1. Nurse Elena is assessing a patient with liver A. Sit upright in a high-Fowler’s position while
cirrhosis and is vigilant for signs of eating.
complications. During the evaluation, she notes
B. Include high-carbohydrate foods in meals.
a specific finding that raises concern for hepatic
encephalopathy. Which assessment finding is C. Take a walk after eating to aid digestion.
most indicative of this condition?
D. Reduce the amount of fluid consumed during
A. Observation of asterixis. meals.
B. Positive hepatojugular reflux. 5. Nurse Carla is assessing the stoma of a
patient with a well-healed colostomy. Which
C. Presence of Chvostek’s sign.
appearance would indicate a healthy and
D. Presence of Trousseau’s sign. normal stoma?
2. Dr. Martin diagnoses Mr. Lewis with hepatitis A. Red and moist.
and determines that the infection was
B. Pale, pink, and moist.
contracted through contaminated food. Nurse
Sarah reviews the case and identifies which type C. Dry and black.
of hepatitis the client is most likely dealing with.
D. Dark or purple in color.
A. Hepatitis A
6. Nurse Daniel is caring for a patient diagnosed
B. Hepatitis B with achalasia, characterized by incomplete
relaxation of the esophageal sphincter. To help
C. Hepatitis C
manage symptoms and improve esophageal
D. Hepatitis D motility, which medication does Nurse Daniel
anticipate administering?
3. Nurse Williams is preparing a discharge
teaching plan for Jeff, a 27-year-old patient who A. Digoxin (Lanoxin).
recently had surgery to close a temporary
B. Propranolol (Inderal).
ileostomy. As part of the nutritional education,
what guideline should Nurse Williams include to C. Isosorbide dinitrate (Isordil).
support Jeff's recovery and adaptation?
D. Captopril (Capoten).
A. Limit fluid intake to prevent complications.
7. Nurse Clara is teaching Mr. Reynolds, a
B. Eat six smaller meals throughout the day. patient with a colostomy, how to perform
ostomy self-care. When instructing him on how
C. Maintain regular eating habits without
to measure and cut the wafer, what should
modification.
Nurse Clara recommend?
D. Consume the largest meal of the day in the
A. Cut the wafer opening 1/2 inch larger than
evening.
the stoma to maximize airflow.
4. Nurse Brian is giving discharge instructions to
B. Cut the wafer opening 1/4 inch larger than
Mr. Lopez, a client recovering from a
the stoma to allow for swelling.
gastrectomy. To help prevent dumping
syndrome, Nurse Brian advises the client to take C. Cut the wafer opening exactly to the size of
which measure? the stoma to ensure a snug fit.
,D. Cut the wafer opening 1/8 inch larger than 11. Nurse Franklin is conducting preoperative
the stoma to prevent irritation. teaching with Gertrude, a 50-year-old patient
with ulcerative colitis, who is scheduled for
8. Nurse Linda is teaching Ms. Carter how to
surgery to create an ileoanal reservoir. Nurse
perform a colostomy irrigation. To improve the
Franklin explains the procedure and its stages.
effectiveness of the irrigation and enhance fecal
What key information should be included in this
returns, what should Nurse Linda advise the
teaching?
client to do?
A. A second surgery will be performed 12
A. Use a smaller amount of irrigation solution.
months later.
B. Increase daily fluid intake.
B. A reservoir will exit through the abdominal
C. Apply heat to the abdomen. wall.
D. Schedule the irrigation in the evening. C. A permanent ileostomy will be created.
9. Nurse Julia is discussing an upcoming D. The procedure is completed in two stages.
vagotomy with Mr. Andrews, a male client
12. Student Nurse Mia is developing a teaching
diagnosed with a peptic ulcer. When he asks
care plan for a patient with achalasia to help
about the purpose of the procedure, how
improve nutrition and manage symptoms during
should Nurse Julia respond?
meals. Which recommendation should be
A. It reduces the signals that stimulate acid included in the care plan?
production.
