MED-SURG EXAM 2 PRACTICE QUESTIONS WITH COMPLETE SOLUTIONS 100% 2023/2024 A client presents to the emergency department with upper gastrointestinal bleeding and is in moderate distress. In planning care, what is the priority nursing action for this client?
a. Assessment of vital signs
b. Completion of abdominal examination
c. Insertion of the prescribed nasogastric tube
d. Thorough investigation of precipitating events - correct answer A
The pernicious anemia that may accompany gastritis is due to which of the following?
a. Chronic autoimmune destruction of cobalamin stores in the body b. Progressive gastric atrophy from chronic breakage in the mucosal barrier and blood loss
c. A lack of intrinsic factor normally produced by acid-secreting cells of the gastric mucosa
d. Hyperchlorhydria resulting from an increase in acid-secreting parietal cells and degradation of RBS's - correct answer C
The nurse performs a detailed assessment of the abdomen of a patient with a possible bowel obstruction, knowing that a manifestation of an obstruction in the small intestine is (select all that apply)
a. Projectile vomiting
b. Diarrhea that is loose or liquid
c. Persistent, colicky abdominal pain
d. Increased, tinkling bowel sounds above the blockage - correct answer A, C, D
The nurse anticipates a patient will need an esophagastroduodenoscopy (EGD). Select all the actions that
are appropriate in this patient's care. A. Signed informed consent
B. Teaching related to conscious sedation
C. Full set of vital signs prior to procedure
D. Clear liquids until procedure E. Keep the patient NPO until gag reflex returns post-procedure - correct answer A, B, C, E
A patient with chronic gastritis associated with the presence of H. pylori is treated with triple-drug therapy. The nurse explains to the patient that the drugs commonly included in this regimen include
a. Famotidine (Pepcid), magnesium hydroxide (Mylanta), and pantoprazole (Protonix).
b. Amoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec).
c. Sucralfate (Carafate), nystatin (Mycostatin), and bismuth subsalicylate (Pepto-Bismol).
d. Metoclopramide (Reglan), bethanechol (Urecholine), and promethazine (Phenergan). - correct answer B
The nurse is caring for a client with acute pancreatitis and is monitoring the client for paralytic ileus. Which assessment data should alert the nurse to this occurrence?
a. Inability to pass flatus
b. Loss of anal sphincter control
c. Severe, constant pain with rapid onset
d. Firm, nontender mass palpable at the lower right costal margin - correct answer A
In caring for a client with cholelithiasis and a possible biliary obstruction what clinical findings would you expect? Select all that apply
a. Clay colored or light colored bowel movements
b. Abdominal pain
c. Dilute yellow urine
d. Jaundice
e. Normal appetite - correct answer A, B, D
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 lower quadrant, radiating to the left scapula and shoulder d. Right upper quadrant, radiating to the right scapula and shoulder - correct answer D
Which of the following would be the most important for a nurse to teach a client who is hospitalized with acute pancreatitis prior to discharge?
a. The importance of monitoring amylase and lipase levels
b. Avoidance of alcohol use for up to a year
c. Use of aspirin instead of acetaminophen as an OTC medication
d. How to care for a T-tube - correct answer B
You are a nurse caring for a client that has just returned from a cholecystectomy. All of the following interventions are appropriate for this patient except
a. Encourage early ambulation
b. Deep breathe and cough every hour
c. Regular diet d. Splint abdomen when moving and coughing - correct answer C
The nurse knows that an important role of the pancreas that may be diminished during pancreatitis is a. release of secretin
b. release of bicarbonate to decrease acidity of gastric chyme.
c. decrease in cholesterol metabolism.
d. release of gastrin by duodenal mucosa - correct answer B
The nurse is taking the patient's blood pressure, while inflating the cuff the nurse notices jerking motions
of the patient's arm and hand. The nurse suspects the patient has
a. Hypokalemia
b. Hypocalcemia
c. Hypernatremia
d. Hypercalcemia - correct answer B
With acute pancreatitis, what lab value rises within 12 hours and stays elevated for 4 days?
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