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METABOLISM - NUTRITION

___b__ 1. You are taking care of a patient with severe COPD. What type of diet would
best suit this patient's needs?

A. Cut apples, fresh broccoli, and grilled chicken

B. Pureed sweet potatoes, ground turkey and gravy with mash potatoes
C. Green beans, boiled carrots, and steamed fish
D. Fried chicken, French fries, and pudding

___a__ 2. A patient who has a colostomy is complaining about having excess gas.
You
ask the patient to tell you what he has ate in the past 48 hours. Which food
would you suspect is causing the patient excessive gas?

A. Cherries, Radishes, and Watermelon 

B. Caraway seeds, tomato soup, and eggs
C. Chicken, grapes, and raspberries
D. Squash, Spinach, and Pickles

__b___ 3. A patient is diagnosed with Congestive Heart Failure and must follow a
specific diet. Which spices are okay for the patient to use daily?

A. Onion Salt & Garlic Powder

B. Ginger and Bay Leaves
C. Sea Salt and pepper
D. Garlic Sodium and Nutmeg

__c___ 4. A patient with gout should follow what type of diet?

A. High-calcium diet
B. Potassium-modified diet
C, Low-purine diet
D. Renal diet

__c___ 5. The patient is on a low potassium diet that includes food such as
applesauce,
green beans, cabbage, lettuce, grapes, and raspberries. What type of patient
would you expect to be on this type of diet?

A. A patient with heart disease

B. A patient with osteoporosis
C. A patient with Addison’s disease
D. A patient who recently had gastric bypass surgery

__a___ 6. A patient with anemia would benefit from which diet?

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A. Legumes, organ meat, and dark green leafy vegetables 

B. Nuts and seeds, fruits, and soy products
C. Vegetables, fish, and pasta
D. Grains, berries, and organic vegetables

__c___ 7. A patient is on a lacto-ovo vegetarian diet. What type of foods can the
patient
eat?

A. Fish, milk, and poached eggs 

B. Chicken, cheese, and grilled eggplant
C. Boiled eggs and chocolate milk
D. Oysters, yogurt, and turkey

__b___ 8. A patient is suffering from a broken jaw. Which foods would be most
beneficial for this patient?

A. Carrots, fried chicken, and cereal 

B. Soup, pudding, and ice cream
C. Rice, watermelon, and smoked fish
D. Tacos, peanuts, and fresh broccoli

__a___ 9. A patient receiving dialysis should avoid what type of foods?

A. Canned soups, cold cut sandwiches, and Chinese take-out

B. Fresh fruits and vegetable, poultry, and beans
C. Steamed broccoli, broiled mackerel, and artificial sweeteners
D. Microwaved sweet potatoes, boiled cabbage, and artichokes

___a__ 10. A patient is admitted for diverticulitis. The patient has been on a full liquid
diet and has been tolerating it well. Now the MD has ordered the patient a
new diet. You would expect to find what type of food on the patient’s lunch
tray?

A. Piece of white bread, skinless white potatoes, and white rice.

B. Glass of whole milk, broccoli, and cabbage
C. Peanut butter sandwich, glass of milk, and strawberries
D. French fries, chicken salad, and apple pie

__a___ 11. A patient has a low magnesium level. Which food of the selection below is
the highest in magnesium?

A. Avocado
B. Liver
C. Mushrooms
D. Rhubarb

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__c___ 12. A patient is started on the diuretic Spironolactone. Which foods should the
patient be careful to avoid eating too much of?

A. Eggs
B. Green leafy vegetables
C. Bananas
D. Hotdogs

___c__ 13. A patient was recently admitted for a Deep Vein Thrombosis and was
started
on Coumadin. During your education with the patient you would instruct the
patient to avoid what food?

A. Bananas 
B. Lettuce
C. Spinach
D. Processed meats

___b__ 14. A patient’s potassium level is 6.0. Which food should the patient avoid?

A. 6.0 is a normal potassium level so the patient can eat whatever they
want without an effect
B. Raisins
C. Rice
D. Egg yolks 

__a___ 15. A patient has a stage 4 pressure ulcer on their sacral area. What type of
foods would the patient most benefit from?

