Braincrafts
Exam 4: NUR242/ NUR 242 (Latest 2023/ 2024) Medical-
Surgical Nursing Exam | Questions and Verified Answers|
100% Correct| Grade A- Galen
Which clinical findings in a patient indicate ulcerative colitis? - (answers)Presence of blood and
mucus in the stool.
Which clinical findings in a patient indicate Crohn's disease? - (answers)Strictures, deep
ulcerations, thickened bowel walls, and inflammation of the ileum and colon. These put the
patient at risk for developing bowel fistulas.
Which physiological change is seen in a patient with ulcerative colitis?
A. Increase in hemoglobin levels
B. Hyperalbuminemia
C. Leukocytosis
D. Hyperkalemia - (answers)C. Leukocytosis - The increase in WBC is due to the inflammatory
conditions that Ulcerative Colitis leads to.
What is gastroenteritis an inflammation of? - (answers)The GI tract. This usually self-resolves
and causes the patient to have diarrhea and stomach cramping.
What is Crohn's disease characterized by? - (answers)Chronic inflammation of the entire GI
tract. "From Gum to Bum!"
Ulcerations, Fissures,
Fistulas.
What is ulcerative colitis characterized by? - (answers)Inflammation limited to the large
intestine onward. It can often include the rectum and rectosigmoid colon.
,Braincrafts
What is Peritonitis characterized by? - (answers)The inflammation of the peritoneum. Board like
abdomen, ascites (distended stomach), severe abdominal pain, hypoactive bowel sounds,
tachypnea and tachycardia. Treatments would be IV fluids, NG suction, pain meds, ensure patent
airway. Surgical would be to repair cause, would may need to be left open. Frequent vital checks,
strict sterile techniques, semi-fowlers.
What is the preferred diagnostic test to differentiate between ulcerative colitis and Crohn's
disease? - (answers)X-Ray Examination with barium enema. The magnetic resonance
enterography helps to assess the degree of the inflammation.
What medications would a patient with Ulcerative Colitis take for flare-ups? -
(answers)Glucocorticoids such as prednisone and prednisolone. These drugs will help reduce
inflammation.
What is the nurse's best action when assessment of a client 2 hours after abdominal surgery
reveals hypoactive bowel sounds? - (answers)Document the finding and continue to monitor.
Post-op abdominal surgery commonly provides hypoactive or absent bowel sounds. The most
reliable way of knowing that peristalsis has returned is when the client passes flatus or stool.
After surgery this may take a few hours. The best action is to document the finding and continue
to monitor for flatus or stool.
What type of bowel sounds will the nurse expect to auscultate when a client reports having
diarrhea for the past two days? - (answers)Increased loud and gurgling sounds (borborygmus).
These sounds result from increased motility of the bowel. These sounds are usually heard when a
client has diarrhea, gastroenteritis, or a complete intestinal obstruction (the sounds will be heard
above the obstruction).
For which abnormal laboratory findings will the nurse monitor when providing care for a client
with acute pancreatitis? - (answers)Increased serum lipase and increased serum amylase. Acute
Pancreatitis is serious inflammation of the pancreas characterized by a sudden onset of
abdominal pain, nausea, and vomiting. Serum levels begin to elevate within 24 hours of onset
and remain elevated for up to 5 days.
, Braincrafts
What increased lab values would you expect to see with liver disease? - (answers)Increased
prothrombin time, Increased unconjugated bilirubin, increased aspartate transaminase, increased
serum ammonia.
What instructions will the nurse provide to a client with a GI problem who is scheduled for an
abdominal x-ray? - (answers)Wear a hospital gown and remove any jewelry or belts. In
preparation for the x-ray jewelry and belts should be removed as they may interfere with the x-
ray.
What is the nurse's first priority when providing care for a client after an
esophagogastroduodenoscopy (EGD)? - (answers)Keeping the client NPO until the gag reflex
returns. Clients are kept NPO until the gag reflex returns (which is usually within 30-60 minutes)
because an absent gag reflex increases the risk for aspiration. Clients must not be offered fluids
or food by mouth until the gag reflex is intact.
Which diagnostic procedure does the nurse expect will be ordered by the health care provider to
view a client's liver, gallbladder, bile ducts, and pancreas for identification of the location of an
obstruction? - (answers)Endoscopic retrograde cholangiopancreatography. This includes a visual
and radiographic examination of the liver, gallbladder, bile ducts, and pancreas to identify the
cause and location of obstruction. After a cannula is inserted into the common bile duct, a
radiopaque dye is instilled, and several x-ray images are obtained. The health care provider may
perform a papillotomy (a small incision in the sphincter around the ampulla of Vater) to remove
gallstones. If a biliary duct stricture is found, plastic or metal stents may be inserted to keep the
ducts open. Biopsies of tissue are also frequently taken during this test.
Which teaching points will the nurse include when instructing a client about preparation for a
colonoscopy? - (answers)Avoid NSAIDs, do not eat or drink for 4-5 hours before the test, drink
only CLEAR liquids the day before the colonoscopy, and know that an IV will be placed to give
medication to help you relax during the procedure. AVOID red, orange, or purple beverages the
day before the test as they may interfere with the test.
