Question 1: A nurse is assessing a client with cirrhosis. Which finding indicates
hepatic encephalopathy?
A. Asterixis and confusion
B. Jaundice
C. Ascites
D. Spider angiomas
CORRECT ANSWER: A. Asterixis and confusion
Rationale: Hepatic encephalopathy is characterized by asterixis (flapping tremor),
confusion, disorientation, and altered level of consciousness due to accumulation of
ammonia. Jaundice, ascites, and spider angiomas are signs of liver dysfunction but not
specifically encephalopathy.
Question 2: A client with cirrhosis is prescribed lactulose. Which finding indicates
the medication is e ective?
A. Increased urine output
B. Two to three soft stools per day
C. Decreased abdominal girth
D. Improved appetite
CORRECT ANSWER: B. Two to three soft stools per day
Rationale: Lactulose is a laxative that reduces ammonia levels by promoting its
excretion in the stool. The goal is two to three soft stools per day. Increased urine
output, decreased abdominal girth, and improved appetite are not direct indicators of
lactulose e ectiveness.
Question 3: A nurse is caring for a client with a nasogastric tube after abdominal
surgery. Which finding indicates a need for immediate intervention?
A. Greenish-brown drainage
B. Bright red drainage
C. Absence of drainage
D. Drainage of 200 mL in 8 hours
CORRECT ANSWER: B. Bright red drainage
Rationale: Bright red drainage from a nasogastric tube indicates active bleeding, which
requires immediate intervention. Greenish-brown drainage, absence of drainage, and
moderate drainage may be expected findings.
,Question 4: A client with peptic ulcer disease is prescribed omeprazole. Which
instruction should the nurse include?
A. "Take the medication before meals."
B. "Take the medication with food."
C. "Take the medication at bedtime."
D. "Take the medication with grapefruit juice."
CORRECT ANSWER: A. "Take the medication before meals."
Rationale: Omeprazole is a proton pump inhibitor that should be taken before meals to
suppress gastric acid secretion. Taking it with food, at bedtime, or with grapefruit juice is
not optimal.
Question 5: A nurse is assessing a client with acute pancreatitis. Which finding is
characteristic?
A. Severe epigastric pain radiating to the back
B. Right lower quadrant pain
C. Left lower quadrant pain
D. Substernal chest pain
CORRECT ANSWER: A. Severe epigastric pain radiating to the back
Rationale: Acute pancreatitis is characterized by severe epigastric pain that radiates to
the back, nausea, vomiting, and elevated amylase and lipase. Right lower quadrant pain
is associated with appendicitis; left lower quadrant pain with diverticulitis; substernal
chest pain with cardiac issues.
Question 6: A client with cirrhosis is prescribed spironolactone. Which laboratory
value should the nurse monitor?
A. Serum potassium
B. Serum sodium
C. Serum calcium
D. Serum chloride
CORRECT ANSWER: A. Serum potassium
Rationale: Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia.
The nurse should monitor serum potassium closely. Sodium, calcium, and chloride are
not the primary concerns.
,Question 7: A nurse is assessing a client with a peptic ulcer. Which finding
indicates a complication?
A. Mild epigastric pain
B. Sudden severe abdominal pain with rigidity
C. Nausea after eating
D. Heartburn
CORRECT ANSWER: B. Sudden severe abdominal pain with rigidity
Rationale: Sudden severe abdominal pain with rigidity may indicate perforation of a
peptic ulcer, a life-threatening complication requiring immediate intervention. Mild
pain, nausea, and heartburn are common symptoms of peptic ulcer disease.
Question 8: A client with hepatic encephalopathy is prescribed rifaximin. Which
instruction should the nurse include?
A. "This medication reduces ammonia production in the gut."
B. "This medication increases ammonia production."
C. "This medication lowers your potassium level."
D. "This medication lowers your calcium level."
CORRECT ANSWER: A. "This medication reduces ammonia production in the gut."
Rationale: Rifaximin is a non-absorbable antibiotic that reduces ammonia-producing
bacteria in the gut. It does not increase ammonia production or a ect potassium or
calcium levels.
