Adult Nursing Exam 4 + Pharmacology Exam 4
Questions With Correct Answers | 100% Pass
Guaranteed | graded A+
1. A nurse is providing discharge teaching to a client who is postoperative following a laparoscopic
cholecystectomy. Which of the following instructions should the nurse include in the teaching? (SATA)
A. Take baths rather than showers
B. Resume a diet of choice
C. Cleanse the puncture site using mild soap and water
D. Remove adhesive strips from the puncture site in 24 hr.
E. Report nausea and vomiting to the surgeon
Correct Answer: B, C, E
A. Incorrect: Baths can increase exposure of healing puncture sites to water and bacteria; showers are generally
preferred once permitted.
B. Correct: After laparoscopic cholecystectomy, clients can generally resume a diet as tolerated/ordered, with gradual
return to usual foods.
C. Correct: Cleaning the puncture site gently with mild soap and water supports hygiene without irritating the incision.
D. Incorrect: Adhesive strips should generally be allowed to loosen and fall off naturally rather than being removed after
24 hours unless specifically directed.
E. Correct: Nausea and vomiting can indicate a postoperative complication and should be reported as instructed.
2. A nurse is reviewing risk factors with a client who has cholecystitis. The nurse should identify which
of the following as a risk factor for cholecystitis?
A. Obesity
B. Rapid weight gain
C. Decreased blood triglyceride level
D. Male sex
Correct Answer: A
A. Correct: Obesity is a major risk factor for gallstone formation and cholecystitis.
B. Incorrect: Rapid weight loss, rather than rapid weight gain, is the classic gallstone risk associated with dieting.
C. Incorrect: Elevated, not decreased, triglycerides are associated with metabolic risk for gallstones.
D. Incorrect: Female sex is a classic risk factor; male sex is not the traditional risk factor in this teaching point.
3. A nurse is completing preoperative teaching for a client who is scheduled for a laparoscopic
cholecystectomy. Which of the following should be included in the teaching?
A. "The scope will be passed through your rectum"
B. "You might have shoulder pain after surgery"
, C. "You will have a Jackson-Pratt drain in place after surgery"
D. "You should limit how often you walk for 1 to 2 weeks"
Correct Answer: B
A. Incorrect: Laparoscopic cholecystectomy uses abdominal incisions, not a rectal route.
B. Correct: Residual carbon dioxide after laparoscopy can irritate the diaphragm and cause referred shoulder pain.
C. Incorrect: A Jackson-Pratt drain is not routinely required after an uncomplicated laparoscopic procedure.
D. Incorrect: Early ambulation is encouraged after surgery to reduce complications; walking should not be routinely
restricted for 1–2 weeks.
4. A nurse is reviewing a new prescription for chenodiol with a client who has cholelithiasis. Which of
the following information should the nurse include in the teaching?
A. This medication is used to decrease acute biliary pain
B. This medication requires thyroid function monitoring every 6 months
C. This medication is not recommended for clients who have diabetes mellitus
D. This medication dissolves gallstones gradually over a period of up to 2 years
Correct Answer: D
A. Incorrect: Chenodiol is used to dissolve selected cholesterol gallstones, not primarily to treat acute biliary pain.
B. Incorrect: Routine thyroid-function monitoring is not the key teaching point for chenodiol.
C. Incorrect: Diabetes is not the defining contraindication stated in this teaching point.
D. Correct: Chenodiol can dissolve suitable cholesterol stones gradually, and therapy may take a long time, potentially
up to about 2 years.
5. A nurse in a clinic is reviewing the laboratory reports of a client who has suspected cholelithiasis.
Which of the following is an expected finding?
A. Blood amylase 80 units/L
B. WBC 9,000/mm³
C. Direct bilirubin 2.1 mg/dL
D. Alkaline phosphatase 25 units/L
Correct Answer: C
A. Incorrect: An amylase of 80 units/L can be within a usual reference range and is not the expected obstructive
pattern.
B. Incorrect: A WBC of 9,000/mm³ is within a typical reference range.
C. Correct: Direct bilirubin elevation supports impaired bile flow/obstruction associated with gallstone disease.
D. Incorrect: An alkaline phosphatase of 25 units/L is low rather than the cholestatic elevation expected with biliary
obstruction.
