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Exam 4 Practice Questions From Brunner and Suddarths Study Guide

1. A hiatal hernia involves: a. an extension of the esophagus through an opening in the diaphragm b. an involution of the esophagus, which causes a severe stricture c. a protrusion of the upper stomach into the lower portion of the thorax d. a twisting of the duodenum through an opening in the diaphragm answer: a

2. The most common site for peptic ulcer formation is the: a. duodenum b. esophagus c. pylorus d. stomach answer: a

3. A symptom that distinguishes a chronic gastric ulcer from a chronic duodenal ulcer is the: a. absence of any correlation between the presence of the ulcer and a malignancy b. normal to below-normal secretion of acid c. relief of pain after food ingestion d. uncommon incidence of vomiting answer: b

4. Peptic ulcers occur with the most frequency in those between the ages of: a. 15 and 25 years b. 20 and 30 years c. 40 and 60 years d. 60 and 80 years answer: c

5. A frequently prescribed proton pump inhibitor of gastric acid is: a. Nexium b. Pepcid c. Tagamet d. Zantac answer: a

6. The percentage of patients with peptic ulcers who experience bleeding is: a. less than 5% b. 15% c. 25% d. greater than 50 % answer: b

7. A characteristic associated with peptic ulcer back pain is a: a. burning sensation localized in the back or midepigastrium b. feeling of emptiness that precedes meals from 1 to 3 hours c. severe gnawing pain that increases in severity as the day progresses d. combination of all of the above answer: d

8. The best time to administer an antacid is: a. with the meal b. 30 minutes before the meal c. 1 to 3 hours after the meal d. immediately after the meal answer: c

9. A Billroth I procedure is a surgical approach to ulcer management whereby: a. a partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum b. a sectioned portion of the stomach is joined to the jejunum c. the antral portion of the stomach is removed and a vagotomy is performed d. the vagus nerve is cut and gastric drainage is established

answer: a

10. The most common complication of peptic ulcer disease that occurs in 10% to 20% of patients is: a. hemorrhage b. intractable ulcer c. perforation d. pyloric obstruction answer: a

11. Nursing interventions associated with peptic ulcers include: a. checking the blood pressure and pulse rate every 15 to 20 minutes b. frequently monitoring hemoglobin and hematocrit levels c. observing stools and vomitus for color, consistency, and volume d. all of the above answer: d

12. If peptic ulcer hemorrhage was suspected, an immediate nursing action would be to: a. place the patient in a recumbent position with his or her legs elevated b. prepare a peripheral and central line for intravenous infusion c. assess vital signs d. accomplish all of the above answer: d

13. Morbid obesity is a term applied to people who are more than: a. 15 kg above their body mass index b. 50 lb above ideal body weight c. 100 lb above ideal body weight d. more than twice their ideal body weight answer: d

14. The average weight loss after bariatric surgery is about what percent of previous body weight? a. 25% b. 40% c. 60% d. 80% answer: c

15. Pulmonary complications frequently follow upper abdominal incisions, because: a. aspiration is a common occurrence associated with postoperative injury to the pyloric sphincter of the cardiac sphincter b. pneumothorax is a common complication of abdominal surgery when the chest cavity has been entered c. the patient tends to have shallow respirations in an attempt to minimize incisional pain d. all of the above answer: c

16. Teaching points to help a patient with total gastric resection to avoid the dumping syndrome include all of the following except: a. eating small, frequent meals b. increasing the carbohydrate content of the diet to supply needed calories for energy c. lying down after meals d. taking fluids between meals to decrease the total volume in the stomach at one time answer: b 17. A positive Rovsings sign in indicative of appendicitis. The nurse knows to assess for this indicator by palpating the: a. RLQ b. LLQ c. RUQ d. LUQ answer: b

18. Common clinical manifestations of Crohns disease are: a. abdominal pain and diarrhea b. edema and weight gain c. nausea and vomiting d. obstruction and ileus answer: a

19. A nurse suspects a diagnosis of regional enteritis when she assesses the symptoms of: a. abdominal distention and rebound tenderness b. hyperactive bowel sounds in the right lower quadrant c. intermittent pain associated with diarrhea d. all of the above answer: d

20. Nutritional management for regional enteritis consists of diet therapy that is: a. high in fats b. high in fiber c. low in protein d. low in residue answer: d

21. Remission of inflammation in ulcerative colitis is possible with: a. antidiarrheal medication b. periods of rest after meals c. steroid therapy d. all of the above answer: d

