Tiêu đề WORKBOOK - GIT (KEY) ✅

COMPREHENSIVE PHASE WORKBOOK GIT NOVEMBER 2024 Philippine Nurse Licensure Examination Review 1. DC was diagnosed with ulcerative colitis and has been placed on steroids. He verbalized his concerns regarding the dangers of steroid use. Which of the following statements by the nurse provides the client with accurate information? A. “Ulcerative colitis can be cured by the use of steroids” B. “Steroids are used in severe flare – ups because they can decrease the incidence of bleeding” C. “Long-term use of steroids will prolong periods of remission” D. “The side-effects of steroids cut weigh their benefit to clients with ulcerative colitis 2. Neri S came to the ER due to persistent diarrhoea. She lost 15 pounds and looks emaciated. The nurse should anticipate that the physician would order which of the following treatment approaches to help the client meet his nutritional needs? A. Initiate continuous enteral feeding B. Encourage a high-calorie, high- protein diet C. Implement TPN D. Provide six small meals a day 3. Fely was prescribed with sulfasalazine (Azulfidine) to continue taking at home. What instructions should the nurse give the client about taking this medication? A. Avoid taking it with food B. Take the total doses at bedtime C. Take it with a full glass of water D. Stop taking it if urine turns orange-yellow 4. During the discharge planning, Fely was advised in terms of diet. Which of the following diets would be most appropriate for her ulcerative colitis? A. High calorie, low protein B. High protein, low residue C. Low fat, high fiber D. Low sodium, high carbohydrate 5. Clara F has a history of Crohn’s disease is admitted to the hospital with fever, diarrhea, cramping abdominal pain, and weight loss. Which of the following laboratory findings would be anticipated for the client? a. Hyperalbuminemia b. Thrombocytopenia c. Hypokalemia d. Hypercalcemia 6. Janina SM is a patient with Crohn’s disease and reports rectal bleeding along with 12 to 20 watery stools per day. Which of the following signs would be indicative of dehydration? A. Sunken eyeballs B. Decreased pulse rate C. Moist skin D. Pitting edema 7. You advise Janina which of the following interventions to prevent exacerbation of his Crohn’s disease? A. Encourage regular ambulation B. Promoting bowel rest C. Maintaining current weight D. Decreasing episodes of rectal bleeding 8. Kelly S was admitted to the hospital due to nausea, vomiting, and abdominal pain. The physician is suspecting bowel obstruction. During your assessment, high-pitched tinkling bowel sounds on auscultation and flat sounds on percussion were heard. The flat sounds are caused by A. Hyperactive peristalsis B. Excessive gas trapped in the intestine C. The presence of a mass or tumor in the bowel D. Fluid trapped in the intestines 9. Cara D’s condition warrants intestinal decompression with a Cantor tube. The primary purpose of a nasoenteric tube such as a Cantor tube is to accomplish which of the following? A. Remove fluid and gas from the intestine B. Prevent fluid accumulation in the stomach C. Break up the obstruction D. Provide an alternative route for drug administration 10. After insertion of a nasoenteric tube, the nurse should place the client in which position? A. Supine B. Right side- lying C. Semi- fowler’s D. Upright in a bedside chair 11. Philip came to the ER due to sudden abdominal pain and vomiting. He was diagnosed with intestinal obstruction. Which of the following nursing diagnoses would be most appropriate? A. Impaired swallowing related to NPO status B. Urinary retention related to deficient fluid volume C. Deficient fluid volume related to nausea and vomiting D. Chronic pain related to abdominal distention 12. Despite insertion of the nasoenteric tube The client with an intestinal obstruction continues to have acute pain even though the nasoenteric tube is patent and draining. Which action by the nurse would be most appropriate? A. Reassure the client that the nasoenteric tube is functioning B. Assess the client for a rigid abdomen C. Administer narcotic as ordered D. Reposition the client on the left side 13. Reese is scheduled for an ileostomy. She verbalized her fears and anxieties about the procedure. Which of the following interventions would be most helpful in preparing the client psychologically for the surgery? A. Include family members in preoperative teaching sessions B. Encourage the client to ask questions about managing an ileostomy C. Provides a brief, thorough explanation of all preoperative and postoperative procedures D. Invite a member of the Ostomy association to visit the client 14. Reese asked why an oral antibiotic neomycin needs to be administered before surgery even if she does not have any infection. You reply that: A. Prevent postoperative bladder infection B. Reduce the number of intestinal bacteria TOP RANK REVIEW ACADEMY, INC. Page 1 | 3