A. Refrain from drinking fluids during meals.
B. It lowers the stomach's ability to absorb food.
B. Consume meals while sitÝng upright.
C. It stops the body's stress responses.
C. Eliminate soft and semi-soft foods from the
D. It promotes healing of the stomach lining. diet.
10. Nurse Daniel is preparing to administer D. Lean forward while swallowing foods.
medication to Mr. Collins through his
13. Nurse Clara is caring for a post-abdominal
nasogastric tube, which is connected to suction.
surgery patient who experiences a sudden
To ensure proper medication administration and
wound evisceration following a severe coughing
effectiveness, what is the most appropriate
episode. After calling the physician, Nurse Clara
action for Nurse Daniel to take?
takes immediate action to protect the exposed
A. Aspirate the nasogastric tube following organs. What is the most appropriate
medication administration to keep it open. intervention?
B. Clamp the nasogastric tube for 30 minutes A. Apply a dry sterile dressing and secure it with
after giving the medication. a binder.
C. Place the client in a supine position to B. Irrigate the wound and exposed organs using
enhance medication absorption. Betadine solution.
D. Adjust the suction to low intermittent for 30 C. Cover the wound with a sterile dressing
minutes post-administration. soaked in saline.
,D. Gently push the organs back in place and B. "Provide a high-fat, low-protein diet to
cover with moist sterile dressings. promote calorie intake."
14. Nurse Carla is conducting an abdominal C. "Begin a clear liquid diet once pain subsides."
assessment on Mr. James. After inspecting the
D. "Administer IV fluids at 150 mL/hr to
skin of his abdomen, she prepares to proceed
maintain hydration."
with the next step in the assessment process.
Which technique should Nurse Carla perform 17. Nurse David is providing postoperative
next? instructions to Mr. Harris, who recently had an
inguinal hernia repair. To help reduce swelling
A. Listen to bowel sounds across all quadrants.
after the procedure, what should Nurse David
B. Palpate the abdomen to assess size. advise the client to do?
C. Perform percussion in the right lower A. Restrict fluid intake.
quadrant.
B. Elevate the scrotum for support.
D. Palpate the liver at the margin of the right
C. Use heat therapy on the abdomen.
ribs.
D. Stick to a low-fiber diet.
15. Nurse Amy is monitoring a patient
recovering from a Billroth II procedure 18. Nurse Ryan is confirming the placement of a
performed to treat a peptic ulcer. During her nasogastric tube for Mrs. Adams by aspirating
assessment, she evaluates for signs of dumping gastric contents and evaluating the pH. Which
syndrome, a known complication of this surgery. pH value would indicate proper placement of
Which symptoms would indicate that the the tube in the stomach?
patient is developing dumping syndrome?
A. A pH reading of 7.0.
A. DifÏculty breathing (dyspnea) and chest
discomfort. B. A pH reading of 3.5.
B. Headache along with a slow heart rate C. A pH reading of 7.5.
(bradycardia). D. A pH reading of 7.35.
C. Lightheadedness accompanied by excessive 19. Nurse Elena is reviewing the medical record
sweating. of Ms. Roberts, a female client with Crohn’s
D. Flushed appearance with dry skin. disease. When assessing the documented stool
characteristics, what should Nurse Elena expect
16. Nurse Julia is reviewing the orders for Mr. to find?
Grant, a male client hospitalized with acute
pancreatitis. While assessing the physician’s A. Persistent constipation.
orders, she identifies one that may not be B. Frequent diarrhea.
appropriate for this condition and plans to
clarify it. Which order should Nurse Julia C. Alternating episodes of constipation and
question? diarrhea.
A. "Administer morphine 2 mg IV every 4 hours D. Continuous oozing of stool from the rectum.
PRN for pain."
, 20. Nurse Clara is monitoring Ms. Adams, a A. Conduct observation first, proceed to
hospitalized client with ulcerative colitis. During percussion, then palpation, and end with
the assessment, Nurse Clara identifies a finding auscultation.
that requires immediate reporting to the
B. Start with observation, then auscultation,
physician. Which finding should Nurse Clara
followed by percussion, and finish with
report?
palpation.
A. Presence of bloody diarrhea.
C. Begin with palpation, followed by percussion,
B. A hemoglobin level of 12 mg/dL. observation, and auscultation.
C. Low blood pressure (hypotension). D. Perform percussion first, move to palpation,
then auscultation, and lastly observation.