A. Dried beans, eggs, meats

B. Liver, spinach, corn
C. Oats, fruits, and vegetables
D. Peanuts, tomatoes, and cabbage

___a__ 16. A patient is post-opt from gallbladder surgery and is ordered a clear liquid
diet. Which of the selection can the patient have?

A. Apple Juice
B. Vanilla Custard
C. Fudge Popsicle
D. Creamy Chicken Soup

__a___ 17. A patient just had a Wound Vac ® placed on her abdomen from abdominal
surgery. Which foods would help promote wound healing?

A. Citrus fruit and tomatoes

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B. Liver, beef, and fish

C. Corn, poultry, and grains
D. Peanuts, beans and pork

__d___ 18. A patient asks you what vitamin is best for eye sight. Your response is:

A. Vitamin B12 
B. Vitamin B6
C. Vitamin C
D. Vitamin A

__d___ 19. You have a patient who just had a stroke and has garbled speech. What
type of diet do you expect the patient to be prescribed after a speech
evaluation?

A. Soft diet
B. Full liquid diet
C. Mechanically altered diet with thin liquids
D. Mechanically altered diet with nectar thick liquids

__a___ 20. A patient is to be started on enteral feedings. What important step should
the
nurse take before the patient is started on enteral feedings?

A. Assess patient allergies to lactose 

B. Assess the patient’s understanding about enteral feedings
C. Evaluate the families perception of the enteral feedings
D. Make sure the patient stays nothing by mouth while enteral feedings are being
administered

__a___ 21. It includes all chemical reactions occurring within a cell

A. metabolism
B. Anabolism
C. Catabolism
D. Exernism

___b__ 22. An unfavorable reaction that requires an input of energy in order to proceed
is ___________.

A. exergonic
B. endergonic
C. impossible
D. none of these

__d___ 23. If the nonprotein component of an enzyme is firmly attached to the protein it
is called a/an _________.

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A. apoenzyme
B. coenzyme
C. holoenzyme
D. prosthetic group

__d___ 24. Which of the following represents work normally done by cells?

A. synthesis of complex molecules

B. nutrient uptake and waste elimination
C. internal and external; movement
D. All of the above

__d___ 25. A client is admitted to the hospital after vomiting bright red blood and is
diagnosed with a bleeding duodenal ulcer. The client develops a sudden,
sharp pain in the midepigastric region along with a rigid, boardlike abdomen.
These clinical manifestations most likely indicate which of the following:

A. An intestinal obstruction has developed

B. Additional ulcers have developed
C. The esophagus has become inflamed
D. The ulcer has perforated

__c___ 26. The nurse is preparing to teach a client with peptic ulcer disease about the
diet that should be followed after discharge.

A. Bland foods
B. High protein foods
C. Any foods that are tolerated
D. Large amounts of milk

__d___ 27. A client is taking an antacid for treatment of peptic ulcer disease. Which of
the following statements best indicate that the client understands how to
correctly take the antacid?

A. “I should take my antacid before I take my other medications.”

B. “I need to decrease my intake of fluids so that I don’t dilute the effects of my
antacid.”
C. “My antacid will be most effective if I take it whenever I experience stomach
pains”
D. “It is best for me to take my antacid 1 to 3 hours after meals”

__b___ 28. A client has been diagnosed with adenocarcinoma of the stomach and is
scheduled to undergo a subtotal gastrectomy (Billroth II procedure). During
preop teaching, the nurse is reinforcing information about the surgical
procedure. Which of the following explanations is most appropriate?