6. A nurse is reviewing the admission laboratory results of a client who has acute pancreatitis. Which of
the following findings should the nurse expect?
A. Decreased blood lipase level
B. Decreased blood amylase level
C. Increased blood calcium level
D. Increased blood glucose level
Correct Answer: D
A. Incorrect: Acute pancreatitis commonly causes increased, not decreased, lipase.
B. Incorrect: Acute pancreatitis commonly causes increased, not decreased, amylase.
C. Incorrect: Calcium can decrease in severe acute pancreatitis because of fat necrosis and saponification.
D. Correct: Pancreatic inflammation can impair insulin secretion and cause hyperglycemia.
7. A nurse is preparing to administer pancrelipase to a client who has pancreatitis. Which of the
following actions should the nurse take?
, A. Instruct the client to chew the medication before swallowing
B. Offer a glass of water following medication administration
C. Administer the medication 30 min before meals
D. Sprinkle the contents on peanut butter
Correct Answer: B
A. Incorrect: Enteric-coated pancrelipase should not be chewed because chewing can damage the protective coating.
B. Correct: Water helps the client swallow the medication safely.
C. Incorrect: Pancrelipase is taken with meals/snacks so enzymes mix with food; taking it 30 minutes before meals is
not the best instruction.
D. Incorrect: Pancrelipase should be mixed with an appropriate soft acidic food if opened, not peanut butter as a routine
method.
8. A nurse is completing an admission assessment of a client who has pancreatitis. Which of the
following findings should the nurse expect?
A. Pain in right upper quadrant radiating to right shoulder
B. Report of pain being worse when sitting upright
C. Pain relieved with defecation
D. Epigastric pain radiating to left shoulder
Correct Answer: D
A. Incorrect: Right-upper-quadrant pain radiating to the right shoulder is more characteristic of biliary disease.
B. Incorrect: Pancreatitis pain often worsens when supine and may improve when leaning forward.
C. Incorrect: Pain relieved by defecation is more consistent with some intestinal disorders than pancreatitis.
D. Correct: Epigastric pain radiating to the back/left shoulder is characteristic of pancreatitis.
9. A nurse is assessing a client who has pancreatitis. Which of the following findings should the nurse
identify as a manifestation of pancreatitis?
A. Generalized cyanosis
B. Hyperactive bowel sounds
C. Gray-blue discoloration of the skin around the umbilicus
D. Wheezing in the lower lung fields
Correct Answer: C
A. Incorrect: Generalized cyanosis is not a typical manifestation of pancreatitis.
B. Incorrect: Bowel sounds are often decreased because of ileus rather than hyperactive.
C. Correct: Cullen sign is periumbilical ecchymosis caused by intra-abdominal bleeding and can occur with severe
pancreatitis.
D. Incorrect: Wheezing is not a characteristic primary manifestation of pancreatitis.
10. A nurse is completing nutrition teaching for a client who has pancreatitis. Which of the following
statements by the client indicates an understanding of the teaching? Select all that apply.
A. "I plan to eat small, frequent meals"
B. "I will eat easy-to-digest foods with limited spice"
C. "I will use skim milk when cooking"
D. "I plan to drink regular cola."
E. "I will limit alcohol intake to 2 drinks per day."
Correct Answer: A, B, C
A. Correct: Small, frequent meals can improve tolerance and reduce digestive workload.
B. Correct: Easy-to-digest, lower-fat foods are commonly recommended as oral intake resumes.
C. Correct: Skim milk reduces fat intake compared with whole milk.
D. Incorrect: Regular cola is not a preferred nutrition choice because it provides little nutritional value and may worsen
GI symptoms.
, E. Incorrect: Alcohol should be avoided rather than limited to two drinks daily in pancreatitis.
11. A nurse on a medical-surgical unit is admitting a client who has hepatitis B with ascites. Which of
the following actions should the nurse include in the plan of care?
A. Initiate contact precautions
B. Weigh client weekly
C. Measure abdominal girth 7.5 cm (3 in) above the umbilicus
D. Provide a high-calorie, high-carbohydrate diet
Correct Answer: D
A. Incorrect: Hepatitis B is primarily blood/body-fluid transmitted; routine contact precautions are not the specific
precaution for ascites.
