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HAAD QUESTIONS

EXAM CODE HAAD 3

1. Following a diagnosis of acute glomerulonephritis (AGN) in their 6


year-old child, the parents remark: We just dont know how he caught
the disease! The nurse's response is based on an understanding that

a. AGN is a streptococcal infection that involves the kidney tubules


b. The disease is easily transmissible in schools and camps
c. The illness is usually associated with chronic respiratory infections
d. It is not "caught" but is a response to a previous B-hemolytic strep
infection

2. The laboratory of a male patient with Peptic ulcer revealed an


elevated titer of Helicobacter pylori. Which of the following statements
indicate an understanding of this data?

a. Treatment will include Ranitidine and Antibiotics


b. No treatment is necessary at this time
c. This result indicates gastric cancer caused by the organism
d. Surgical treatment is necessary

3. The client presents with severe rectal bleeding, 16 diarrheal stools a


day, severe abdominal pain, tenesmus and dehydration. Because of these
symptoms the nurse should be alert for other problems associated with
what disease?

a. Chrons disease
b. Ulcerative colitis
c. Diverticulitis
d. Peritonitis

4. Which description of pain would be most characteristic of a duodenal


ulcer?

a. Gnawing, dull, aching, hungerlike pain in the epigastric area that is


relieved by food intake
b. RUQ pain that increases after meal
c. Sharp pain in the epigastric area that radiates to the right shoulder
d. A sensation of painful pressure in the midsternal area

5. The client underwent Billroth surgery for gastric ulcer. Post-


operatively, the drainage from his NGT is thick and the volume of
secretions has dramatically reduced in the last 2 hours and the client
feels like vomiting. The most appropriate nursing action is to:

a. Reposition the NGT by advancing it gently NSS


b. Notify the MD of your findings
c. Irrigate the NGT with 50 cc of sterile
d. Discontinue the low-intermittent suction

6. Included in the plan of care for the immediate post-gastroscopy period


will be:

a. Maintain NGT to intermittent suction


b. Assess gag reflex prior to administration of fluids
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c. Assess for pain and medicate as ordered


d. Measure abdominal girth every 4 hours

7. What instructions should the client be given before undergoing a


paracentesis?

a. NPO 12 hours before procedure


b. Empty bladder before procedure
c. Strict bed rest following procedure
d. Empty bowel before procedure

8. After Billroth II Surgery, the client developed dumping syndrome.


Which of the following should the nurse exclude in the plan of care?

a. Sit upright for at least 30 minutes after meals


b. Take only sips of H2O between bites of solid food
c. Eat small meals every 2-3 hours
d. Reduce the amount of simple carbohydrate in the diet

9. Ryan has undergone subtotal gastrectomy. The nurse should expect that
nasogastric tube drainage will be what color for about 12 to 24 hours
after surgery?

a. Bile green
b. Bright red
c. Cloudy white
d. Dark brown

10. Nurse Bea should instruct the male client with an ileostomy to report
immediately which of the following symptom?

a. Absence of drainage from the ileostomy for 6 or more hours


b. Passage of liquid stool in the stoma
c. Occasional presence of undigested food
d. A temperature of 37.6 C

11. A client with peptic ulcer is being assessed by the nurse for
gastrointestinal perforation. The nurse should monitor for:

a. (+) guaiac stool test


b. Slow, strong pulse
c. Sudden, severe abdominal pain
d. Increased bowel sounds

12. Tony returns from surgery with permanent colostomy. During the first
24 hours the colostomy does not drain. The nurse should be aware that:

a. Proper functioning of nasogastric suction


b. Presurgical decrease in fluid intake
c. Absence of gastrointestinal motility
d. Intestinal edema following surgery

13. A client has undergone gastrectomy. Nurse Jovy is aware that the
best position for the client is:

a. Left side lying


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b. Low fowlers
c. Prone
d. Supine

14. During the initial postoperative period of the clients stoma. The nurse
evaluates which of the following observations should be reported
immediately to the physician?