C. Decrease the potential for postoperative hypostatic pneumonia D. Increase the body’s immunologic response to the stressors of surgery 15. Of the following outcomes for the care of Reese after an ileostomy, which has the highest priority? A. Providing relief from constipation B. Assisting the client with self- care activities C. Maintaining fluid and electrolyte balance D. Minimizing odor formation 16. The nurse explains to Reese that a skin barrier must be used around the stoma at all times. The primary function of a skin barrier is to A. Help prevent the formation of odor B. Help maintain an accurate output record C. Protect against irritation from ileostomy effluent D. Allow the client to keep the Ostomy pouch on longer 17. Which of the following signs should Reese report immediately? A. Passage of liquid stool from the stoma B. Occasional presence of undigested food in the effluent C. Absence of drainage from the ileostomy for 6 or more hours D. Temperature of 37.7 C 18. Reese is about to get discharged today. Nurse Hanna evaluates the client’s understanding of ileostomy care. Which of the following statements indicates that discharge teaching has been effective? A. “I should be able to resume weight lifting in 2 weeks” B. “I can return to work in 2 weeks” C. “I need to drink at least 3L of fluids a day” D. “I will need to avoid getting my stoma wet while bathing” 19. Selena consults via teleconsult the sudden onset of abdominal cramps, vomiting, and watery discharge from her ileostomy. How should the nurse respond to this client? A. Tell the client to come into the clinic for an examination if the symptoms persist for longer than 24 hours B. Encourage the client to increase fluid intake to 3L/day to replace fluid lost through vomiting C. Instruct the client to take 30ml of milk of magnesia to stimulate a bowel movement D. Tell the client that he needs to be examined immediately by the physician 20. Enecita was put on bowel rest due to exacerbation of Crohn’s disease. Total parenteral nutrition was prescribeD. While administering the solution, it is important for the nurse to remember that total parental solutions are used to A. Increase cell nutrition B. Treat metabolic acidosis C. Provide hydration D. Reverse a positive nitrogen balance 21. You would regularly assess which parameter to gauge the client’s ability to metabolize the TPN solution? A. Tachycardia B. Hypertension C. Elevated BUN concentration D. Hyperglycemia 22. Which of the following is the most appropriate nursing diagnosis for Enecita who is currently receiving TPN? A. Impaired swallowing B. Impaired gas exchange C. Risk for fluid volume excess D. Ineffective tissue perfusion 23. You assessed Enecita’s line during one of your rounds when you noticed that the tubing got disconnected. Which complication can this cause? A. Phlebitis B. Pneumothorax C. Hemorrhage D. Air embolus 24. You monitored Enecita 4 hours later and discovers that a client’s TPN solution was running at an incorrect rate and is now 4 hours behind schedule. Which action is most appropriate for the nurse to take to correct the problem? A. Readjust the solution to infuse the desired amount B. Continue the infusion at the current rate, but run the next bottle at an increased rate C. Double the infusion rate for 2 hours D. Notify the physician 25. You are currently hanging a new TPN infusion. Enecita asks why a fat emulsion solution is needed. You reply that it: A. Provides essential fatty acids B. Provide extra carbohydrates C. Promotes effective metabolism of glucose D. Maintains a normal body weight 26. You plan to monitor Enecita after the first few days of TPN. Which of the following signs should you consider to be indicative of a complication A. Glycosuria B. A 1- to 2- lbs weight gain C. Decreased appetite D. Elevated temperature 27. You keenly monitor the flow rate of Enecita’s TPN. You prevent a too rapid rate to prevent which of the following complications? A. Negative nitrogen balance B. Circulatory overload C. Hypoglycemia D. Hypokalemia 28. Edelweiss was diagnosed with diverticulitis recently. You review her chart for admission. Which of the following laboratory findings would the nurse expect to find in a client with diverticulitis? A. Elevated RBC count B. Decreased platelet count C. Elevated WBC count D. Elevated serum BUN concentration 29. You review the orders for Edelweiss and you saw a barium enema was ordereD. You are aware that barium enema should not be ordered for this patient because: A. Can perforate an intestinal abscess B. Would greatly increase the client’s pain C. Is of minimal diagnostic value in diverticulitis D. Is too lengthy a procedure for the client to tolerate 30. During your health teaching, you advise the Edelweiss to integrate which intervention into her daily routine at home? A. Using enemas to relieve constipation B. Decreasing fluid intake to increase the formed consistency of the stool C. Eating a high-fiber diet when symptomatic with diverticulitis D. Refraining from straining and lifting activities 31. Which of the following medications would you anticipate to administer to a Jamie, a patient with diverticulosis? A. Psyllium hydrophilic mucilloid (Metamucil) B. Diphenoxylate with atropine sulfate (Lomotil) C. Diazepam (valium) D. Aluminum Hydroxide (Amphojel) 32. Edelweiss came back to the ER due to sudden abdominal pain. Which of the following signs would suggest perforation of an inflamed diverticula? A. Hyperactive bowel sounds B. Rigid abdominal wall C. Explosive diarrhea D. Excessive flatulence TOP RANK REVIEW ACADEMY, INC. Page 2 | 3