B. Incorrect: Daily weights are more useful for monitoring fluid changes than weekly weights in significant ascites.
C. Incorrect: Abdominal girth should be measured consistently at the umbilical level, not 7.5 cm above it.
D. Correct: Adequate calories and carbohydrates help prevent catabolism in chronic liver disease.
12. A nurse is caring for a client who has a new diagnosis of hepatitis C. Which of the following is an
expected laboratory finding?
A. Presence of immunoglobulin G antibodies (IgG)
B. Presence of enzyme immunoassay (EIA)
C. Aspartate aminotransferase (AST) 35 units/L
D. Alanine aminotransferase (ALT) 15 IU/L
Correct Answer: B
A. Incorrect: IgG alone does not establish the expected initial laboratory finding for a new hepatitis C diagnosis.
B. Correct: An enzyme immunoassay is used to screen for hepatitis C antibodies.
C. Incorrect: AST 35 units/L may be normal and does not specifically indicate active hepatitis C.
D. Incorrect: ALT 15 IU/L is typically normal and does not support active hepatic inflammation.
13. A nurse is caring for a client who has cirrhosis. Which of the following medications can the nurse
expect to administer to this client? (Select all that apply.)
A. Diuretic
B. Beta-blocking agent
C. Opioid analgesic
D. Lactulose (Cephulac)
E. Sedative
Correct Answer: A, B, D
A. Correct: Diuretics such as spironolactone are commonly used to manage cirrhotic ascites.
B. Correct: Nonselective beta blockers can reduce portal-hypertension complications such as variceal bleeding.
C. Incorrect: Opioids can worsen sedation and hepatic encephalopathy and are used cautiously.
D. Correct: Lactulose lowers intestinal ammonia absorption and is commonly used for hepatic encephalopathy.
E. Incorrect: Sedatives can precipitate or worsen encephalopathy and are generally avoided when possible.
14. A nurse is teaching a client who has hepatitis B about home care. Which of the following should the
nurse include in the teaching? (Select all that apply.)
A. Limit physical activity
B. Avoid alcohol
C. Take acetaminophen for comfort
D. Wear a mask when in public places
E. Eat small frequent meals
Correct Answer: A, B, E
A. Correct: Rest and limiting strenuous activity can help during the acute phase of hepatitis.
Questions With Correct Answers | 100% Pass
Guaranteed | graded A+
1. A nurse is providing discharge teaching to a client who is postoperative following a laparoscopic
cholecystectomy. Which of the following instructions should the nurse include in the teaching? (SATA)
A. Take baths rather than showers
B. Resume a diet of choice
C. Cleanse the puncture site using mild soap and water
D. Remove adhesive strips from the puncture site in 24 hr.
E. Report nausea and vomiting to the surgeon
Correct Answer: B, C, E
A. Incorrect: Baths can increase exposure of healing puncture sites to water and bacteria; showers are generally
preferred once permitted.
B. Correct: After laparoscopic cholecystectomy, clients can generally resume a diet as tolerated/ordered, with gradual
return to usual foods.
C. Correct: Cleaning the puncture site gently with mild soap and water supports hygiene without irritating the incision.
D. Incorrect: Adhesive strips should generally be allowed to loosen and fall off naturally rather than being removed after
24 hours unless specifically directed.
E. Correct: Nausea and vomiting can indicate a postoperative complication and should be reported as instructed.
2. A nurse is reviewing risk factors with a client who has cholecystitis. The nurse should identify which
of the following as a risk factor for cholecystitis?
A. Obesity
B. Rapid weight gain
C. Decreased blood triglyceride level
D. Male sex
Correct Answer: A
A. Correct: Obesity is a major risk factor for gallstone formation and cholecystitis.
B. Incorrect: Rapid weight loss, rather than rapid weight gain, is the classic gallstone risk associated with dieting.
C. Incorrect: Elevated, not decreased, triglycerides are associated with metabolic risk for gallstones.
D. Incorrect: Female sex is a classic risk factor; male sex is not the traditional risk factor in this teaching point.
3. A nurse is completing preoperative teaching for a client who is scheduled for a laparoscopic
cholecystectomy. Which of the following should be included in the teaching?
