BRUNNER AND SUDDARTHS CANADIAN
TEXTBOOK OF MEDICAL SURGICAL NURSING
4 CERTIFICATION EVALUATION EXAMS 2026
SOLVED QUESTIONS WITH FULL SOLUTION
◉ Multiple Choice
2. A nurse is promoting increased protein intake to enhance a
client's wound healing. What is the enzyme that will initiate the
digestion of the protein that the client consumes?
A. Pepsin
B. Intrinsic factor
C. Lipase
D. Amylase.
Answer: A
Rationale: The enzyme that initiates the digestion of protein is
pepsin. Intrinsic factor combines with vitamin B12 for absorption by
the ileum. Lipase aids in the digestion of fats and amylase aids in the
digestion of starch.
PTS: 1 REF: p. 1210
,NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal
Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level:
Understand
◉ Multiple Choice
3. A client has been brought to the emergency department with
abdominal pain and is subsequently diagnosed with appendicitis.
The client is scheduled for an appendectomy but questions the nurse
about how a person's health is affected by the absence of the
appendix. How should the nurse best respond?
A. "Your appendix doesn't play a major role in health, so you won't
notice any difference after your recovery from surgery."
B. "The surgeon will encourage you to limit your fat intake for a few
weeks after the surgery, but your body will then begin to
compensate."
C. "Your body will absorb slightly fewer nutrients from the food you
eat, but you won't be aware of this."
D. "Your small intestine will adapt over time to the absence of your
appendix.".
Answer: A
,Rationale: The appendix is an appendage of the cecum (not the small
intestine) that has little or no physiologic function. Its absence does
not affect digestion or absorption.
PTS: 1 REF: p. 1209
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal
Function
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level:
Apply
◉ Multiple Choice
4. An adult client is scheduled for an upper GI series that will use a
barium swallow. What teaching should the nurse include when the
client has completed the test?
A. Stool will be yellow for the first 24 hours' postprocedure.
B. The barium may cause diarrhea for the next 24 hours.
C. Fluids must be increased to facilitate the evacuation of the stool.
D. Slight anal bleeding may be noted as the barium is passed..
Answer: C
Rationale: Postprocedural client education includes information
about increasing fluid intake; evaluating bowel movements for
, evacuation of barium; and noting increased number of bowel
movements. The number of bowel movement is noted because
barium, due to its high osmolarity, may draw fluid into the bowel,
thus increasing the intraluminal contents and resulting in greater
output. Yellow stool, diarrhea, and anal bleeding are not expected.
PTS: 1 REF: p. 1219
NAT: Client Needs: Physiological Integrity: Reduction of Risk
Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal
Function
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level:
Apply
◉ Multiple Choice
5. A nurse is caring for a client with recurrent hematemesis who is
scheduled for upper gastrointestinal fibroscopy. How should the
nurse in the radiology department prepare this client?
A. Insert a nasogastric tube.
B. Administer a micro Fleet enema at least 3 hours before the
procedure.
C. Have the client lie in a supine position for the procedure.
D. Apply local anesthetic to the back of the client's throat..
TEXTBOOK OF MEDICAL SURGICAL NURSING
4 CERTIFICATION EVALUATION EXAMS 2026
SOLVED QUESTIONS WITH FULL SOLUTION
◉ Multiple Choice
2. A nurse is promoting increased protein intake to enhance a
client's wound healing. What is the enzyme that will initiate the
digestion of the protein that the client consumes?
A. Pepsin
B. Intrinsic factor
C. Lipase
D. Amylase.
Answer: A
Rationale: The enzyme that initiates the digestion of protein is
pepsin. Intrinsic factor combines with vitamin B12 for absorption by
the ileum. Lipase aids in the digestion of fats and amylase aids in the
digestion of starch.
PTS: 1 REF: p. 1210
,NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal
Function
KEY: Integrated Process: Nursing Process BLM: Cognitive Level:
Understand
◉ Multiple Choice
3. A client has been brought to the emergency department with
abdominal pain and is subsequently diagnosed with appendicitis.
The client is scheduled for an appendectomy but questions the nurse
about how a person's health is affected by the absence of the
appendix. How should the nurse best respond?
A. "Your appendix doesn't play a major role in health, so you won't
notice any difference after your recovery from surgery."
B. "The surgeon will encourage you to limit your fat intake for a few
weeks after the surgery, but your body will then begin to
compensate."
C. "Your body will absorb slightly fewer nutrients from the food you
eat, but you won't be aware of this."
D. "Your small intestine will adapt over time to the absence of your
appendix.".
Answer: A
,Rationale: The appendix is an appendage of the cecum (not the small
intestine) that has little or no physiologic function. Its absence does
not affect digestion or absorption.
PTS: 1 REF: p. 1209
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal
Function
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level:
Apply
◉ Multiple Choice
4. An adult client is scheduled for an upper GI series that will use a
barium swallow. What teaching should the nurse include when the
client has completed the test?
A. Stool will be yellow for the first 24 hours' postprocedure.
B. The barium may cause diarrhea for the next 24 hours.
C. Fluids must be increased to facilitate the evacuation of the stool.
D. Slight anal bleeding may be noted as the barium is passed..
Answer: C
Rationale: Postprocedural client education includes information
about increasing fluid intake; evaluating bowel movements for
, evacuation of barium; and noting increased number of bowel
movements. The number of bowel movement is noted because
barium, due to its high osmolarity, may draw fluid into the bowel,
thus increasing the intraluminal contents and resulting in greater
output. Yellow stool, diarrhea, and anal bleeding are not expected.
PTS: 1 REF: p. 1219
NAT: Client Needs: Physiological Integrity: Reduction of Risk
Potential
TOP: Chapter 38: Assessment of Digestive and Gastrointestinal
Function
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level:
Apply
◉ Multiple Choice
5. A nurse is caring for a client with recurrent hematemesis who is
scheduled for upper gastrointestinal fibroscopy. How should the
nurse in the radiology department prepare this client?
A. Insert a nasogastric tube.
B. Administer a micro Fleet enema at least 3 hours before the
procedure.
C. Have the client lie in a supine position for the procedure.
D. Apply local anesthetic to the back of the client's throat..