a. Stoma is dark red to purple


b. Stoma is oozes a small amount of blood
c. Stoma is lightly edematous
d. Stoma does not expel stool

15. Louis develops peritonitis and sepsis after surgical repair of ruptures
diverticulum. The nurse in charge should expect an assessment of the
client to reveal:

a. Tachycardia
b. Abdominal rigidity
c. Bradycardia
d. Increased bowel sounds

16. Nurse Trish is aware that the laboratory test result that most likely
would indicate acute pancreatitis is an elevated:

a. Serum bilirubin level


b. Serum amylase level
c. Potassium level
d. Sodium level

17. Which intervention would the nurse include in the teaching plan for a
client diagnosed with gastroesophageal reflux disease (GERD)?

a. Avoiding eating within 2 hours of bedtime


b. Eating a high-fat, low-fiber diet
c. Completing all antibiotics
d. Sleeping with the head of the bed flat

18. A client with colon cancer underwent an abdominal perineal resection


with creation of a sigmoid colostomy 2 days ago. Which situation would
warrant immediate intervention by the nurse?

a. The client asks the enterostomal therapist about supplies.


b. The ostomy bag contains a small amount of brown liquid stool.
c. The stoma appears dark and dusky purple in color.
d. The suction drainage device contains 15 ml of dark red liquid.

19. The nurse would include which nursing intervention for a client
diagnosed with acute diverticulitis?

a. Administration of stimulant laxatives


b. Increased fluid intake
c. Continuation of client's nothing-by-mouth status
d. High-fiber diet

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20. Which assessment data for a client who is 1 day postabdominal


surgery would warrant immediate nursing intervention?

a. Blood pressure of 110/70 mm Hg and hematocrit of 42%


b. Complaints of abdominal pain as an
c. Hypoactive bowel sounds and a serum potassium of 3.7 mEq/L
d. Rigid, hard, boardlike abdomen and a white blood cell (WBC) count of
20,000 mm

21. When preparing the discharge teaching plan for a client with
stomatitis, which topic should be included:

a. Discussing the importance of eating spicy and acidic foods


b. Instructing the client to eat a bland diet
c. Instructing the client to gargle with mouthwash
d. Using a hard bristle toothbrush for mouth care

22. Which clinical manifestation would the nurse expect to assess in a


client diagnosed with a duodenal ulcer?

a. Aching or gnawing pain in the right epigastrium, relieved by eating


b. Burning in the upper epigastrium 30 to 60 minutes after meals
c. Low-grade fever and left lower quadrant pain
d. Severe localized diffuse abdominal pain and rebound tenderness

23. Which instruction would be included in a teaching plan for a client


experiencing constipation?

a. Increase daily fluid intake to more than 2,000 ml.


b. Perform daily isometric exercises.
c. Restrict fiber intake.
d. Use laxatives daily.

24. Which option best describes the rationale for administering histamine-
2 (H2)-receptor antagonists in a client diagnosed with peptic ulcer
disease?

a. Change in stomach acid to a viscous material that binds to proteins in


ulcerated tissues
b. Decrease in the amount of hydrochloric acid secreted by the parietal
cells in the stomach
c. Inhibition of vagal stimulation, thereby decreasing gastric acid
secretions in the duodenum
d. Neutralization of hydrochloric acid in the stomach, thereby decreasing
the gastric pH

25. Which medication would the nurse anticipate being prescribed for a
client diagnosed with malabsorption syndrome?

a. Glucocorticosteroids and stool softeners


b. Histamine-2 (H2)-receptor antagonists and mucosal protectant drugs
c. Proton pump inhibitors and antacids
d. Water-soluble and fat-soluble vitamins

26. Which intervention would be included in the care plan for a client
experiencing an acute exacerbation of chronic inflammatory bowel disease?
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a. Administering I.V. fluid therapy


b. Assessing the client for fluid volume overload
c. Instructing the client to eat cold foods and decrease smoking
d. Monitoring the client's intake and output every 12 hours