A. "The scope will be passed through your rectum"
B. "You might have shoulder pain after surgery"
, C. "You will have a Jackson-Pratt drain in place after surgery"
D. "You should limit how often you walk for 1 to 2 weeks"
Correct Answer: B
A. Incorrect: Laparoscopic cholecystectomy uses abdominal incisions, not a rectal route.
B. Correct: Residual carbon dioxide after laparoscopy can irritate the diaphragm and cause referred shoulder pain.
C. Incorrect: A Jackson-Pratt drain is not routinely required after an uncomplicated laparoscopic procedure.
D. Incorrect: Early ambulation is encouraged after surgery to reduce complications; walking should not be routinely
restricted for 1–2 weeks.
4. A nurse is reviewing a new prescription for chenodiol with a client who has cholelithiasis. Which of
the following information should the nurse include in the teaching?
A. This medication is used to decrease acute biliary pain
B. This medication requires thyroid function monitoring every 6 months
C. This medication is not recommended for clients who have diabetes mellitus
D. This medication dissolves gallstones gradually over a period of up to 2 years
Correct Answer: D
A. Incorrect: Chenodiol is used to dissolve selected cholesterol gallstones, not primarily to treat acute biliary pain.
B. Incorrect: Routine thyroid-function monitoring is not the key teaching point for chenodiol.
C. Incorrect: Diabetes is not the defining contraindication stated in this teaching point.
D. Correct: Chenodiol can dissolve suitable cholesterol stones gradually, and therapy may take a long time, potentially
up to about 2 years.
5. A nurse in a clinic is reviewing the laboratory reports of a client who has suspected cholelithiasis.
Which of the following is an expected finding?
A. Blood amylase 80 units/L
B. WBC 9,000/mm³
C. Direct bilirubin 2.1 mg/dL
D. Alkaline phosphatase 25 units/L
Correct Answer: C
A. Incorrect: An amylase of 80 units/L can be within a usual reference range and is not the expected obstructive
pattern.
B. Incorrect: A WBC of 9,000/mm³ is within a typical reference range.
C. Correct: Direct bilirubin elevation supports impaired bile flow/obstruction associated with gallstone disease.
D. Incorrect: An alkaline phosphatase of 25 units/L is low rather than the cholestatic elevation expected with biliary
obstruction.
6. A nurse is reviewing the admission laboratory results of a client who has acute pancreatitis. Which of
the following findings should the nurse expect?
A. Decreased blood lipase level
B. Decreased blood amylase level
C. Increased blood calcium level
D. Increased blood glucose level
Correct Answer: D
A. Incorrect: Acute pancreatitis commonly causes increased, not decreased, lipase.
B. Incorrect: Acute pancreatitis commonly causes increased, not decreased, amylase.
C. Incorrect: Calcium can decrease in severe acute pancreatitis because of fat necrosis and saponification.
D. Correct: Pancreatic inflammation can impair insulin secretion and cause hyperglycemia.
7. A nurse is preparing to administer pancrelipase to a client who has pancreatitis. Which of the
following actions should the nurse take?
, A. Instruct the client to chew the medication before swallowing
B. Offer a glass of water following medication administration
C. Administer the medication 30 min before meals
D. Sprinkle the contents on peanut butter
Correct Answer: B
A. Incorrect: Enteric-coated pancrelipase should not be chewed because chewing can damage the protective coating.
B. Correct: Water helps the client swallow the medication safely.
C. Incorrect: Pancrelipase is taken with meals/snacks so enzymes mix with food; taking it 30 minutes before meals is
not the best instruction.
D. Incorrect: Pancrelipase should be mixed with an appropriate soft acidic food if opened, not peanut butter as a routine
method.
8. A nurse is completing an admission assessment of a client who has pancreatitis. Which of the
following findings should the nurse expect?
A. Pain in right upper quadrant radiating to right shoulder
B. Report of pain being worse when sitting upright
C. Pain relieved with defecation
D. Epigastric pain radiating to left shoulder
Correct Answer: D
A. Incorrect: Right-upper-quadrant pain radiating to the right shoulder is more characteristic of biliary disease.
B. Incorrect: Pancreatitis pain often worsens when supine and may improve when leaning forward.
C. Incorrect: Pain relieved by defecation is more consistent with some intestinal disorders than pancreatitis.
D. Correct: Epigastric pain radiating to the back/left shoulder is characteristic of pancreatitis.
9. A nurse is assessing a client who has pancreatitis. Which of the following findings should the nurse
identify as a manifestation of pancreatitis?