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A. The procedure will result in enlargement of the pyloric spinchter

B. The procedure will result in anastomosis of the gastric stump to the jejunum
C. The procedure will result in removal of the duodenum
D. The procedure will result in repositioning of the vagus nerve

__c___ 29. The client tells the nurse that since his diagnosis of stomach cancer, he has
been having trouble sleeping and frequently preoccupied with thought about
how his life will change. He says “I wish my life could stay the same.” Based
on this information, which of the following nursing diagnoses would be
appropriate at this time?

A. Ineffective coping related to the diagnosis of cancer

B. Disturbed sleep pattern related to the diagnosis of cancer.
C. Anticipatory grieving related to the diagnosis of cancer
D. Anxiety related to the need for gastric surgery

__b___ 30. As a result of gastric resection, the client is at risk for development of
dumping syndrome. The nurse would prepare a plan of care for this client
based on knowledge that this problem stems primarily from which of the
following gastrointestinal changes?

A. Excess secretion of digestive enzymes in the intestines

B. Rapid emptying of stomach content into the small intestine
C. Excess glycogen production by the liver
D. Loss of gastric enzymes

_c____ 31. A client who has been diagnosed with gastroesophageal reflux disease
(GERD) complains of heartburns. To decrease the heartburns, the nurse
should instruct the client to eliminate which of the following items from the
diet?

A. Lean beef
B. Air-popped popcorn
C. Hot chocolate
D. Raw vegetables

__b___ 32. Which of the following factors would most likely contribute to the
development of a client’s hiatal hernia?

A. Having a sedentary deskjob

B. Being 5 feet, 3 inches tall and weighing 190 pounds
C. Using laxatives frequently
D. Being 40 years old

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__a___ 33. The nurse instructs the client on health maintenance activities to help
control
symptoms from her hiatal hernia. Which of the following statements would
indicate that the client has understood the instruction?

A. “I’ll avoid lying down after meal”

B. “I can still enjoy my potato chips and cola at bedtime.”
C. “I wish I didn’t have to give up swimming”
D. “If I wear a girdle, I’ll have more support for my stomach”

__d___ 34. Which of the following has been identified as a potential risk factor for the
development of colon cancer?

A. Chronic constipation
B. Long-term use of laxatives
C. History of smoking
D. History of inflammatory bowel disease

_c____ 35. Which position would be ideal for a client in the early postoperative period
after a hemorrhoidectomy?

A. High-Fowler’s
B. Supine
C. Side-lying
D. Trendelenburg’s

__c___ 36. The nurse teaches the client who has had rectal surgery the proper timing
for sitz baths. The nurse knows that the client has understood the teaching
when the client states that it is most important to take a sitz bath

A. First thing each morning

B. As needed for discomfort
C. After a bowel movement
D. At bedtime

__b___ 37. Which goal for the client’s care should take priority during the first day of
hospitalization for an exacerbation of ulcerative colitis?

A. Promoting self-care and independence

B. Managing diarrhea
C. Maintaining adequate nutrition
D. Promoting rest and comfort

__d___ 38. A client who has ulcerative colitis says to the nurse, “I can’t take this
anymore! I’m constantly in pain and I can’t leave my room because I need to
stay by the toilet. I don’t know how to deal with this!” Based on these

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comment, an appropriate nursing diagnosis for client would be:

A. Impaired physical mobility related to fatigue

B. Disturbed thought processes related to chronic fatigue
C. Social isolation related to chronic fatigue
D. Ineffective coping related to chronic abdominal pain

__c___ 39. A client who has Ulcerative colitis has persistent diarrhea. He is thin and
has
lost 12 pounds since the exacerbation of his ulcerative colitis. The nurse
should anticipate that the physician will order which of the following
treatment approaches to help the client meet his nutritional needs?

A. Initiate continuous enteral feedings

B. Encourage a high-calorie, high protein diet
C. Implement total parenteral nutrition (TPN)
D. Provide six small meals a day.

__a___ 40. A client with Crohn’s disease experiences rectal bleeding along with 15 to
20
watery stools per day. Which of the following signs would be indicative of
dehydration?