22. A problem unique to the patient with an ileostomy is that: a. regular bowel habits cannot be established b. sexual activity is restricted c. skin excoriation can occur d. the collecting appliance is bulky and large

answer: a

23. Postoperative nursing management for a patient with a continent ileostomy includes all of the following except: a. checking to make certain that the rectal packing is in place b. irrigating the ileostomy catheter every 3 hours c. nasogastric tube feedings, 30 to 50 ml, every 4 to 6 hours d. perineal irrigations after the dressings are removed answer: c

24. Clinical manifestations associated with small-bowel obstruction include all of the following except: a. dehydration b. pain that is wavelike c. the passage of blood-tinged stool d. vomiting answer: c

25. Acute glomerulonephritis refers to a group of kidney diseases in which there is: a. an inflammatory reaction b. an antigen-antibody reaction to streptococci that results in circulating molecular complexes c. cellular complexes that lodge in the glomeruli and injure the kidney d. a combination of all of the above answer: d

26. In most cases, the major stimulus to acute glomerulonephritis is: a. Escherichia coli. b. group A streptococcal infection of the throat c. Staphylococcus aureus. d. Neisseria gonorrhoeae. Answer: b

27. Laboratory findings consistent with acute glomerulonephritis include all of the following except: a. hematuria b. polyuria c. proteinuria d. white cell casts answer: b

28. Chronic glomerulonephritis is manifested by: a. anemia secondary to erthropoiesis b. hypercalcemia and decreased serum phosphorus c. hypokalemia and elevated bicarbonate d. metabolic alkalosis answer: a

29. The major manifestation of nephritic syndrome is: a. hematuria b. hyperalbuminemia c. edema d. anemia answer: d

30. A clinical diagnosis of nephritic syndrome is consistent with an exceedingly high level of: a. albumin b. low-density lipoproteins c. protein in the urine d. serum cholesterol answer: c 31. Complications of chronic pyelonephritis include: a. end-stage renal disease b. hypertension c. kidney stone formation d. all of the above

answer: d

32. The most common symptom of cancer of the bladder is: a. back pain b. dysuria c. visible, painless hematuria d. infection answer: c

33. The predominant cause of bladder cancer is: a. chronic renal failure b. cigarette smoking c. environmental pollution d. metastasis from another primary site answer: b

34. The most effective intravesical agent for transurethral resection or fulguration for bladder cancer is: a. bacilli Calmette-Guerin (BCG) b. doxorubicin c. ethoglucid d. thiotepa answer: a

35. The urinary diversion whereby the patient will void from his rectum for the rest of his life is known as a: a. cutaneous ureterostomy b. nephrostomy c. suprapubic cystotomy d. ureterosigmoidostomy answer: d

36. As a cause of death in American men older than 55 years of age, cancer of the prostate ranks: a. first b. second c. third. d. fourth answer: b

37. The racial group most likely to acquire and die from prostate cancer is: a. African Americans b. Caucasians c. Hispanics d. Italians answer: a

38. Prostatic cancer commonly metastasizes to the: a. bone and lymph nodes b. liver and spleen c. lungs and pancreas d. brain and bladder answer: a

39. The 10-year survival rate for prostate cancer is: a. 25% b. 50% c. 85% d. 100% answer: c 40. The concentration of prostate-specific antigen (PSA) is proportional to the total prostatic mass. As a diagnostic tool, PSA would indicate all of the following except: a. local progression of the disease b. patient responsiveness to cancer therapy c. recurrence of prostate cancer d. the presence of malignancy

answer: d

41. The closed surgical procedure for a prostatectomy uses which approach: a. perineal b. suprapubic c. retropubic d. transurethral answer: d 42. Patients undergoing open surgical removal of the prostate, using the perineal approach, seem to experience a high incidence of: a. paralytic ileus b. pneumonia c. impotence d. all of the above answer: a

43. In most instances, patients can be advised that sex can resume, after a prostatectomy, in about: a. 4 weeks b. 2 months c. 3 days d. 4 months answer: b

44. During the 2 months it takes for the prostatic fossa to heal, the patient is advised not to: a. engage in strenuous activity b. perform the Valsalva maneuver c. take long automobile rides d. do all of the above answer: a

45. In the 15- to 35-year-old age group, testicular cancer has a mortality rate of: a. 5% b. 10% c. 20% d. 40% answer: d

46. Retroperitoneal lymphadenectomy after orchiectomy would probably lead to: a. altered libido b. inability to have orgasm c. infertility d. all of the above answer: a