D. Rebound tenderness in the abdomen.
24. Nurse Daniel is caring for Mr. Carter, a male
21. Nurse Rachel is creating a care plan for a 67-
client 24 hours post-cholecystectomy. He
year-old patient diagnosed with hepatic
observes that the T-tube has drained 750 mL of
encephalopathy. To manage the condition
green-brown fluid since surgery. What is the
effectively and reduce ammonia levels, Nurse
most appropriate nursing intervention for Nurse
Rachel includes specific interventions in the care
Daniel to perform?
plan. Which action should she prioritize?
A. Irrigate the T-tube to maintain patency.
A. Administer a lactulose enema as prescribed.
B. Record the drainage findings in the client’s
B. Promote a diet high in protein.
chart.
C. Encourage walking four times daily.
C. Notify the physician immediately about the
D. Use sedatives as needed for agitation. output.
22. Nurse Sarah is monitoring Ms. Jennings, a D. Clamp the T-tube to limit further drainage.
female client, for early signs of dumping
25. Nurse Megan is caring for Mr. Carter, a post-
syndrome following gastric surgery. Which of
operative client transitioning from a clear liquid
the following findings would most likely indicate
diet to a full liquid diet. Excited for the change,
the onset of this condition?
Mr. Carter asks about the new options available.
A. Blurred vision and chest discomfort. Which item would Nurse Megan appropriately
offer as part of the full liquid diet?
B. Sweating and pale skin.
A. Tea
C. Abdominal cramping and pain.
B. Gelatin
D. Slow heart rate and indigestion.
C. Custard
23. Nurse Taylor is assessing Brent, a 52-year-old
patient, to evaluate his abdominal health. To D. Popsicle
ensure the most accurate findings without
26. Nurse Jamie is advising a 21-year-old client
disrupting normal bowel activity, she carefully
with a colostomy who is experiencing issues
considers the correct sequence for performing
with excessive flatus. Which food should Nurse
the abdominal assessment. What sequence
Jamie recommend to help reduce gas?
should Nurse Taylor follow?
cirrhosis and is vigilant for signs of eating.
complications. During the evaluation, she notes
B. Include high-carbohydrate foods in meals.
a specific finding that raises concern for hepatic
encephalopathy. Which assessment finding is C. Take a walk after eating to aid digestion.
most indicative of this condition?
D. Reduce the amount of fluid consumed during
A. Observation of asterixis. meals.
B. Positive hepatojugular reflux. 5. Nurse Carla is assessing the stoma of a
patient with a well-healed colostomy. Which
C. Presence of Chvostek’s sign.
appearance would indicate a healthy and
D. Presence of Trousseau’s sign. normal stoma?
2. Dr. Martin diagnoses Mr. Lewis with hepatitis A. Red and moist.
and determines that the infection was
B. Pale, pink, and moist.
contracted through contaminated food. Nurse
Sarah reviews the case and identifies which type C. Dry and black.
of hepatitis the client is most likely dealing with.
D. Dark or purple in color.
A. Hepatitis A
6. Nurse Daniel is caring for a patient diagnosed
B. Hepatitis B with achalasia, characterized by incomplete
relaxation of the esophageal sphincter. To help
C. Hepatitis C
manage symptoms and improve esophageal
D. Hepatitis D motility, which medication does Nurse Daniel
anticipate administering?
3. Nurse Williams is preparing a discharge
teaching plan for Jeff, a 27-year-old patient who A. Digoxin (Lanoxin).
recently had surgery to close a temporary
B. Propranolol (Inderal).
ileostomy. As part of the nutritional education,
what guideline should Nurse Williams include to C. Isosorbide dinitrate (Isordil).
support Jeff's recovery and adaptation?
D. Captopril (Capoten).
A. Limit fluid intake to prevent complications.
7. Nurse Clara is teaching Mr. Reynolds, a
B. Eat six smaller meals throughout the day. patient with a colostomy, how to perform
ostomy self-care. When instructing him on how
C. Maintain regular eating habits without
to measure and cut the wafer, what should
modification.
Nurse Clara recommend?