27. A client diagnosed with gastroenteritis asks the nurse, "What does my
diagnosis mean?" Which response by the nurse best describes this
condition?

a. "An acute inflammation of the esophageal mucosa resulting in


heartburn and belching"
b. "An inflammation of small saccular bowel wall herniations resulting in
low-grade fever and left lower-abdominal pain"
c. "An inflammation of the peritoneum, which causes a boardlike abdomen
and severe abdominal pain"
d. "An inflammation of the stomach and small intestines, which causes
abdominal cramping and diarrhea"

28. Which of the following medications represents the category proton


(gastric acid) pump inhibitors?

a. Omeprazole (Prilosec)
b. Sucralfate (Carafate)
c. Famotidine (Pepcid)
d. Metronidazole (Flagyl)

29. Crohn's disease is a condition of malabsorption caused by:

a. disaccharidase deficiency.
b. gastric resection.
c. infectious disease.
d. inflammation of all layers of intestinal mucosa.

30. The nurse teaches the patient whose surgery will result in a sigmoid
colostomy that the feces expelled through the colostomy will be

a. solid
b. mushy
c. semi-mushy
d. fluid

31. Which of the following categories of laxatives draw water into the
intestines by osmosis?

a. Bulk-forming agents (Metamucil)


b. Stimulants (Dulcolax)
c. Fecal softeners (Colace)
d. Saline agents (milk of magnesia)

32. Which type of diarrhea is caused by increased production and


secretion of water and electrolyes by the intestinal mucosa into the
intestinal lumen?

a. Osmotic diarrhea
b. Secretory diarrhea
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c. Mixed diarrhea
d. Diarrheal disease

33. Which of the following terms most precisely refers to the incision of
the common bile duct for removal of stones?

a. Choledochoduodenostomy
b. Choledocholithotomy
c. Cholecystostomy
d. Choledochotomy
34. An 82 year-old client complains of chronic constipation. To improve
bowel function, the nurse should first suggest:

a. Increasing fiber intake to 20-30 grams daily


b. Daily use of laxatives
c. Avoidance of binding foods such as cheese and chocolate
d. Monitoring a balance between activity and rest
The correct answer is A: Increasing fiber intake to 20-30 grams daily

35. When preparing to teach a client with colostomy how to irrigate his
colostomy, the nurse should plan to perform the procedure:

a. When the client would have normally had a bowel movement


b. After the client accepts he had a bowel movement
c. Before breakfast and morning care
d. At least 2 hours before visitors arrive

36. Arthur Cruz, a 45 year old artist, has recently had an


abdominoperineal resection and colostomy. Mr. Cruz accuses the nurse of
being uncomfortable during a dressing change, because his wound looks
terrible. The nurse recognizes that the client is using the defense
mechanism known as:

a Reaction Formation
b. Sublimation
c. Intellectualization
d. Projection

37. When observing an ostomate do a return demonstration of the


colostomy irrigation, the nurse notes that he needs more teaching if he:

a. Stops the flow of fluid when he feels uncomfortable


b. Lubricates the tip of the catheter before inserting it into the stoma
c. Hangs the bag on a clothes hook on the bathroom door during fluid
insertion
d. Discontinues the insertion of fluid after only 500 ml of fluid has been
instilled

38. The nurse would know that dietary teaching had been effective for
a client with colostomy when he states that he will eat:

a. Food low in fiber so that there is less stool


b. Everything he ate before the operation but will avoid those foods that
cause gas
c. Bland foods so that his intestines do not become irritated

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d. Soft foods that are more easily digested and absorbed by the large
intestines

39. When doing colostomy irrigation at home, a client with colostomy


should be instructed to report to his physician :

a. Abdominal cramps during fluid inflow


b. Difficulty in inserting the irrigating tube
c. Passage of flatus during expulsion of feces
d. Inability to complete the procedure in half an hour

40. A client with colostomy refuses to allow his wife to see the incision
or stoma and ignores most of his dietary instructions. The nurse on
assessing this data, can assume that the client is experiencing:

a. A reaction formation to his recent altered body image.