Question 9: A nurse is caring for a client with a new ileostomy. Which finding
indicates a need for further teaching?
A. "I will empty the pouch when it is one-third full."
B. "I will avoid foods that cause gas and odor."
C. "I will take enteric-coated medications as prescribed."
D. "I will drink plenty of fluids to prevent dehydration."
CORRECT ANSWER: C. "I will take enteric-coated medications as prescribed."
Rationale: Clients with an ileostomy should avoid enteric-coated medications because
they may not be absorbed properly without the colon. Emptying the pouch when one-
third full, avoiding gas-forming foods, and maintaining adequate fluid intake are correct.
, Question 10: A client with cirrhosis is prescribed furosemide. Which laboratory
value should the nurse monitor?
A. Serum potassium
B. Serum calcium
C. Serum magnesium
D. Serum sodium
CORRECT ANSWER: A. Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium loss. The nurse should
monitor serum potassium closely. Calcium, magnesium, and sodium are also
monitored but potassium is the primary concern.
Question 11: A nurse is assessing a client with gastroesophageal reflux disease
(GERD). Which finding is characteristic?
A. Heartburn after meals
B. Right upper quadrant pain
C. Left lower quadrant pain
D. Substernal chest pain
CORRECT ANSWER: A. Heartburn after meals
Rationale: GERD is characterized by heartburn, regurgitation, and dysphagia, typically
worsening after meals or when lying down. Right upper quadrant pain is associated with
gallbladder disease; left lower quadrant pain with diverticulitis; substernal chest pain
with cardiac issues.
Question 12: A client with acute pancreatitis is prescribed meperidine. Which
instruction should the nurse include?
A. "This medication is for pain relief."
B. "This medication increases pancreatic enzymes."
C. "This medication lowers your potassium level."
D. "This medication lowers your calcium level."
CORRECT ANSWER: A. "This medication is for pain relief."
Rationale: Meperidine is an opioid analgesic used for pain relief in acute pancreatitis. It
does not increase pancreatic enzymes or a ect potassium or calcium levels.
hepatic encephalopathy?
A. Asterixis and confusion
B. Jaundice
C. Ascites
D. Spider angiomas
CORRECT ANSWER: A. Asterixis and confusion
Rationale: Hepatic encephalopathy is characterized by asterixis (flapping tremor),
confusion, disorientation, and altered level of consciousness due to accumulation of
ammonia. Jaundice, ascites, and spider angiomas are signs of liver dysfunction but not
specifically encephalopathy.
Question 2: A client with cirrhosis is prescribed lactulose. Which finding indicates
the medication is e ective?
A. Increased urine output
B. Two to three soft stools per day
C. Decreased abdominal girth
D. Improved appetite
CORRECT ANSWER: B. Two to three soft stools per day
Rationale: Lactulose is a laxative that reduces ammonia levels by promoting its
excretion in the stool. The goal is two to three soft stools per day. Increased urine
output, decreased abdominal girth, and improved appetite are not direct indicators of
lactulose e ectiveness.
Question 3: A nurse is caring for a client with a nasogastric tube after abdominal
surgery. Which finding indicates a need for immediate intervention?
A. Greenish-brown drainage
B. Bright red drainage
C. Absence of drainage
D. Drainage of 200 mL in 8 hours
CORRECT ANSWER: B. Bright red drainage
Rationale: Bright red drainage from a nasogastric tube indicates active bleeding, which
requires immediate intervention. Greenish-brown drainage, absence of drainage, and
moderate drainage may be expected findings.
,Question 4: A client with peptic ulcer disease is prescribed omeprazole. Which
instruction should the nurse include?
A. "Take the medication before meals."
B. "Take the medication with food."
C. "Take the medication at bedtime."
D. "Take the medication with grapefruit juice."
CORRECT ANSWER: A. "Take the medication before meals."
Rationale: Omeprazole is a proton pump inhibitor that should be taken before meals to
suppress gastric acid secretion. Taking it with food, at bedtime, or with grapefruit juice is
not optimal.