D. Consume the largest meal of the day in the
A. Cut the wafer opening 1/2 inch larger than
evening.
the stoma to maximize airflow.
4. Nurse Brian is giving discharge instructions to
B. Cut the wafer opening 1/4 inch larger than
Mr. Lopez, a client recovering from a
the stoma to allow for swelling.
gastrectomy. To help prevent dumping
syndrome, Nurse Brian advises the client to take C. Cut the wafer opening exactly to the size of
which measure? the stoma to ensure a snug fit.
,D. Cut the wafer opening 1/8 inch larger than 11. Nurse Franklin is conducting preoperative
the stoma to prevent irritation. teaching with Gertrude, a 50-year-old patient
with ulcerative colitis, who is scheduled for
8. Nurse Linda is teaching Ms. Carter how to
surgery to create an ileoanal reservoir. Nurse
perform a colostomy irrigation. To improve the
Franklin explains the procedure and its stages.
effectiveness of the irrigation and enhance fecal
What key information should be included in this
returns, what should Nurse Linda advise the
teaching?
client to do?
A. A second surgery will be performed 12
A. Use a smaller amount of irrigation solution.
months later.
B. Increase daily fluid intake.
B. A reservoir will exit through the abdominal
C. Apply heat to the abdomen. wall.
D. Schedule the irrigation in the evening. C. A permanent ileostomy will be created.
9. Nurse Julia is discussing an upcoming D. The procedure is completed in two stages.
vagotomy with Mr. Andrews, a male client
12. Student Nurse Mia is developing a teaching
diagnosed with a peptic ulcer. When he asks
care plan for a patient with achalasia to help
about the purpose of the procedure, how
improve nutrition and manage symptoms during
should Nurse Julia respond?
meals. Which recommendation should be
A. It reduces the signals that stimulate acid included in the care plan?
production.
A. Refrain from drinking fluids during meals.
B. It lowers the stomach's ability to absorb food.
B. Consume meals while sitÝng upright.
C. It stops the body's stress responses.
C. Eliminate soft and semi-soft foods from the
D. It promotes healing of the stomach lining. diet.
10. Nurse Daniel is preparing to administer D. Lean forward while swallowing foods.
medication to Mr. Collins through his
13. Nurse Clara is caring for a post-abdominal
nasogastric tube, which is connected to suction.
surgery patient who experiences a sudden
To ensure proper medication administration and
wound evisceration following a severe coughing
effectiveness, what is the most appropriate
episode. After calling the physician, Nurse Clara
action for Nurse Daniel to take?
takes immediate action to protect the exposed
A. Aspirate the nasogastric tube following organs. What is the most appropriate
medication administration to keep it open. intervention?
B. Clamp the nasogastric tube for 30 minutes A. Apply a dry sterile dressing and secure it with
after giving the medication. a binder.
C. Place the client in a supine position to B. Irrigate the wound and exposed organs using
enhance medication absorption. Betadine solution.
D. Adjust the suction to low intermittent for 30 C. Cover the wound with a sterile dressing
minutes post-administration. soaked in saline.
,D. Gently push the organs back in place and B. "Provide a high-fat, low-protein diet to
cover with moist sterile dressings. promote calorie intake."
14. Nurse Carla is conducting an abdominal C. "Begin a clear liquid diet once pain subsides."
assessment on Mr. James. After inspecting the
D. "Administer IV fluids at 150 mL/hr to
skin of his abdomen, she prepares to proceed
maintain hydration."
with the next step in the assessment process.
Which technique should Nurse Carla perform 17. Nurse David is providing postoperative
next? instructions to Mr. Harris, who recently had an
inguinal hernia repair. To help reduce swelling
A. Listen to bowel sounds across all quadrants.
after the procedure, what should Nurse David
B. Palpate the abdomen to assess size. advise the client to do?
C. Perform percussion in the right lower A. Restrict fluid intake.
quadrant.
B. Elevate the scrotum for support.
D. Palpate the liver at the margin of the right
C. Use heat therapy on the abdomen.
ribs.