b. A difficult time accepting reality and is in a state of denial.
C. Impotency due to the surgery and needs sexual counseling
d. Suicide thoughts and should be seen by psychiatrist

41. A client with a history of recurrent GI bleeding is admitted to the


hospital for a gastrectomy. Following surgery, the client has a
nasogastric tube to low continuous suction. He begins to hyperventilate.
The nurse should be aware that this pattern will alter his arterial blood
gases by:

a. Increasing HCO3
b. Decreasing PCO2
c. Decreasing pH
d. Decreasing PO2

42. Jude develops GI bleeding and is admitted to the hospital. An


important etiologic clue for the nurse to explore while taking his history
would be:

a. The medications he has been taking


b. Any recent foreign travel
c. His usual dietary pattern
d. His working patterns

43. The meal pattern that would probably be most appropriate for a
client recovering from GI bleeding is:

a. Three large meals large enough to supply adequate energy.


b. Regular meals and snacks to limit gastric discomfort
c. Limited food and fluid intake when he has pain
d. A flexible plan according to his appetite

44. Mr. Valdez has undergone surgical repair of his inguinal hernia.
Discharge teaching should include

a. telling him to avoid heavy lifting for 4 to 6 weeks


b. instructing him to have a soft bland diet for two weeks
c. telling him to resume his previous daily activities without limitations
d. recommending him to drink eight glasses of water daily

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45. Roxy is admitted to the hospital with a possible diagnosis of


appendicitis. On physical examination, the nurse should be looking for
tenderness on palpation at McBurneys point, which is located in the

a. left lower quadrant


b. left upper quadrant
c. right lower quadrant
d. right upper quadrant

46. Which of the following terms is used to refer to protrusion of


abdominal organs through the surgical incision?

a. Evisceration
b. Erythema
c. Hernia
d. Dehiscence

47. A client with gout is prescribed with probenecid (Benemid). Which


Client statement reflects a need for further teaching about the therapy

a. I should drunk at least 3 liters of water everyday


b. I should take my aspirin before probernecid
c. I should take my medication after meals
d. I should This medication will lower my uric acid

48. You are assigned in the Orthopedic Ward where clients are
complaining of pain in varying degrees upon movement of body parts. The
nurse would instruct the patient which of the following to minimize
complications?

a. Drinking a minimum of 3000ml of fluid per day


b. Eating a minimum of 2500 calories per day
c. Walking at least three miles per day
d. Resting at least three hours per day

49. After surgery, Gina returns from the Post-anesthesia Care Unit
(Recovery Room) with a nasogastric tube in place following a gall bladder
surgery. She continues to complain of nausea. Which action would the
nurse take?

a. Call the physician immediately.


b Administer the prescribed antiemetic.
c. Check the patency of the nasogastric tube for any obstruction.
d. Change the patients position

50. The client is diagnosed with ulcerative colitis. When assessing this
client, which sign/ symptom would the nurse expect to find?

a. Twenty bloody stools a day.


b. Oral temperature of 102_F.
c. Hard, rigid abdomen.
d. Urinary stress incontinence.

51. The client is prescribed prednisone, a steroid, for an acute episode of


inflammatory bowel disease. Which intervention should the nurse discuss
with the client?
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a. Take this medication on an empty stomach.


b. Notify the HCP if you experience a moon face.
c. Be sure to take this medication as prescribed.
d. Take the medication in the morning only.

52. The client diagnosed with inflammatory bowel disease has a serum
potassium level of 3.4 mEq/L. Which action should the nurse implement
first?

a. Notify the health-care provider.


b. Assess the client for leg cramps.
c. Request telemetry for the client.
d. Prepare to administer potassium IV.

53. The client is diagnosed with an acute exacerbation of ulcerative


colitis. Which intervention should the nurse implement?

a. Provide a low-residue diet.


b. Monitor intravenous fluids.
c. Assess vital signs daily.
d. Administer antacids orally.