A. Generalized cyanosis
B. Hyperactive bowel sounds
C. Gray-blue discoloration of the skin around the umbilicus
D. Wheezing in the lower lung fields
Correct Answer: C
A. Incorrect: Generalized cyanosis is not a typical manifestation of pancreatitis.
B. Incorrect: Bowel sounds are often decreased because of ileus rather than hyperactive.
C. Correct: Cullen sign is periumbilical ecchymosis caused by intra-abdominal bleeding and can occur with severe
pancreatitis.
D. Incorrect: Wheezing is not a characteristic primary manifestation of pancreatitis.
10. A nurse is completing nutrition teaching for a client who has pancreatitis. Which of the following
statements by the client indicates an understanding of the teaching? Select all that apply.
A. "I plan to eat small, frequent meals"
B. "I will eat easy-to-digest foods with limited spice"
C. "I will use skim milk when cooking"
D. "I plan to drink regular cola."
E. "I will limit alcohol intake to 2 drinks per day."
Correct Answer: A, B, C
A. Correct: Small, frequent meals can improve tolerance and reduce digestive workload.
B. Correct: Easy-to-digest, lower-fat foods are commonly recommended as oral intake resumes.
C. Correct: Skim milk reduces fat intake compared with whole milk.
D. Incorrect: Regular cola is not a preferred nutrition choice because it provides little nutritional value and may worsen
GI symptoms.
, E. Incorrect: Alcohol should be avoided rather than limited to two drinks daily in pancreatitis.
11. A nurse on a medical-surgical unit is admitting a client who has hepatitis B with ascites. Which of
the following actions should the nurse include in the plan of care?
A. Initiate contact precautions
B. Weigh client weekly
C. Measure abdominal girth 7.5 cm (3 in) above the umbilicus
D. Provide a high-calorie, high-carbohydrate diet
Correct Answer: D
A. Incorrect: Hepatitis B is primarily blood/body-fluid transmitted; routine contact precautions are not the specific
precaution for ascites.
B. Incorrect: Daily weights are more useful for monitoring fluid changes than weekly weights in significant ascites.
C. Incorrect: Abdominal girth should be measured consistently at the umbilical level, not 7.5 cm above it.
D. Correct: Adequate calories and carbohydrates help prevent catabolism in chronic liver disease.
12. A nurse is caring for a client who has a new diagnosis of hepatitis C. Which of the following is an
expected laboratory finding?
A. Presence of immunoglobulin G antibodies (IgG)
B. Presence of enzyme immunoassay (EIA)
C. Aspartate aminotransferase (AST) 35 units/L
D. Alanine aminotransferase (ALT) 15 IU/L
Correct Answer: B
A. Incorrect: IgG alone does not establish the expected initial laboratory finding for a new hepatitis C diagnosis.
B. Correct: An enzyme immunoassay is used to screen for hepatitis C antibodies.
C. Incorrect: AST 35 units/L may be normal and does not specifically indicate active hepatitis C.
D. Incorrect: ALT 15 IU/L is typically normal and does not support active hepatic inflammation.
13. A nurse is caring for a client who has cirrhosis. Which of the following medications can the nurse
expect to administer to this client? (Select all that apply.)
A. Diuretic
B. Beta-blocking agent
C. Opioid analgesic
D. Lactulose (Cephulac)
E. Sedative
Correct Answer: A, B, D
A. Correct: Diuretics such as spironolactone are commonly used to manage cirrhotic ascites.
B. Correct: Nonselective beta blockers can reduce portal-hypertension complications such as variceal bleeding.
C. Incorrect: Opioids can worsen sedation and hepatic encephalopathy and are used cautiously.
D. Correct: Lactulose lowers intestinal ammonia absorption and is commonly used for hepatic encephalopathy.
E. Incorrect: Sedatives can precipitate or worsen encephalopathy and are generally avoided when possible.
14. A nurse is teaching a client who has hepatitis B about home care. Which of the following should the
nurse include in the teaching? (Select all that apply.)
A. Limit physical activity
B. Avoid alcohol
C. Take acetaminophen for comfort
D. Wear a mask when in public places
E. Eat small frequent meals
Correct Answer: A, B, E
A. Correct: Rest and limiting strenuous activity can help during the acute phase of hepatitis.