D. Stick to a low-fiber diet.
15. Nurse Amy is monitoring a patient
recovering from a Billroth II procedure 18. Nurse Ryan is confirming the placement of a
performed to treat a peptic ulcer. During her nasogastric tube for Mrs. Adams by aspirating
assessment, she evaluates for signs of dumping gastric contents and evaluating the pH. Which
syndrome, a known complication of this surgery. pH value would indicate proper placement of
Which symptoms would indicate that the the tube in the stomach?
patient is developing dumping syndrome?
A. A pH reading of 7.0.
A. DifÏculty breathing (dyspnea) and chest
discomfort. B. A pH reading of 3.5.
B. Headache along with a slow heart rate C. A pH reading of 7.5.
(bradycardia). D. A pH reading of 7.35.
C. Lightheadedness accompanied by excessive 19. Nurse Elena is reviewing the medical record
sweating. of Ms. Roberts, a female client with Crohn’s
D. Flushed appearance with dry skin. disease. When assessing the documented stool
characteristics, what should Nurse Elena expect
16. Nurse Julia is reviewing the orders for Mr. to find?
Grant, a male client hospitalized with acute
pancreatitis. While assessing the physician’s A. Persistent constipation.
orders, she identifies one that may not be B. Frequent diarrhea.
appropriate for this condition and plans to
clarify it. Which order should Nurse Julia C. Alternating episodes of constipation and
question? diarrhea.
A. "Administer morphine 2 mg IV every 4 hours D. Continuous oozing of stool from the rectum.
PRN for pain."
, 20. Nurse Clara is monitoring Ms. Adams, a A. Conduct observation first, proceed to
hospitalized client with ulcerative colitis. During percussion, then palpation, and end with
the assessment, Nurse Clara identifies a finding auscultation.
that requires immediate reporting to the
B. Start with observation, then auscultation,
physician. Which finding should Nurse Clara
followed by percussion, and finish with
report?
palpation.
A. Presence of bloody diarrhea.
C. Begin with palpation, followed by percussion,
B. A hemoglobin level of 12 mg/dL. observation, and auscultation.
C. Low blood pressure (hypotension). D. Perform percussion first, move to palpation,
then auscultation, and lastly observation.
D. Rebound tenderness in the abdomen.
24. Nurse Daniel is caring for Mr. Carter, a male
21. Nurse Rachel is creating a care plan for a 67-
client 24 hours post-cholecystectomy. He
year-old patient diagnosed with hepatic
observes that the T-tube has drained 750 mL of
encephalopathy. To manage the condition
green-brown fluid since surgery. What is the
effectively and reduce ammonia levels, Nurse
most appropriate nursing intervention for Nurse
Rachel includes specific interventions in the care
Daniel to perform?
plan. Which action should she prioritize?
A. Irrigate the T-tube to maintain patency.
A. Administer a lactulose enema as prescribed.
B. Record the drainage findings in the client’s
B. Promote a diet high in protein.
chart.
C. Encourage walking four times daily.
C. Notify the physician immediately about the
D. Use sedatives as needed for agitation. output.
22. Nurse Sarah is monitoring Ms. Jennings, a D. Clamp the T-tube to limit further drainage.
female client, for early signs of dumping
25. Nurse Megan is caring for Mr. Carter, a post-
syndrome following gastric surgery. Which of
operative client transitioning from a clear liquid
the following findings would most likely indicate
diet to a full liquid diet. Excited for the change,
the onset of this condition?
Mr. Carter asks about the new options available.
A. Blurred vision and chest discomfort. Which item would Nurse Megan appropriately
offer as part of the full liquid diet?
B. Sweating and pale skin.
A. Tea
C. Abdominal cramping and pain.
B. Gelatin
D. Slow heart rate and indigestion.
C. Custard
23. Nurse Taylor is assessing Brent, a 52-year-old
patient, to evaluate his abdominal health. To D. Popsicle
ensure the most accurate findings without
26. Nurse Jamie is advising a 21-year-old client
disrupting normal bowel activity, she carefully
with a colostomy who is experiencing issues
considers the correct sequence for performing
with excessive flatus. Which food should Nurse
the abdominal assessment. What sequence
Jamie recommend to help reduce gas?
should Nurse Taylor follow?