A. Sunken eyeballs
B. Decreased pulse rate
C. Moist skin
D. Pitting edema

_b____ 41. Which of the following would be a priority focus of care of the client
experiencing an exacerbation of Crohn’s disease?

A. Encouraging regular ambulation

B. Promoting bowel rest
C. Maintaining current weight
D. Decreasing episodes of rectal bleeding

__a___ 42. The physician orders intestinal decompression with a Cantor tube for the
client. The primary purpose of a nasoenteric tube such as a Cantor tube is:

A. To remove fluids and gas from intestines

B. To prevent fluid accumulation in the stomach
C. To break up the obstruction
D. To provide an alternative route for drug administration

__c___ 43. After insertion of a nasogastric tube, the nurse should place the client in

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which position?

A. Supine
B. Right side-lying
C. Semi-Fowler’s
D. Upright in a bedside chair

__d___ 44. Which of the following nursing diagnoses would be most appropriate for a
client with an intestinal obstruction?

A. Impaired swallowing related to NPO status

B. Urinary retention related to deficient fluid volume
C. Deficient fluid volume related to nausea and vomiting
D. Chronic pain related to abdominal distention

__b___ 45. A client who is scheduled for an ileostomy has an order for oral neomycin
to
be administered before surgery. The nurse understands that the rationale for
administering oral neomycin before surgery is to:

A. Prevent postoperative bladder infection

B. Reduce number of intestinal bacteria
C. Decrease the potential for postoperative hypostatic pneumonia
D. Increase the body’s immunologic response to the stressors of surgery

__c___ 46. The nurse should instruct the client with an ileostomy to report which of the
following symptoms immediately?

A. Passage of liquid stool from stoma

B. Occasional presence of undigested food in the effluent
C. Absence of drainage from the ileostomy for 6 or more hours
D. Temperature of 99.80 F (37.70C).

__c___ 47. The nurse evaluates the client’s understanding of ileostomy care. Which of
the following statements indicates that the discharge teaching has been
effective?

A. “I should be able to resume weightlifting in 2 weeks”

B. “I can return to work in 2 weeks”
C. “I will need to drink 3000 ml of fluids a day”
D. “I will need to avoid getting my stoma wet while bathing”

__d___ 48. The nurse discovers the client’s TPN solution was running at an incorrect
rate and is now 2 hours behind schedule. Which action is most appropriate
for the nurse to take to correct the problem?

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A. Readjust the solution to infuse the desired amount

B. Continue the infusion at the desired amount
C. Double the infusion rate for 2 hours
D. Notify the physician

__d___ 49. Which of the following should the nurse interpret as an indication of a
complication after the first few days of TPN therapy?

A. Glucosuria
B. A 1- to 2-lb. weight gain
C. Decreased appetite
D. Elevated temperature

__b___ 50. Which of the following medications would the nurse anticipate
administering
to a client with diverticular disease?

A. Psyllium hydrophilic mucilloid (Metamucil)

B. Diphenoxylate with atropine sulfate (Lomotil)
C. Diazepam (Valium)
D. Aluminum hydroxide (Amphojel)

__b___ 51. A client who had an appendectomy for a perforated appendix returns from
surgery with a drain inserted in the incisional site. The nurse understands
that the purpose of the drain is to accomplish which of the following?

A. Provide access for wound irrigation

B. Promote drainage of wound exudates.
C. Minimize development of scar tissue
D. Decrease postoperative discomfort

__a___ 52. In a client with acute appendicitis, the nurse should anticipate which of the
following treatments?

A. Administration of enemas to cleanse the bowel

B. Insertion of a nasogastric tube
C. Placement of client on NPO status
D. Administration of heat to the abdomen

__c___ 53. A client who has history of inguinal hernia is admitted to the hospital with
complaints of a sudden, severe abdominal pain, vomiting and abdominal
distention. Based on these assessment findings, the nurse suspects that
which of the following complications has developed?

