NURS 341 MED SURG FINAL EXAM WITH
VERIFIED QUESTIONS AND ANSWERS||
ALREADY GRADED A+|| GUARANTEED PASS ||
LATEST VERSION 2025
A patient preparing to undergo a colon resection for cancer of the colon asks
about the elevated carcinoembryonic antigen (CEA) test result. The nurse
explains that the test is used to
a. identify any metastasis of the cancer.
b. monitor the tumor status after surgery.
c. confirm the diagnosis of a specific type of cancer.
d. determine the need for postoperative chemotherapy. - ANSWER-ANS: B
CEA is used to monitor for cancer recurrence after surgery. CEA levels do not
help to determine whether there is metastasis of the cancer. Confirmation of the
diagnosis is made on the basis of biopsy. Chemotherapy use is based on factors
other than CEA.
DIF: Cognitive Level: Understand (comprehension) REF: 955
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
A 71-yr-old patient had an abdominal-perineal resection for colon cancer.
Which nursing action is most important to include in the plan of care for the day
after surgery?
a. Teach about a low-residue diet.
b. Monitor output from the stoma.
c. Assess the perineal drainage and incision.
d. Encourage acceptance of the colostomy stoma. - ANSWER-ANS: C
,Because the perineal wound is at high risk for infection, the initial care is
focused on
assessment and care of this wound. Teaching about diet is best done closer to
discharge from the hospital. There will be very little drainage into the
colostomy until peristalsis returns. The patient will be encouraged to assist with
the colostomy, but this is not the highest priority in the immediate postoperative
period.
DIF: Cognitive Level: Analyze (analysis) REF: 956
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
A patient is transferred from the recovery room to a surgical unit after a
transverse colostomy. The nurse observes the stoma to be deep pink with edema
and a small amount of sanguineous drainage. The nurse should
a. place ice packs around the stoma.
b. notify the surgeon about the stoma.
c. monitor the stoma every 30 minutes.
d. document stoma assessment findings. - ANSWER-ANS: D
The stoma appearance indicates good circulation to the stoma. There is no
indication that surgical intervention is needed or that frequent stoma monitoring
is required. Swelling of the stoma is normal for 2 to 3 weeks after surgery, and
an ice pack is not needed.
DIF: Cognitive Level: Apply (application) REF: 960
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
Which information will the nurse include in teaching a patient who had a
proctocolectomy and ileostomy for ulcerative colitis?
a. Restrict fluid intake to prevent constant liquid drainage from the stoma.
b. Use care when eating high-fiber foods to avoid obstruction of the ileum.
c. Irrigate the ileostomy daily to avoid having to wear a drainage appliance.
d. Change the pouch every day to prevent leakage of contents onto the skin. -
ANSWER-ANS: B
,High-fiber foods are introduced gradually and should be well chewed to avoid
obstruction of the ileostomy. Patients with ileostomies lose the absorption of
water in the colon and need to take in increased amounts of fluid. The pouch
should be drained frequently but is changed every 5 to 7 days. The drainage
from an ileostomy is liquid and continuous, so control by irrigation is not
possible.
DIF: Cognitive Level: Apply (application) REF: 962
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
A patient with a new ileostomy asks how much drainage to expect. The nurse
explains that after the bowel adjusts to the ileostomy, the usual drainage will be
about _____ cups daily.
a. 2
b. 3
c. 4
d. 5 - ANSWER-ANS: A
After the proximal small bowel adapts to reabsorb more fluid, the average
amount of ileostomy drainage is about 500 mL daily. One cup is about 240 mL.
DIF: Cognitive Level: Understand (comprehension) REF: 958
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
The nurse admitting a patient with acute diverticulitis explains that the initial
plan of care is to
a. administer IV fluids.
b. prepare for colonoscopy.
c. give stool softeners and enemas.
d. order a diet high in fiber and fluids. - ANSWER-ANS: A
A patient with acute diverticulitis will be NPO and given parenteral fluids. A
diet high in fiber and fluids will be implemented before discharge. Bulk-
forming laxatives, rather than stool softeners, are usually given, and these will
be implemented later in the hospitalization. The patient with acute diverticulitis
, will not have enemas or a colonoscopy because of the risk for perforation and
peritonitis.
DIF: Cognitive Level: Apply (application) REF: 964
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
A 40-yr-old male patient has had a herniorrhaphy to repair an incarcerated
inguinal hernia.
Which patient teaching will the nurse provide before discharge?
a. Soak in sitz baths several times each day.
b. Cough 5 times each hour for the next 48 hours.
c. Avoid use of acetaminophen (Tylenol) for pain.
d. Apply a scrotal support and ice to reduce swelling. - ANSWER-ANS: D
A scrotal support and ice are used to reduce edema and pain. Coughing will
increase pressure on the incision. Sitz baths will not relieve pain and would not
be of use after this surgery. Acetaminophen can be used for postoperative pain.
DIF: Cognitive Level: Apply (application) REF: 965
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
Which breakfast choice indicates a patient's good understanding of information
about a diet for celiac disease?
a. Oatmeal with nonfat milk
b. wheat toast with butter
c. Bagel with low-fat cream cheese
d. Corn tortilla with scrambled eggs - ANSWER-ANS: D
Avoidance of gluten-containing foods is the only treatment for celiac disease.
Corn does not contain gluten, but oatmeal and wheat do.