54. The client diagnosed with IBD is prescribed total parental nutrition
(TPN). Which intervention should the nurse implement?

a. Check the clients glucose level.


b. Administer an oral hypoglycemic.
c. Assess the peripheral intravenous site.
d. Monitor the clients oral food intake.

55. The client is diagnosed with an acute exacerbation of IBD. Which


priority intervention should the nurse implement first?

a. Weigh the client daily and document it in the clients chart.


b. Teach coping strategies such as dietary modifications.
c. Record the frequency, amount, and color of stools.
d. Monitor the clients oral fluid intake every shift.

56. The client diagnosed with Crohns disease is crying and tells the
nurse, I cant take it anymore. I never know when I will get sick and
end up here in the hospital. Which statement would be the nurses best
response?

a. I understand how frustrating this must be for you.


b. You must keep thinking about the good things in your life.
c. I can see you are very upset. Ill sit down and we can talk.
d. Are you thinking about doing anything like committing suicide?

57. The client diagnosed with ulcerative colitis has had an ileostomy.
Which statement indicates the client needs more teaching concerning the
ileostomy?

a. My stoma should be pink and moist.


b. I will irrigate my ileostomy every morning.
c. If I get a red, bumpy, itchy rash I will call my HCP.
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d. I will change my pouch if it starts leaking.

58. The client diagnosed with IBD is prescribed sulfasalazine (Asulfidine),


a sulfonamide antibiotic. Which statement best describes the rationale for
administering this medication?

a. It is administered rectally to help decrease colon inflammation.


b. This medication slows gastrointestinal motility and reduces diarrhea.
c. This medication kills the bacteria that cause the exacerbation.
d. It acts topically on the colon mucosa to decreases inflammation.

59. The client is diagnosed with Crohns disease, also known as regional
enteritis. Which statement by the client would support this diagnosis?

a. My pain goes away when I have a bowel movement.


b. I have bright red blood in my stool all the time.
c. I have episodes of diarrhea and constipation.
d. My abdomen is hard and rigid and I have a fever.

60. The client diagnosed with ulcerative colitis is prescribed a low-residue


diet. Which meal selection indicates the client understands the diet
teaching?

a. Grilled hamburger on a wheat bun and fried potatoes.


b. A chicken salad sandwich and lettuce and tomato salad.
c. Roast pork, white rice, and plain custard.
d. Fried fish, whole grain pasta, and fruit salad.

61. The client with ulcerative colitis is scheduled for an ileostomy. The
nurse is aware that the clients stoma will be located in which area of
the abdomen?

a. A
b. B
c. C
d. D

62. The male client in a health-care providers office tells the nurse that
he has been experiencing heartburn at night that awakens him. Which
assessment question should the nurse ask?

a. How much weight have you gained recently?


b. What have you done to alleviate the heartburn?
c. Do you consume many milk and dairy products?
d. Have you been around anyone with a stomach virus?

63. The nurse caring for a client diagnosed with gastroesophageal reflux
disease (GERD) writes the nursing problem of behavior modification.
Which intervention should be included for this problem?

a. Teach the client to sleep with a foam wedge under the head.
b. Encourage the client to decrease the amount of smoking.
c. Instruct the client to take over-the-counter medication for relief of
pain.
d. Discuss the need to attend Alcoholics Anonymous to quit drinking.

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64. The nurse is preparing a client diagnosed with GERD for discharge
following an esophagogastroduodenoscopy. Which statement indicates the
client understands the discharge instructions?

a. I should not eat for twenty-four (24) hours following this procedure.
b. I can lie down whenever I want after a meal. It wont make a
difference.
c. The stomach contents wont bother my esophagus but will make me
nauseous.
d. I should avoid drinking orange juice and eating tomatoes until my
esophagus heals.

65. The nurse is planning the care of a client diagnosed with lower
esophageal sphincter dysfunction. Which dietary modifications should be
included in the plan of care?

a. Allow any of the clients favorite foods as long as the amount of the
food is limited.
b. Have the client perform eructation exercises several times a day.
c. Eat 4 to 6 small meals a day and limit fluids during mealtimes.
d. Encourage the client to consume a glass of red wine with one (1) meal
a day.

