A 35-year-old patient had gastric bypass surgery 12 hours ago. She is receiving morphine by a patient-
controlled analgesia (PCA) pump for pain. The pulse oximetry reading is 94% and the patient has a respiratory
rate of 18 breaths/minute. However, the nurse notes the patient appears confused and has hypersomnolence
during the day. The patient is diagnosed with obesity hyperventilation syndrome. Which of the following is the
best nursing intervention to improve the patient's mentation?
A. Arousing and turning the patient hourly
B. Obtaining an order to begin oxygen by nasal cannula
C. Assisting the patient to a semi-Fowler's position and encouraging deep breathing
D. Discontinuing the PCA and giving naloxone (Narcan) per order - ansC
A 48-year-old patient with suspected gastrointestinal (GI) bleeding undergoes diagnostic endoscopy, which
determines the site of bleeding is a duodenal ulcer. The nurse explains to the patient that bleeding ulcers are
most commonly related to which of the following?
A. Intake of spicy foods
B. Use of salicylates
C. History of smoking
D. Severe retching and vomiting - ansB
A female patient diagnosed with colorectal cancer underwent colon resection and creation of a colostomy 3
days ago. The nurse begins to provide information on care of the colostomy when the patient states, "My
husband will be taking care of it for me. Please teach him." The nurse's best response would be:
A. "It seems you have problems with accepting your colostomy. Would you like me to ask the doctor for a
psychology consult?"
B. "You seem to be tired right now. I'll come back later when you feel more like participating in education
about your care routines."
,C. "What concerns do you have about performing your own colostomy care?"
D. "When your husband arrives, I'll be happy to instruct him on your care needs." - ansC
A male patient expresses concern about his sexual function following placement of a colostomy. The nurse is
correct to tell him that:
A. male impotence is not common.
B. sexual function is reduced.
C. his surgeon can discuss effects of the procedure.
D. libido will not be affected. - ansA
A nurse is providing a staff inservice about the various forms of hepatitis. Which of the following forms of
hepatitis would the nurse correctly identify as transmitted by the fecal-oral route?
A. Hepatitis A
B. Hepatitis B
C. Hepatitis C
D. Hepatitis D - ansA
A nurse is providing education about cirrhosis to a group of adults at a community center. The nurse identifies
which ethnic group as most likely to die as a result of this disease?
A. African Americans
B. Caucasians
C. Asian Americans
D. Hispanics - ansA
A patient asks the nurse about herbal products or dietary supplements that may decrease symptoms of
, dyspepsia. The nurse suggests the patient speak with the health care provider about use of which of the
following supplements?
A. Fish oil
B. Saw palmetto
C. Black cohosh
D. Caraway oil - ansD
A patient had ileostomy placement 2 days ago. The nursing assistant reports 24-hour output for this patient as
2,000 cc, and informs the nurse the patient is experiencing nausea and vomiting. The nurse knows this:
A. is a sign of ileostomy rejection.
B. can place the patient at risk for dehydration.
C. is rare after surgery but can be treated with antiemetics.
D. can decrease the likelihood of constipation. - ansB
A patient has a nasogastric (NG) tube to low constant suction following a partial hastrectomy with a vagotomy.
Following standards of practice, the nurse would question the surgeon about which of the following
postoperative orders?
A. Notify physician for temperature over 101.5 F.
B. Call physician for any bright red blood from the NG tube.
C. Irrigate the NG tube with 30 ml normal saline every 8 hours.
D. Keep the NG tube taped and secured to the patient's nares. - ansC
A patient has a nasogastric tube in place for possible small bowel obstruction. The nurse will assess the patient
for potential complications of NG tube usage, including:
A. gastrocolic reflux.