the next day. The nurse writes down which instruction for the client to follow before the test? A. Fast for 8 hours before the test B. Eat a regular supper and breakfast C. Continue to take all oral medications as scheduled D. Monitor own bowel movement pattern for constipation

47.The nurse is performing an abdominal assessment and inspects the skin of the abdomen. The nurse performs which assessment technique next? A. Palpates the abdomen for size B. Palpates the liver at the right rib margin C. Listens to bowel sounds in all for quadrants D. Percusses the right lower abdominal quadrant 48.The nurse is monitoring a female client with a diagnosis of peptic ulcer. Which assessment findings would most likely indicate perforation of the ulcer? A. Bradycardia B. Numbness in the legs C. Nausea and vomiting D. A rigid, board-like abdomen 49.A male client with a peptic ulcer is scheduled for a vagotomy and the client asks the nurse about the purpose of this procedure. Which response by the nurse best describes the purpose of a vagotomy? A. Halts stress reaction B. Heals the gastric mucosa C. Reduces the stimulus to acid secretions D. Decreases food absorption in the stomach 50.The nurse is providing discharge instructions to a male client following gastrectomy and instructs the client to take which measure to assist in preventing dumping syndrome? A. Ambulate following a meal B. Eat high carbohydrate foods C. Limit the fluid taken with meal D. Sit in a high-Fowlers position during meals 51.The nurse is caring for a hospitalized female client with a diagnosis of ulcerative colitis. Which finding, if noted on assessment of the client, would the nurse report to the physician? A. Hypotension B. Bloody diarrhea C. Rebound tenderness D. A hemoglobin level of 12 mg/dL 52.The nurse is caring for a male client postoperatively following creation of a colostomy. Which nursing diagnosis should the nurse include in the plan of care? A. Sexual dysfunction B. Body image, disturbed C. Fear related to poor prognosis

D. Nutrition: more than body requirements, imbalanced 53.The nurse is reviewing the record of a female client with Crohns disease. Which stool characteristics should the nurse expect to note documented in the clients record? A. Diarrhea B. Chronic constipation C. Constipation alternating with diarrhea D. Stools constantly oozing form the rectum 54.The nurse is performing a colostomy irrigation on a male client. During the irrigation, the client begins to complain of abdominal cramps. What is the appropriate nursing action? A. Notify the physician B. Stop the irrigation temporarily C. Increase the height of the irrigation D. Medicate for pain and resume the irrigation 55.Nursing assessment of a client with peritonitis (acute or chronic inflammation of the peritoneum) reveals hypotension, tachycardia, and signs and symptoms of dehydration. The nurse also expects to find: A. tenderness and pain in the right upper abdominal quadrant. B. jaundice and vomiting. C. severe abdominal pain with direct palpation or rebound tenderness. D. rectal bleeding and a change in bowel habits. 56.What laboratory finding is the primary diagnostic indicator for pancreatitis? A. Elevated blood urea nitrogen (BUN) B. Elevated serum lipase C. Elevated aspartate aminotransferase (AST) D. Increased lactate dehydrogenase (LD) 57.When evaluating a client for complications of acute pancreatitis, the nurse would observe for: A. increased intracranial pressure. B. decreased urine output. C. bradycardia. D. hypertension. 58.