NURS 498 WEEK 11 Final Exam 2024 Latest Exam
With Answers/Rationale 100% Guaranteed Pass
Includes reproduction, GI, neuro, and oncology. Includes quiz and Kahoot questions for weeks 8-11.
The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease about
dietary measures to implement during exacerbation episodes. Which statement made by the client
indicates a need for further instruction?
a. "I can have exacerbations and remissions with Crohn's disease."
b. "I'm going to learn some stress reduction techniques."
c. "I should increase the fibre in my diet."
d. "I will need to avoid caffeinated beverages."
c. "I should increase the fibre in my diet."
The nurse is caring for a client following a gastrojejunostomy (Billroth II procedure). Which post-
operative prescription should the nurse question and verify?
a. leg exercises
b. early ambulation
c. irrigating the nasogastric tube
d. deep breathing and coughing exercises
c. irrigating the nasogastric tube
- In a Billroth II procedure, the proximal remnant of the stomach is anastomosed to the proximal
jejunum. Patency of the NG tube is critical for preventing the retention of gastric secretions. The nurse
should never irrigate or reposition the gastric tube after surgery unless specifically prescribed by the
health care provider.
A client with a gunshot wound to the abdomen undergoes surgery, and a colostomy is formed as
illustrated. Which of the following information should the nurse include in client teaching?
a. Soft, formed stool can be expected as drainage.
b. Irrigations can regulate drainage from the stomas.
c. This type of colostomy is usually temporary.
d. Stool will be expelled from both ostomy stomas.
,c. This type of colostomy is usually temporary.
- A loop, or double-barrel stoma, is usually temporary. The stool will be expelled from the proximal
stoma only.
A nurse is developing a care plan for a client with hepatic encephalopathy. Which are the goals for the
care of this client? Select all that apply.
a. check the pupil reaction
b. administer lactulose to reduce blood ammonia levels
c. encourage physical activity
d. monitor coordination while walking
e. provide food and fluids high in carbohydrates
f. prevent constipation
a. check the pupil reaction
b. administer lactulose to reduce blood ammonia levels
d. monitor coordination while walking
e. provide food and fluids high in carbohydrates
f. prevent constipation
A client with cirrhosis is receiving lactulose. The nurse notes the client is more confused and has
asterixis. The nurse should:
a. increase protein in the diet
b. monitor serum bilirubin levels
c. withhold the lactulose
d. assess for gastrointestinal bleeding
d. assess for gastrointestinal bleeding
,A few months after bariatric surgery, an older-adult client tells the nurse, "My skin is hanging in folds. I
think I need cosmetic surgery." Which of the following responses by the nurse is best?
a. "Perhaps you would like to talk to a counsellor about your body image."
b. "The skin folds will gradually disappear once most of the weight is lost."
c. "The important thing is that your weight loss is improving your health."
d. "Cosmetic surgery is certainly a possibility once your weight has stabilized."
d. "Cosmetic surgery is certainly a possibility once your weight has stabilized."
- Reconstructive surgery may be used to eliminate excess skin folds after at least a year has passed since
the surgery. Skin folds may not disappear over time, especially in older clients.
After the nurse has completed teaching a client with newly diagnosed celiac disease, which of the
following breakfast choices by the client indicates good understanding of the information?
a. Corn tortilla with eggs
b. Oatmeal with non-fat milk
c. Whole wheat toast with butter
d. Bagel with cream cheese
a. Corn tortilla with eggs
- Avoidance of gluten-containing foods is the only treatment for celiac disease. Corn does not contain
gluten, while oatmeal and wheat do.
A client with ulcerative colitis who is taking azathioprine calls the nurse in the outpatient clinic about all
of these symptoms. Which of the following symptoms is most important to communicate to the health
care provider?
a. Frequent headaches
b. Nausea
c. Elevated temperature
d. Joint pain
c. Elevated temperature
- Since azathioprine suppresses immune function, rapid treatment of infection is essential.
, The nurse is providing discharge teaching to a client following gastrectomy and should instruct the client
to take measures to assist in preventing dumping syndrome.
a. eat high-carbohydrate foods
b. limit the fluid taken with meals
c. sit in a high-fowlers position during meals.
d. ambulate following a meal
b. limit the fluid taken with meals
- dumping syndrome is a term that refers to a constellation of vasomotor symptoms that occurs after
eating, especially following gastrojejunostomy (Billroth). Early manifestations usually occur within 30
minutes of eating and include vertigo, tachycardia, syncope, sweating, pallor, palpitations, and the
desire to lie down. The nurse should instruct the client to decrease the amount of fluid taken at meals
and to avoid high-carbohydrate foods, including fluids such as fruit nectars; to assume a low-fowler's
position during meals; to lie down 30 minutes after eating to delay gastric emptying; and to take
antispasmodics as prescribed.
The nurse is caring for a client who returns to the surgical nursing unit following a vertical banded
gastroplasty with a nasogastric tube to low, intermittent suction and a patient-controlled analgesia
(PCA) machine for pain control. Which of the following nursing actions should be included in the
postoperative plan of care?
a. Remind the client that PCA use may slow the return of bowel function.
b. Irrigate the nasogastric (NG) tube frequently with normal saline.
c. Offer sips of sweetened liquids at frequent intervals.
d. Support the surgical incision during client coughing and turning in bed.
d. Support the surgical incision during client coughing and turning in bed.
- The incision should be protected from strain to decrease the risk for wound dehiscence. The client
should be encouraged to use the PCA since pain control will improve cough effort and client mobility.
NG irrigation may damage the suture line or overfill the stomach pouch. Sugar-free clear liquids are
offered during the immediate postoperative time to decrease the risk for dumping syndrome.