A. Peritonitis

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B. Incarcerated hernia
C. Strangulated hernia
D. Intestinal perforation

__b___ 54. A client has just had an inguinal herniorraphy. Which of the following
nursing
interventions would be appropriate for his care?

A. Help the client to turn, cough and deep breathe every 2 hours
B. Apply an ice bag to the scrotum
C. Apply a truss before the client ambulates
D. Maintain the client in high Fowler’s position while in bed

__a___ 55. The nurse is monitoring a client admitted to the hospital with a diagnosis of
appendicitis who is scheduled for surgery in 2 hours. The client begins to
complain of increased abdominal pain and begins to vomit. On assessment,
the nurse notes that the abdomen is distended and bowel sounds are
diminished. Which is the most appropriate nursing intervention?

A. Notify the health care provider (HCP).

B. Administer the prescribed pain medication.
C. Call and ask the operating room team to perform surgery as soon as
possible.
D. Reposition the client and apply a heating pad on the warm setting to the
client’s abdomen.

def_____ 56. A client admitted to the hospital with a suspected diagnosis of acute
pancreatitis is being assessed by the nurse. Which assessment findings
would be consistent with acute pancreatitis? Select all that apply.

A. Diarrhea
B. Black, tarry stools
C. Hyperactive bowel sounds
D. Gray-blue color at the flank
E. Abdominal guarding and tenderness
F. Left upper quadrant pain with radiation to the back

_ace____ 57. The nurse is assessing a client who is experiencing an acute episode of
cholecystitis. Which of these clinical manifestations support this diagnosis?
Select all that apply.

A. Fever
B. Positive Cullen’s sign
C. Complaints of indigestion
D. Palpable mass in the left upper quadrant
E. Pain in the upper right quadrant after a fatty meal

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F. Vague lower right quadrant abdominal discomfort

__b___ 58. A client is diagnosed with viral hepatitis, complaining of “no appetite” and
“losing my taste for food.” What instruction should the nurse give the client to
provide adequate nutrition?

A. Select foods high in fat.

B. Increase intake of fluids, including juices.
C. Eat a good supper when anorexia is not as severe.
D. Eat less often, preferably only 3 large meals daily.

__a___ 59. A client has developed hepatitis A after eating contaminated oysters. The
nurse assesses the client for which expected assessment finding?

A. Malaise
B. Dark stools
C. Weight gain
D. Left upper quadrant discomfort

__acd___ 60. A client has just had a hemorrhoidectomy. Which nursing interventions
are
appropriate for this client? Select all that apply.

A. Administer stool softeners as prescribed.

B. Instruct the client to limit fluid intake to avoid urinary retention.
C. Encourage a high-fiber diet to promote bowel movements without straining.
D. Apply cold packs to the anal-rectal area over the dressing until the packing is
removed.
E. Help the client to a Fowler’s position to place pressure on the rectal area and
decrease bleeding.

_abce____ 61. The nurse is planning to teach a client with gastroesophageal reflux
disease
(GERD) about substances to avoid. Which items should the nurse include on
this list? Select all that apply.

A. Coffee
B. Chocolate
C. Peppermint
D. Nonfat milk
E. Fried chicken
F. Scrambled eggs

_b____ 62. The health care provider has determined that a client has contracted
hepatitis A based on flulike symptoms and jaundice. Which statement made

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by the client supports this medical diagnosis?

A. “I have had unprotected sex with multiple partners.”

B. “I ate shellfish about 2 weeks ago at a local restaurant.”
C. “I was an intravenous drug abuser in the past and shared needles.”
D. “I had a blood transfusion 30 years ago after major abdominal surgery.”

_ace____ 63. The nurse is providing dietary teaching for a client with a diagnosis of
chronic gastritis. The nurse instructs the client to include which foods rich in
vitamin B12 in the diet? Select all that apply.

A. Nuts
B. Corn
C. Liver
D. Apples
E. Lentils
F. Bananas

_c____ 64. The nurse is assessing a client 24 hours following a cholecystectomy. The
nurse notes that the T-tube has drained 750 mL of green-brown drainage
since the surgery. Which nursing intervention is most appropriate?