Question 5: A nurse is assessing a client with acute pancreatitis. Which finding is
characteristic?
A. Severe epigastric pain radiating to the back
B. Right lower quadrant pain
C. Left lower quadrant pain
D. Substernal chest pain
CORRECT ANSWER: A. Severe epigastric pain radiating to the back
Rationale: Acute pancreatitis is characterized by severe epigastric pain that radiates to
the back, nausea, vomiting, and elevated amylase and lipase. Right lower quadrant pain
is associated with appendicitis; left lower quadrant pain with diverticulitis; substernal
chest pain with cardiac issues.
Question 6: A client with cirrhosis is prescribed spironolactone. Which laboratory
value should the nurse monitor?
A. Serum potassium
B. Serum sodium
C. Serum calcium
D. Serum chloride
CORRECT ANSWER: A. Serum potassium
Rationale: Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia.
The nurse should monitor serum potassium closely. Sodium, calcium, and chloride are
not the primary concerns.
,Question 7: A nurse is assessing a client with a peptic ulcer. Which finding
indicates a complication?
A. Mild epigastric pain
B. Sudden severe abdominal pain with rigidity
C. Nausea after eating
D. Heartburn
CORRECT ANSWER: B. Sudden severe abdominal pain with rigidity
Rationale: Sudden severe abdominal pain with rigidity may indicate perforation of a
peptic ulcer, a life-threatening complication requiring immediate intervention. Mild
pain, nausea, and heartburn are common symptoms of peptic ulcer disease.
Question 8: A client with hepatic encephalopathy is prescribed rifaximin. Which
instruction should the nurse include?
A. "This medication reduces ammonia production in the gut."
B. "This medication increases ammonia production."
C. "This medication lowers your potassium level."
D. "This medication lowers your calcium level."
CORRECT ANSWER: A. "This medication reduces ammonia production in the gut."
Rationale: Rifaximin is a non-absorbable antibiotic that reduces ammonia-producing
bacteria in the gut. It does not increase ammonia production or a ect potassium or
calcium levels.
Question 9: A nurse is caring for a client with a new ileostomy. Which finding
indicates a need for further teaching?
A. "I will empty the pouch when it is one-third full."
B. "I will avoid foods that cause gas and odor."
C. "I will take enteric-coated medications as prescribed."
D. "I will drink plenty of fluids to prevent dehydration."
CORRECT ANSWER: C. "I will take enteric-coated medications as prescribed."
Rationale: Clients with an ileostomy should avoid enteric-coated medications because
they may not be absorbed properly without the colon. Emptying the pouch when one-
third full, avoiding gas-forming foods, and maintaining adequate fluid intake are correct.
, Question 10: A client with cirrhosis is prescribed furosemide. Which laboratory
value should the nurse monitor?
A. Serum potassium
B. Serum calcium
C. Serum magnesium
D. Serum sodium
CORRECT ANSWER: A. Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium loss. The nurse should
monitor serum potassium closely. Calcium, magnesium, and sodium are also
monitored but potassium is the primary concern.
Question 11: A nurse is assessing a client with gastroesophageal reflux disease
(GERD). Which finding is characteristic?
A. Heartburn after meals
B. Right upper quadrant pain
C. Left lower quadrant pain
D. Substernal chest pain
CORRECT ANSWER: A. Heartburn after meals
Rationale: GERD is characterized by heartburn, regurgitation, and dysphagia, typically
worsening after meals or when lying down. Right upper quadrant pain is associated with
gallbladder disease; left lower quadrant pain with diverticulitis; substernal chest pain
with cardiac issues.
Question 12: A client with acute pancreatitis is prescribed meperidine. Which
instruction should the nurse include?
A. "This medication is for pain relief."
B. "This medication increases pancreatic enzymes."
C. "This medication lowers your potassium level."
D. "This medication lowers your calcium level."
CORRECT ANSWER: A. "This medication is for pain relief."
Rationale: Meperidine is an opioid analgesic used for pain relief in acute pancreatitis. It
does not increase pancreatic enzymes or a ect potassium or calcium levels.