66. The nurse is caring for a client diagnosed with gastroesophageal


reflux disease (GERD).
Which nursing interventions should be implemented?

a. Place the client prone in bed and administer nonsteroidal anti-


inflammatory medications.
b. Have the client remain upright at all times and walk for 30 minutes
three (3) times a week.
c. Instruct the client to maintain a right lateral side-lying position and
take antacids before meals.
d. Elevate the head of the bed 30 degrees and discuss lifestyle
modifications with the client.

67. The nurse is caring for an adult client diagnosed with


gastroesophageal reflux disease (GERD). Which condition is the most
common comorbid disease associated with GERD?

a. Adult-onset asthma.
b. Pancreatitis.
c. Peptic ulcer disease.
d. Increased gastric emptying.

68. The nurse is administering morning medications at 0730. Which


medication would have priority?

a. A proton pump inhibitor.


b. A nonnarcotic analgesic.
c. A histamine receptor antagonist.
d. A mucosal barrier agent.

69. The nurse is preparing a client diagnosed with gastroesophageal reflux


disease (GERD) for surgery. Which information should be brought to the
attention of the health-care provider?
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a. The clients Bernstein esophageal test was positive.


b. The clients abdominal x-ray shows a hiatal hernia.
c. The clients WBC count is 14,000 mg/dL.
d. The clients hemoglobin is 13.8 mg/dL.

70. The charge nurse is making assignments. Staffing includes a registered


nurse with 5 years of medical-surgical experience, a newly graduated
registered nurse, and 2 unlicensed nursing assistants. Which client should
be assigned to the most experienced nurse?

a. The 39-year-old client diagnosed with lower esophageal dysfunction


who is complaining of pyrosis.
b. The 54-year-old client diagnosed with Barretts esophagitis who is
scheduled to have an endoscopy this morning.
c. The 46-year-old client diagnosed with gastroesophageal reflux disease
who has wheezes in all 5 lobes.
d. The 68-year-old client who is 3 days post-op hiatal hernia and needs
to be ambulated 4 times today.

71. Which statement made by the client would alert the nurse that the
client may be experiencing GERD?

a. My chest hurts when I walk up the stairs in my home.


b. I take antacid tablets with me wherever I go.
c. My spouse tells me I snore very loudly at night.
d. I drink six (6) to seven (7) soft drinks every day.

72. The nurse is performing an admission assessment on a client diagnosed


with gastroesophageal reflux disease (GERD). Which signs and symptoms
would indicate GERD?

a. Pyrosis, water brash, and flatulence.


b. Weight loss, dysarthria, and diarrhea.
c. Decreased abdominal fat, proteinuria, and constipation.
d. Mid-epigastric pain, positive H. pylori test, and melena.

73. The client diagnosed with gastroesophageal reflux disease (GERD) is at


greater risk for which disease?

a. Hiatal hernia.
b. Gastroenteritis.
c. Esophageal cancer.
d. Gastric cancer.

74. Which assessment data support the clients diagnosis of gastric ulcer?

a. Presence of blood in the clients stool for the past month.


b. Complaints of a burning sensation that moves like a wave.
c. Sharp pain in the upper abdomen after eating a heavy meal.
d. Comparison of complaints of pain with ingestion of food and sleep.

75. The client has been seen by the health-care provider and the
suspected diagnosis is peptic ulcer disease. Which diagnostic test would
confirm this diagnosis?

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a. Esophagogastroduodenoscopy (EGD).
b. Magnetic resonance imaging (MRI).
c. Occult blood test.
d. Gastric acid stimulation.

76. When the nurse is conducting the initial interview, which specific data
should the nurse obtain from the client who is suspected of having peptic
ulcer disease?

a. History of side effects experienced from all medication.


b. Use of nonsteroidal anti-inflammatory drugs (NSAIDs).
c. Any known allergies to drugs and environmental factors.
d. Medical histories of at least three (3) generations.