A. Clamp the T-tube.

B. Irrigate the T-tube.
C. Document the findings.
D. Notify the health care provider.

__d___ 65. The nurse is monitoring a client with a diagnosis of peptic ulcer. Which
assessment finding would most likely indicate perforation of the ulcer?

A. Bradycardia
B. Numbness in the legs
C. Nausea and vomiting
D. A rigid, boardlike abdomen

__c___ 66. The nurse is caring for a client following a gastrojejunostomy (Billroth II
procedure). Which postoperative prescription should the nurse question and
verify?

A. Leg exercises
B. Early ambulation
C. Irrigating the nasogastric tube
D. Coughing and deep-breathing exercises

_c____ 67. The nurse is providing discharge instructions to a client following

gastrectomy and should instruct the client to take which measure to assist in

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preventing dumping syndrome?

A. Ambulate following a meal.

B. Eat high-carbohydrate foods.
C. Limit the fluids taken with meals.
D. Sit in a high Fowler’s position during meals.

__abe___ 68. The nurse is reviewing the prescription for a client admitted to the
hospital
with a diagnosis of acute pancreatitis. Which interventions would the nurse
expect to be prescribed for the client? Select all that apply.

A. Maintain NPO (nothing by mouth) status.

B. Encourage coughing and deep breathing.
C. Give small, frequent high-calorie feedings.
D. Maintain the client in a supine and flat position.
E. Give hydromorphone intravenously as prescribed for pain.
F. Maintain intravenous fluids at 10 mL/hour to keep the vein open.

__a___ 69. The nurse is providing discharge teaching for a client with newly diagnosed
Crohn’s disease about dietary measures to implement during exacerbation
episodes. Which statement made by the client indicates a need for further
instruction?

A. “I should increase the fiber in my diet.”

B. “I will need to avoid caffeinated beverages.”
C. “I’m going to learn some stress reduction techniques.”
D. “I can have exacerbations and remissions with Crohn’s disease.”

__c___ 70. The nurse is reviewing the record of a client with a diagnosis of cirrhosis
and
notes that there is documentation of the presence of asterixis. How should
the nurse assess for its presence?

A. Dorsiflex the client’s foot.

B. Measure the abdominal girth.
C. Ask the client to extend the arms.
D. Instruct the client to lean forward.

__c___ 71. The nurse is reviewing the laboratory results for a client with cirrhosis and
notes that the ammonia level is 85 mcg/dL (51 mcmol/L). Which dietary
selection does the nurse suggest to the client?

A. Roast pork
B. Cheese omelet
C. Pasta with sauce

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D. Tuna fish sandwich

__c___ 72. The nurse is doing an admission assessment on a client with a history of
duodenal ulcer. To determine whether the problem is currently active, the
nurse should assess the client for which sign(s)/ symptom(s) of duodenal
ulcer?

A. Weight loss
B. Nausea and vomiting
C. Pain relieved by food intake
D. Pain radiating down the right arm

__a___ 73. A client with hiatal hernia chronically experiences heartburn following
meals.
The nurse should plan to teach the client to avoid which action because it is
contraindicated with a hiatal hernia?

A. Lying recumbent following meals

B. Consuming small, frequent, bland meals
C. Taking H2-receptor antagonist medication
D. Raising the head of the bed on 6-inch (15 cm) blocks

_b____ 74. The nurse is providing care for a client with a recent transverse colostomy.
Which observation requires immediate notification of the health care
provider?

A. Stoma is beefy red and shiny

B. Purple discoloration of the stoma
C. Skin excoriation around the stoma
D. Semi-formed stool noted in the ostomy pouch

__a___ 75. A client had a new colostomy created 2 days earlier and is beginning to
pass
malodorous flatus from the stoma. What is the correct interpretation by the
nurse?