Which actions will the nurse include when providing care for a client after a colonoscopy
procedure? - (answers)Check vital signs every 15-30 minutes until the client is alert. Keep client
in the LEFT LATERAL POSITION to promote passing of flatus. Assess for signs and symptoms
Exam 4: NUR242/ NUR 242 (Latest 2023/ 2024) Medical-
Surgical Nursing Exam | Questions and Verified Answers|
100% Correct| Grade A- Galen
Which clinical findings in a patient indicate ulcerative colitis? - (answers)Presence of blood and
mucus in the stool.
Which clinical findings in a patient indicate Crohn's disease? - (answers)Strictures, deep
ulcerations, thickened bowel walls, and inflammation of the ileum and colon. These put the
patient at risk for developing bowel fistulas.
Which physiological change is seen in a patient with ulcerative colitis?
A. Increase in hemoglobin levels
B. Hyperalbuminemia
C. Leukocytosis
D. Hyperkalemia - (answers)C. Leukocytosis - The increase in WBC is due to the inflammatory
conditions that Ulcerative Colitis leads to.
What is gastroenteritis an inflammation of? - (answers)The GI tract. This usually self-resolves
and causes the patient to have diarrhea and stomach cramping.
What is Crohn's disease characterized by? - (answers)Chronic inflammation of the entire GI
tract. "From Gum to Bum!"
Ulcerations, Fissures,
Fistulas.
What is ulcerative colitis characterized by? - (answers)Inflammation limited to the large
intestine onward. It can often include the rectum and rectosigmoid colon.
,Braincrafts
What is Peritonitis characterized by? - (answers)The inflammation of the peritoneum. Board like
abdomen, ascites (distended stomach), severe abdominal pain, hypoactive bowel sounds,
tachypnea and tachycardia. Treatments would be IV fluids, NG suction, pain meds, ensure patent
airway. Surgical would be to repair cause, would may need to be left open. Frequent vital checks,
strict sterile techniques, semi-fowlers.
What is the preferred diagnostic test to differentiate between ulcerative colitis and Crohn's
disease? - (answers)X-Ray Examination with barium enema. The magnetic resonance
enterography helps to assess the degree of the inflammation.
What medications would a patient with Ulcerative Colitis take for flare-ups? -
(answers)Glucocorticoids such as prednisone and prednisolone. These drugs will help reduce
inflammation.
What is the nurse's best action when assessment of a client 2 hours after abdominal surgery
reveals hypoactive bowel sounds? - (answers)Document the finding and continue to monitor.
Post-op abdominal surgery commonly provides hypoactive or absent bowel sounds. The most
reliable way of knowing that peristalsis has returned is when the client passes flatus or stool.
After surgery this may take a few hours. The best action is to document the finding and continue
to monitor for flatus or stool.
What type of bowel sounds will the nurse expect to auscultate when a client reports having
diarrhea for the past two days? - (answers)Increased loud and gurgling sounds (borborygmus).
These sounds result from increased motility of the bowel. These sounds are usually heard when a
client has diarrhea, gastroenteritis, or a complete intestinal obstruction (the sounds will be heard
above the obstruction).
For which abnormal laboratory findings will the nurse monitor when providing care for a client
with acute pancreatitis? - (answers)Increased serum lipase and increased serum amylase. Acute
Pancreatitis is serious inflammation of the pancreas characterized by a sudden onset of
abdominal pain, nausea, and vomiting. Serum levels begin to elevate within 24 hours of onset
and remain elevated for up to 5 days.
, Braincrafts
What increased lab values would you expect to see with liver disease? - (answers)Increased
prothrombin time, Increased unconjugated bilirubin, increased aspartate transaminase, increased
serum ammonia.
What instructions will the nurse provide to a client with a GI problem who is scheduled for an
abdominal x-ray? - (answers)Wear a hospital gown and remove any jewelry or belts. In
preparation for the x-ray jewelry and belts should be removed as they may interfere with the x-
ray.
What is the nurse's first priority when providing care for a client after an
esophagogastroduodenoscopy (EGD)? - (answers)Keeping the client NPO until the gag reflex
returns. Clients are kept NPO until the gag reflex returns (which is usually within 30-60 minutes)
because an absent gag reflex increases the risk for aspiration. Clients must not be offered fluids
or food by mouth until the gag reflex is intact.
Which diagnostic procedure does the nurse expect will be ordered by the health care provider to
view a client's liver, gallbladder, bile ducts, and pancreas for identification of the location of an
obstruction? - (answers)Endoscopic retrograde cholangiopancreatography. This includes a visual
and radiographic examination of the liver, gallbladder, bile ducts, and pancreas to identify the
cause and location of obstruction. After a cannula is inserted into the common bile duct, a
radiopaque dye is instilled, and several x-ray images are obtained. The health care provider may
perform a papillotomy (a small incision in the sphincter around the ampulla of Vater) to remove
gallstones. If a biliary duct stricture is found, plastic or metal stents may be inserted to keep the
ducts open. Biopsies of tissue are also frequently taken during this test.
Which teaching points will the nurse include when instructing a client about preparation for a
colonoscopy? - (answers)Avoid NSAIDs, do not eat or drink for 4-5 hours before the test, drink
only CLEAR liquids the day before the colonoscopy, and know that an IV will be placed to give
medication to help you relax during the procedure. AVOID red, orange, or purple beverages the
day before the test as they may interfere with the test.
Which actions will the nurse include when providing care for a client after a colonoscopy
procedure? - (answers)Check vital signs every 15-30 minutes until the client is alert. Keep client
in the LEFT LATERAL POSITION to promote passing of flatus. Assess for signs and symptoms