With Answers/Rationale 100% Guaranteed Pass
Includes reproduction, GI, neuro, and oncology. Includes quiz and Kahoot questions for weeks 8-11.
The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease about
dietary measures to implement during exacerbation episodes. Which statement made by the client
indicates a need for further instruction?
a. "I can have exacerbations and remissions with Crohn's disease."
b. "I'm going to learn some stress reduction techniques."
c. "I should increase the fibre in my diet."
d. "I will need to avoid caffeinated beverages."
c. "I should increase the fibre in my diet."
The nurse is caring for a client following a gastrojejunostomy (Billroth II procedure). Which post-
operative prescription should the nurse question and verify?
a. leg exercises
b. early ambulation
c. irrigating the nasogastric tube
d. deep breathing and coughing exercises
c. irrigating the nasogastric tube
- In a Billroth II procedure, the proximal remnant of the stomach is anastomosed to the proximal
jejunum. Patency of the NG tube is critical for preventing the retention of gastric secretions. The nurse
should never irrigate or reposition the gastric tube after surgery unless specifically prescribed by the
health care provider.
A client with a gunshot wound to the abdomen undergoes surgery, and a colostomy is formed as
illustrated. Which of the following information should the nurse include in client teaching?
a. Soft, formed stool can be expected as drainage.
b. Irrigations can regulate drainage from the stomas.
c. This type of colostomy is usually temporary.
d. Stool will be expelled from both ostomy stomas.
,c. This type of colostomy is usually temporary.
- A loop, or double-barrel stoma, is usually temporary. The stool will be expelled from the proximal
stoma only.
A nurse is developing a care plan for a client with hepatic encephalopathy. Which are the goals for the
care of this client? Select all that apply.
a. check the pupil reaction
b. administer lactulose to reduce blood ammonia levels
c. encourage physical activity
d. monitor coordination while walking
e. provide food and fluids high in carbohydrates
f. prevent constipation
a. check the pupil reaction
b. administer lactulose to reduce blood ammonia levels
d. monitor coordination while walking
e. provide food and fluids high in carbohydrates
f. prevent constipation
A client with cirrhosis is receiving lactulose. The nurse notes the client is more confused and has
asterixis. The nurse should:
a. increase protein in the diet
b. monitor serum bilirubin levels
c. withhold the lactulose
d. assess for gastrointestinal bleeding
d. assess for gastrointestinal bleeding
,A few months after bariatric surgery, an older-adult client tells the nurse, "My skin is hanging in folds. I
think I need cosmetic surgery." Which of the following responses by the nurse is best?
a. "Perhaps you would like to talk to a counsellor about your body image."
b. "The skin folds will gradually disappear once most of the weight is lost."
c. "The important thing is that your weight loss is improving your health."
d. "Cosmetic surgery is certainly a possibility once your weight has stabilized."
d. "Cosmetic surgery is certainly a possibility once your weight has stabilized."
- Reconstructive surgery may be used to eliminate excess skin folds after at least a year has passed since
the surgery. Skin folds may not disappear over time, especially in older clients.
After the nurse has completed teaching a client with newly diagnosed celiac disease, which of the
following breakfast choices by the client indicates good understanding of the information?
a. Corn tortilla with eggs
b. Oatmeal with non-fat milk
c. Whole wheat toast with butter
d. Bagel with cream cheese
a. Corn tortilla with eggs
- Avoidance of gluten-containing foods is the only treatment for celiac disease. Corn does not contain
gluten, while oatmeal and wheat do.
A client with ulcerative colitis who is taking azathioprine calls the nurse in the outpatient clinic about all
of these symptoms. Which of the following symptoms is most important to communicate to the health
care provider?
a. Frequent headaches
b. Nausea
c. Elevated temperature
d. Joint pain
c. Elevated temperature
- Since azathioprine suppresses immune function, rapid treatment of infection is essential.
, The nurse is providing discharge teaching to a client following gastrectomy and should instruct the client
to take measures to assist in preventing dumping syndrome.
a. eat high-carbohydrate foods
b. limit the fluid taken with meals
c. sit in a high-fowlers position during meals.
d. ambulate following a meal
b. limit the fluid taken with meals
- dumping syndrome is a term that refers to a constellation of vasomotor symptoms that occurs after
eating, especially following gastrojejunostomy (Billroth). Early manifestations usually occur within 30
minutes of eating and include vertigo, tachycardia, syncope, sweating, pallor, palpitations, and the
desire to lie down. The nurse should instruct the client to decrease the amount of fluid taken at meals
and to avoid high-carbohydrate foods, including fluids such as fruit nectars; to assume a low-fowler's
position during meals; to lie down 30 minutes after eating to delay gastric emptying; and to take
antispasmodics as prescribed.
The nurse is caring for a client who returns to the surgical nursing unit following a vertical banded
gastroplasty with a nasogastric tube to low, intermittent suction and a patient-controlled analgesia
(PCA) machine for pain control. Which of the following nursing actions should be included in the
postoperative plan of care?
a. Remind the client that PCA use may slow the return of bowel function.
b. Irrigate the nasogastric (NG) tube frequently with normal saline.
c. Offer sips of sweetened liquids at frequent intervals.
d. Support the surgical incision during client coughing and turning in bed.
d. Support the surgical incision during client coughing and turning in bed.
- The incision should be protected from strain to decrease the risk for wound dehiscence. The client
should be encouraged to use the PCA since pain control will improve cough effort and client mobility.
NG irrigation may damage the suture line or overfill the stomach pouch. Sugar-free clear liquids are
offered during the immediate postoperative time to decrease the risk for dumping syndrome.