A. This is a normal, expected event.

B. The client is experiencing early signs of ischemic bowel.
C. The client should not have the nasogastric tube removed.
D. This indicates inadequate preoperative bowel preparation.

__d___ 76. A client has just had surgery to create an ileostomy. The nurse assesses
the
client in the immediate postoperative period for which most frequent
complication of this type of surgery?

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A. Folate deficiency
B. Malabsorption of fat
C. Intestinal obstruction
D. Fluid and electrolyte imbalance

__a___ 77. The nurse provides instructions to a client about measures to treat
inflammatory bowel syndrome (IBS). Which statement by the client indicates
a need for further teaching?

A. “I need to limit my intake of dietary fiber.”

B. “I need to drink plenty, at least 8 to 10 cups daily.”
C. “I need to eat regular meals and chew my food well.”
D. “I will take the prescribed medications because they will regulate my bowel
patterns.”

__a___ 78. The nurse is monitoring a client for the early signs and symptoms of
dumping syndrome. Which findings indicate this occurrence?

A. Sweating and pallor

B. Bradycardia and indigestion
C. Double vision and chest pain
D. Abdominal cramping and pain

__c___ 79. If a gallstone becomes lodged in the common bile duct, the nurse should
anticipate that the client’s stools would most likely become what color?

A. Green
B. Gray
C. Black
D. Brown

__b___ 80. When the client’s common bile duct is obstructed, the nurse should
evaluate
the client for signs of which of the following complications?

A. Respiratory distress
B. Circulatory overload
C. Urinary tract infection
D. Prolonged bleeding time

__b___ 81. A client undergoes a traditional cholecystectomty and choledochotomy and

returns from surgery with a T-tube. To evaluate the effectiveness of the T-
tube, the nurse should understand that the primary reason for the tube is to
accomplish which of the following goals?

A. Promote wound drainage

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B. Provide a way to irrigate the tract

C. Minimize the passage of bile into the duodenum
D. Prevent the bile into the duodenum

__d___ 82. After a cholecystectomy, it is recommended that the client follows a low-fat
diet at home. Which of the following foods would be most appropriate to
include in a low-fat diet?

A. Cheese omelet
B. Peanut butter
C. Ham salad sandwich
D. Roasted beef

_c____ 83. A client undergoes a laparoscopic cholecystectomy. Which of the following

dietary instructions would the nurse give the client immediately after surgery?

A. “You cannot eat or drink anything for 24 hours”

B. “You may resume your normal diet the day after surgery”
C. “Drink liquid today and eat lightly for a few days”
D. “You can progress from a liquid to a bland diet as tolerated”

__b__ 84. When providing care for a client with acute pancreatitis, the nurse would
anticipate which of the following orders?

A. Increase oral intake 3000 ml. every 24 hours

B. Insert a nasogastric tube and connect it to low suction
C. Place the client in the reverse Trendelenburg position
D. Place the client on precautions

__a___ 85. The nurse notes that a client with acute pancreatitis occasionally
experiences muscle twitching and jerking. How should the nurse interpret
the significance of these symptoms?

A. The client maybe developing hypocalcemia

B. The client is experiencing a reaction to Meperidine (Demerol)
C. The client has a nutritional imbalance
D. The client needs a muscle relaxant to help him rest.

__b___ 86. Pancreatic enzyme replacements are ordered for the client with chronic
pancreatitis. When should the nurse the client to take them to obtain the most
therapeutic effect?

A. Three times daily between meals

B. With each meal and snack
C. In the morning and at bedtime
D. Every 4 hours, at specified times

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__c___ 87. The nurse should teach the client with chronic pancreatitis to monitor the
effectiveness of pancreatic enzyme replacement therapy by doing which of
the following?

A. Monitoring fluid intake

B. Performing regular glucose fingerstick tests
C. Observing stools for steatorrhea
D. Testing urine for ketones

__c___ 88. The nurse is assessing a client who is in the early stage of cirrhosis of the
liver. Which of the following signs would the nurse anticipate finding?