DIF: Cognitive Level: Apply (application) REF: 967
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
VERIFIED QUESTIONS AND ANSWERS||
ALREADY GRADED A+|| GUARANTEED PASS ||
LATEST VERSION 2025
A patient preparing to undergo a colon resection for cancer of the colon asks
about the elevated carcinoembryonic antigen (CEA) test result. The nurse
explains that the test is used to
a. identify any metastasis of the cancer.
b. monitor the tumor status after surgery.
c. confirm the diagnosis of a specific type of cancer.
d. determine the need for postoperative chemotherapy. - ANSWER-ANS: B
CEA is used to monitor for cancer recurrence after surgery. CEA levels do not
help to determine whether there is metastasis of the cancer. Confirmation of the
diagnosis is made on the basis of biopsy. Chemotherapy use is based on factors
other than CEA.
DIF: Cognitive Level: Understand (comprehension) REF: 955
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
A 71-yr-old patient had an abdominal-perineal resection for colon cancer.
Which nursing action is most important to include in the plan of care for the day
after surgery?
a. Teach about a low-residue diet.
b. Monitor output from the stoma.
c. Assess the perineal drainage and incision.
d. Encourage acceptance of the colostomy stoma. - ANSWER-ANS: C
,Because the perineal wound is at high risk for infection, the initial care is
focused on
assessment and care of this wound. Teaching about diet is best done closer to
discharge from the hospital. There will be very little drainage into the
colostomy until peristalsis returns. The patient will be encouraged to assist with
the colostomy, but this is not the highest priority in the immediate postoperative
period.
DIF: Cognitive Level: Analyze (analysis) REF: 956
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
A patient is transferred from the recovery room to a surgical unit after a
transverse colostomy. The nurse observes the stoma to be deep pink with edema
and a small amount of sanguineous drainage. The nurse should
a. place ice packs around the stoma.
b. notify the surgeon about the stoma.
c. monitor the stoma every 30 minutes.
d. document stoma assessment findings. - ANSWER-ANS: D
The stoma appearance indicates good circulation to the stoma. There is no
indication that surgical intervention is needed or that frequent stoma monitoring
is required. Swelling of the stoma is normal for 2 to 3 weeks after surgery, and
an ice pack is not needed.
DIF: Cognitive Level: Apply (application) REF: 960
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
Which information will the nurse include in teaching a patient who had a
proctocolectomy and ileostomy for ulcerative colitis?
a. Restrict fluid intake to prevent constant liquid drainage from the stoma.
b. Use care when eating high-fiber foods to avoid obstruction of the ileum.
c. Irrigate the ileostomy daily to avoid having to wear a drainage appliance.
d. Change the pouch every day to prevent leakage of contents onto the skin. -
ANSWER-ANS: B
,High-fiber foods are introduced gradually and should be well chewed to avoid
obstruction of the ileostomy. Patients with ileostomies lose the absorption of
water in the colon and need to take in increased amounts of fluid. The pouch
should be drained frequently but is changed every 5 to 7 days. The drainage
from an ileostomy is liquid and continuous, so control by irrigation is not
possible.
DIF: Cognitive Level: Apply (application) REF: 962
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
A patient with a new ileostomy asks how much drainage to expect. The nurse
explains that after the bowel adjusts to the ileostomy, the usual drainage will be
about _____ cups daily.
a. 2
b. 3
c. 4
d. 5 - ANSWER-ANS: A
After the proximal small bowel adapts to reabsorb more fluid, the average
amount of ileostomy drainage is about 500 mL daily. One cup is about 240 mL.
DIF: Cognitive Level: Understand (comprehension) REF: 958
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
The nurse admitting a patient with acute diverticulitis explains that the initial
plan of care is to
a. administer IV fluids.
b. prepare for colonoscopy.
c. give stool softeners and enemas.
d. order a diet high in fiber and fluids. - ANSWER-ANS: A
A patient with acute diverticulitis will be NPO and given parenteral fluids. A
diet high in fiber and fluids will be implemented before discharge. Bulk-
forming laxatives, rather than stool softeners, are usually given, and these will
be implemented later in the hospitalization. The patient with acute diverticulitis
, will not have enemas or a colonoscopy because of the risk for perforation and
peritonitis.
DIF: Cognitive Level: Apply (application) REF: 964
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
A 40-yr-old male patient has had a herniorrhaphy to repair an incarcerated
inguinal hernia.
Which patient teaching will the nurse provide before discharge?
a. Soak in sitz baths several times each day.
b. Cough 5 times each hour for the next 48 hours.
c. Avoid use of acetaminophen (Tylenol) for pain.
d. Apply a scrotal support and ice to reduce swelling. - ANSWER-ANS: D
A scrotal support and ice are used to reduce edema and pain. Coughing will
increase pressure on the incision. Sitz baths will not relieve pain and would not
be of use after this surgery. Acetaminophen can be used for postoperative pain.
DIF: Cognitive Level: Apply (application) REF: 965
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
Which breakfast choice indicates a patient's good understanding of information
about a diet for celiac disease?
a. Oatmeal with nonfat milk
b. wheat toast with butter
c. Bagel with low-fat cream cheese
d. Corn tortilla with scrambled eggs - ANSWER-ANS: D
Avoidance of gluten-containing foods is the only treatment for celiac disease.
Corn does not contain gluten, but oatmeal and wheat do.
DIF: Cognitive Level: Apply (application) REF: 967
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