33. Kyle, a 7 year old child, was rushed to the ER due to abdominal pain. His working diagnosis is appendicitis. You should anticipate which of the following treatments? A. Administration of enemas to clean bowel B. Insertion of a nasogastric tube C. Placement of client on NPO status D. Administration of heat to the abdomen 34. Kyle develops a fever, tachycardia and hypotension. Based on these assessment findings, the nurse suspects which of the following complication? A. Deficient fluid volume B. Intestinal obstruction C. Bowel ischemia D. Peritonitis 35. Kyle had an appendectomy 4 hours ago. You are currently monitoring the patient and would include which of the following interventions? A. Administering sitz baths four times a day B. Noting the first bowel movement after surgery C. Limiting the client’s activity to bathroom privileges D. Measuring abdominal girth every 2 hours 36. Kyla had a drain inserted in the incisional site of his appendectomy. The nurse understands that the purpose of the drain is to accomplish which of the following? A. Provide access for wound irrigation B. Promote drainage of wound exudates C. Minimize development of scar tissue D. Decrease postoperative discomfort 37. Mayang, a patient with suspected Crohn’s disease, is to have an upper gastrointestinal series. The nurse understands that an upper GI series with barium would be contraindicated if the client had: A. Hemorrhoids B. A perforation C. Hyperkalemia D. An inflamed colon 38. Raymund has been newly diagnosed with diverticulosis. Which of the following should be included in your health teaching? A. Refrain from eating 3 large meals a day B. Drink a maximum of a liter and a half of fluid each day C. Maintain a recumbent position for 30 minutes after eating D. Increased your intake of foods high in dietary fiber 39. Manoling is a chronic alcoholic. He came in for severe epigastric pain. Eventually, he was diagnosed with pancreatitis. You explain that pancreatitis is: A. It is due to the auto digestion of the pancreas B. It is due to the defect in the islets of Langerhans in the pancreas C. It is caused by a rupture of the ampulla of vater from the pancreas D. It is caused by a decrease in enzymes produced by the pancreas 40. Reynald, a chronic alcoholic, underwent liver biopsy for a cirrhosis workup. However, the nurse observes that the wound dressing is soaked with moderate, large amount of bile colored drainage. The client also complaints of right upper quadrant pain. The nurse should. A. Medicate the client as ordered B. Ensure that the client remains in the supine position C. Monitor the client’s vital sign every 15 minutes D. Notify the physician of the client’s status immediately 41. Marky was rushed to the ER after a right lower quadrant pain. However, 2 hours after admission, the pain disappeared and the patient has a rigid abdomen. An emergency surgery for a ruptured appendix has to be done. After assessing that the client is manifesting the symptoms of shock, the nurse should: A. Prepare for blood transfusion B. Notify the physician immediately C. Elevate the head of the bed 30 degrees D. Increase the liter flow of the O2 being administered 42. Tony was admitted for a surgical procedure for cancer of the pancreas that included the removal of the stomach, the head of the pancreas, the distal end of the duodenum, and the spleen, the post op manifestation by the client that would require immediate attention by the nurse would be: A. Jaundice B. Indigestion C. Weight loss D. Hyperglycemia 43. Paulita was prescribed with total parenteral nutrition and asks the nurse about the complications associated with it. Which of the following is a complication? A. Infection B. Hepatitis C. Anorexia D. Dysrhythmias 44. Quentin is having surgery for cholecystectomy and common bile duct exploration. Quentin asks how it will affect his digestion. You answer that: A. Need to take oral bile salts B. Be unable to concentrate bile C. Be incapable of producing bile D. Not be able to digest fatty food 45. Ressa undergoes an abdominal cholecystectomy with common duct exploration. 1 hour post-operatively, which of the following interventions would you do first? A. Irrigating the T tube frequently B. Changing the dressing BID C. Encouraging deep breathing and coughing D. Promoting an adequate fluid intake by mouth 46. Ressa soon develops prolonged bile drainage due to obstruction from T tube. You expect that she may develop symptoms related to a lack of fat soluble vitamin such as: A. Easy bruising B. Muscle twitching C. Excessive jaundice D. Tingling of the fingers 47. Carlito’s working diagnosis is acute pancreatitis. Which of the following laboratory findings would you look for to help support this diagnosis? A. Blood glucose levels B. Serum amylase level C. Serum bilirubin level D. White blood cell count 48. Carlito’s acute pancreatitis goes into remission. During the discharge planning, you have to instruct him to: A. Avoid eating hot spicy food B. Avoid ingesting alcoholic beverages C. Eat a bland diet with 6 meals a day D.Eat a high carbohydrate, low fat, low protein diet 49. Mariana’s serum ammonia level is elevateD. The priority nursing intervention should be to: A. Weigh the client daily B. Restrict the client’s intake of fluid C. Measure the client’s urine specific gravity D. Observe the client for increasing confusion 50. A client with cirrhosis may have alterations in which of the following laboratory values? A. Carbon dioxide level B. pH C. Prothrombin time (PT) D. White blood cell count (WBC) TOP RANK REVIEW ACADEMY, INC. Page 3 | 3