A. Peripheral edema
B. Ascites
C. Anorexia
D. Jaundice

__a___ 89. Which diet should be implemented to a client who is in the early stages of
cirrhosis?

A. High calorie, high carbohydrate

B. High protein, low fat
C. Low fat, low protein
D. High carbohydrates, low sodium

_d____ 90. The client has developed ascites. The nurse should recognize that the
pathologic basis for the development of ascites in clients with cirrhosis is
portal hypertension and

A. An excess serum sodium level

B. An increased metabolism of aldosterone
C. A decreased flow of hepatic lymph
D. A decreased serum albumin level

__d___ 91. A client with cirrhosis vomits bright red blood and the physician decides to
insert a Sengstaken-Blakemore tube. The nurse should explain to the client
that the tube acts by:

A. Providing a large diameter for effective gastric lavage

B. Applying direct pressure to gastric bleeding sites
C. Blocking blood flow to gastric bleeding sites
D. Apply direct pressure to esophagus

__c___ 92. The physician orders oral neomycin and neomycin enema for the client with

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cirrhosis. The nurse understands that the purpose of this therapy is to:

A. Reduce abdominal pressure

B. Prevent straining during defecation
C. Block ammonia formation
D. Reduce bleeding within the intestine

__c___ 93. A client’s serum ammonia level is elevated and the physician orders 30 ml
of
lactulose (Cephuhlac). Which of the following side-effects of this drug would
the nurse expect to see?

A. Increased urine output

B. Improved level of consciousness
C. Increased bowel movements
D. Nausea and vomiting

_c____ 94. The nurse is providing discharge instructions for the client with cirrhosis.
Which of the following statements best indicates that the client has
understood the teaching?

A. “I should eat a high-protein, high-carbohydrate diet to provide energy”

B. “It is safer for me to take acetaminophen (Tylenol) for pain instead of aspirin”
C. “I should avoid constipation to decrease chances of bleeding”
D. “If I get enough rest and follow my diet, it is possible for my cirrhosis to be
cured”

_d____ 95. A client has undergone esophagogastroduodenoscopy. The nurse should

place highest priority on which item as part of the client’s care plan?

A. Monitoring the temperature

B. Monitoring complaints of heartburn
C. Giving warm gargles for a sore throat
D. Assessing for the return of the gag reflex

_b____ 96. A client has been admitted to the hospital with a diagnosis of acute
pancreatitis and the nurse is assessing the client’s pain. What type of pain is
consistent with this diagnosis?

A. Burning and aching, located in the left lower quadrant and radiating to the hip
B. Severe and unrelenting located in the epigastric area and radiating to the
back
C. Burning and aching, located in the epigastric area and radiating to the
umbilicus
D. Severe and unrelenting, located in the left lower quadrant and radiating to the
groin

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_d____ 97. The nurse is assessing a client who is experiencing an acute episode of
cholecystitis. Where should the nurse anticipate the location of the pain?

A. Right lower quadrant, radiating to the back

B. Right lower quadrant, radiating to the umbilicus
C. Right upper quadrant, radiating to the left scapula and shoulder
D. Right upper quadrant, radiating to the right scapula and shoulder

_c____ 98. The nurse has taught the client about an upcoming endoscopic retrograde
cholangiopancreatography procedure. The nurse determines that the client
needs further information if the client makes which statement?

A. “I know I must sign the consent form.”

B. “I hope the throat spray keeps me from gagging”
C. “I’m glad I don’t have to lie still for this procedure”
D. “I’m glad some IV medication will be given to relax me”

__a___ 99. The health care provider has determined that a client with hepatitis has
contracted the infection from 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

_b____ 100. The nurse is caring for a client with a diagnosis of chronic gastritis. The
nurse monitors the client, knowing that this client is at risk for which vitamin
deficiency?

A. Vitamin A
B. Vitamin B12
C. Vitamin C
D. Vitamin E

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Celia Cruz-Fajardo, M.D.