77. When assessing the client with the diagnosis of peptic ulcer disease,
which physical examination should the nurse implement first?

a. Auscultate the clients bowel sounds in all four quadrants.


b. Palpate the abdominal area for tenderness.
c. Percuss the abdominal borders to identify organs.
d. Assess the tender area progressing to nontender.

78. The client diagnosed with peptic ulcer disease is admitted into the
hospital. Which nursing diagnosis should the nurse include in the plan of
care to observe for physiological complications?

a. Alteration in bowel elimination patterns.


b. Knowledge deficit in the causes of ulcers.
c. Inability to cope with changing family roles.
d. Potential for alteration in gastric emptying.

79. When planning the care for a client diagnosed with peptic ulcer
disease, which expected outcome should the nurse include?

a. The clients pain is controlled with the use of NSAIDs.


b. The client maintains lifestyle modifications.
c. The client has no signs and symptoms of hemoptysis.
d. The client takes antacids with each meal.

80. The nurse has been assigned to care for a client diagnosed with
peptic ulcer disease. When the nurse is evaluating care, which assessment
data require further intervention?

a. Bowel sounds auscultated fifteen (15) times in one (1) minute.


b. Belching after eating a heavy and fatty meal late at night.
c. A decrease in systolic BP of 20 mm Hg from lying to sitting.
d. A decreased frequency of distress located in the epigastric region.

81. Which medication should the nurse question before administering to


the client with peptic ulcer disease?

a. E-mycin, an antibiotic.
b. Prilosec, a proton pump inhibitor.
c. Flagyl, an antimicrobial agent.
d. Tylenol, a nonnarcotic analgesic.

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82. The nurse has administered an antibiotic, a proton pump inhibitor, and
Pepto-Bismol for peptic ulcer disease secondary to H. pylori. Which data
would indicate to the nurse that the medications are effective?

a. A decrease in alcohol intake.


b. Maintaining a bland diet.
c. A return to previous activities.
d. A decrease in gastric distress.

83. Which assessment data would indicate to the nurse that the clients
gastric ulcer has perforated?

a. Complaints of sudden, sharp, substernal pain.


b. Rigid, boardlike abdomen with rebound tenderness.
c. Frequent, clay-colored, liquid stool.
d. Complaints of vague abdominal pain in the right upper quadrant.

84. The client with a history of peptic ulcer disease has been admitted
into the hospital intensive care unit with frank gastric bleeding. Which
priority intervention should the nurse implement?

a. Maintain a strict record of intake and output.


b. Insert a nasogastric tube and begin saline lavage.
c. Assist the client with keeping a detailed calorie count.
d. Provide a quite environment to promote rest.

85. The client admitted to the medical unit with diverticulitis is


complaining of severe pain in the left lower quadrant and has an oral
temperature of 100.6_F. Which action should the nurse implement first?

a. Notify the health-care provider.


b. Document the findings in the chart.
c. Administer an oral antipyretic.
d. Assess the clients abdomen.

86. The nurse is teaching the client diagnosed with diverticulosis. Which
instruction should the nurse include in the teaching session?

a. Discuss the importance of drinking 1000 mL of water daily.


b. Instruct the client to exercise at least three (3) times a week.
c. Teach the client about a eating a low-residue diet.
d. Explain the need to have daily bowel movements.

87. The client is admitted to the medical unit with a diagnosis of acute
diverticulitis. Which health-care providers order should the nurse
question?

a. Insert a nasogastric tube.


b. Start IV D5W at 125 mL/hr.
c. Put client on a clear liquid diet.
d. Place client on bed rest with bathroom privileges.

88. The nurse is discussing the therapeutic diet for the client diagnosed
with diverticulosis. Which meal indicates the client understands the
discharge teaching?

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a. Fried fish, mashed potatoes, and iced tea.


b. Ham sandwich, applesauce, and whole milk.
c. Chicken salad on whole-wheat bread and water.
d. Lettuce, tomato, and cucumber salad and coffee.

89. The client is two (2) hours post-colonoscopy. Which assessment data
would warrant intermediate intervention by the nurse?

a. The client has a soft, nontender abdomen.


b. The client has a loose, watery stool.
c. The client has hyperactive bowel sounds.
d. The clients pulse is 104 and BP is 98/60.

90. The nurse is preparing to administer an aminoglycoside antibiotic to


the client just admitted with a diagnosis of acute diverticulitis. Which
intervention should the nurse implement?

a. Obtain a serum trough level.


b. Ask about drug allergies.
c. Monitor the peak level.
d. Assess the vital signs.

91. The client diagnosed with acute diverticulitis is complaining of severe


abdominal pain. On assessment, the nurse finds a hard, rigid abdomen and
T 102_F. Which intervention should the nurse implement?

a. Notify the health-care provider.


b. Prepare to administer a Fleets enema.
c. Administer an antipyretic suppository.
d. Continue to monitor the client closely.

92. The client with acute diverticulitis has a nasogastric tube draining
green liquid bile. Which action should the nurse implement?

a. Document the findings as normal.


b. Assess the clients bowel sounds.
c. Determine the clients last bowel movement.
d. Insert the N/G tube at least 2 more inches.

93. Which client would be most likely to have the diagnosis of


diverticulosis?

a. A 60-year-old male with a sedentary lifestyle.


b. A 72-year-old female with multiple childbirths.
c. A 63-year-old female with hemorrhoids.
d. A 40-year-old male with a family history of diverticulosis.

94. The client is admitted to the medical floor with acute diverticulitis.
Which collaborative intervention would the nurse anticipate the health-
care provider ordering?

a. Administer total parenteral nutrition.


b. Maintain NPO and nasogastric tube.
c. Maintain on a high-fiber diet and increase fluids.
d. Obtain consent for abdominal surgery.

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95. The occupational health nurse is preparing a presentation to a group


of factory workers about preventing colon cancer. Which information
should be included in the presentation?

a. Wear a high filtration mask when around chemicals.


b. Eat several servings of cruciferous vegetables daily.
c. Take a multiple vitamin every day.
d. Do not engage in high-risk sexual behaviors.

96. The nurse is admitting a male client to a medical floor with a


diagnosis of adenocarcinoma of the rectosigmoid colon. Which assessment
data support this diagnosis?

a. The client reports up to 20 bloody stools per day.


b. The client states that he has a feeling of fullness after a heavy meal.
c. The client has diarrhea alternating with constipation.
d. The client complains of right lower quadrant pain with rebound
tenderness.

97. The 85-year-old male client diagnosed with cancer of the colon asks
the nurse, Why did I get this cancer? Which statement is the nurses
best response?

a. Cancer of the colon is associated with a lack of fiber in the diet.


b. Cancer of the colon has a greater incidence among those younger than
age 50 years.
c. Cancer of the colon has no known risk factors.
d. Cancer of the colon is rare among male clients.

98. The client who has had an abdominal perineal resection is being
discharged. Which discharge information should the nurse teach?

a. The stoma should be a white, blue, or purple color.


b. Limit ambulation to prevent the pouch from coming off.
c. Take pain medication when the pain level is at an 8.
d. Empty the pouch when it is one-third to one-half full.

99. The nurse caring for a client one (1) day postoperative sigmoid
resection notes a moderate amount of dark reddish brown drainage on the
midline abdominal incision. Which intervention should the nurse implement
first?

a. Mark the drainage on the dressing with the time and date.
b. Change the dressing immediately using sterile technique.
c. Notify the health-care provider immediately.
d. Reinforce the dressing with a sterile gauze pad.

100. The client complains to the nurse of unhappiness with the health-
care provider. Which intervention should the nurse implement next?

a. Call the HCP and suggest he or she talk with the client.
b. Determine what about the HCP is bothering the client.
c. Notify the nursing supervisor to arrange a new HCP to take over.
d. Explain to the client that until discharge, the client will have to keep
the HCP.

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